The Focusing Matrix for Quality Improvement

This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.

1. Prioritizing Solutions: Focusing Matrix

2. By the end of this session, participants will be able to: Prioritize problems and opportunities for improvement utilizing the Focusing Matrix tool Learning Objective

3. AIM What are we trying to accomplish? MEASUREMENT How will we know if a change is an improvement? CHANGE What changes can we make to result in improvement? - Langley G, Nolan T, Norman C, Provost L (1996) The Improvement Guide Focusing matrices are a QI tool that can help answer this question The Model for Improvement

4. How Do You Make Tea?

5. The initiative “I made a cup of tea” Only describes what was done, now how it was done PDSA cycles help teams clearly articulate the HOW of change ideas This helps teams learn how to work smarter, not harder Use the 5 How’s when designing your change ideas The Importance of How

6. “Not all changes lead to improvement, but all improvement requires change” - Langley et al. (2009) The Improvement Guide: A Practical Approach to Enhancing Organizational Performance Where do You Start?

7. How do you currently prioritize within your current practice? Personal, clinical or professional examples For Discussion…

8. Why Prioritize Change Ideas? Helps a team make decisions by narrowing down options Sometimes having too many choices leave a team “paralyzed” QI teams may disagree about where to start first Many change ideas may seem like a great way forward, but prioritizing can help determine which ones may have the most impact Increases follow-through of implementing change ideas by gaining consensus before implementation

9. Also called Prioritization Matrix Simple tool to sort ideas by: » Importance: How much impact they may have » Ease of Implementation: How easy they are to accomplish Provides team with a structured decision-making process Can be helpful for explaining change ideas to stakeholders and/or getting buy-in QI Tool: Focusing Matrix

10. Importance Ease of Implementation 1 (Least important) 2 3 4 5 (Most important) 1 (Hardest) 2 3 4 5 (Easiest) #1 Priority Most important & easiest to implement #2 Priority QI Tool: Focusing Matrix

11. Example of Prioritizing Change Interventions: WTH Drivers Diagram

12. Prioritization Matrix: IMPORTANCE 1 (LEAST) 2 3 4 5 (MOST) EASE OF IMPLEMENTATION 1 (HARDEST) Insecurity in the community Weather 2 3 Request for motor bike and bicycle to tracking team Request for recruitment of Covs to ease tracing Initiate outreach activities with focus on VL sample collection Address barriers to adherence Train counselors on VL sample collection Generate and implementation supportive supervision plan Continues clients tracking and proper documentation of details Health education and mentorship of existing counselors Earlier generated of the clients lists Intensify pre and post test counselling for all client Create community awareness through radio talk shows Request for facility phone and airtime 4 IP and FO to improve on job mentorship of PMTCT staff and data clerks on EID_HEI registers. Develop, provide and ensure use of SOPs on EID_HEI management Task shifting among the technical staff at the facility IP and FO to provide continuous on job mentorship on registers completion and importance of EID_HEI confirmatory PCR test and linkage to ART Staffs to be encouraged to work systematically to avoid postponement of tasks and missed documentation of clients information PMTCT providers to seek and obtain functional client’s telephone contacts with optional contacts provided by the client to avoid lost address ANC-PMTCT providers to discuss with the mother the delivery plan and importance of bringing the child to the PMTCT clinic after delivery. IP to ensure proper hand over and orientation of the rotated staff to ensure systematic continuity of work Adhere to TLD algorithm Review & print SOPs Establish VL sample collection point in PHCC Triage clients for VL Daily and weekly data checks MMD Create new TX centers Strengthen community refills Initiate inter facility tracking of HVL clients Provide data collection tools 5 (EASIEST)

13. Any Questions Skip to answers