Quality Improvement in Healthcare

[@MelissaLeVesque-w6e]

I was mesmerized by the drawings...I think the content really stuck more because I was so fascinated!

[@zacharymendoza7177]

Everyday we try to improve something about ourselves or the way we go about things. Some improvements are so minuscule that we do not even notice them. However, something we can all appreciate is the quality improvement of healthcare. Some errors are over looked and do not even come into discussion where we can improve. Take the washing hand statistic. 44,000-98,000 people in the U.S. die from preventable errors every year. We do not need to flip the entire system, but the objective is to become more efficient in what we do in the healthcare field. With improvement comes change and not everyone is okay with change. As Dr. Evans stated "people can become overwhelmed with change." As humans we like to be set in routines that go smoothly. Any bump in the road can steer us in the wrong direction and become lost. Small changes can be good and overtime can accumulate into something greater. Take the study of fractured hip patients in St. Micheal's Hospital. The tweak in the system of getting to the patients in the ER bumped the percentage of patients receiving surgery in a 48 hour period from 66% to 90%. Even though not every change will make that big of an impact it is still a goal to improve.

[@geenieyourshaw6907]

Watched this for a class and woah did I learn a lot. This is the most helpful and clear video on QI I've seen to date. Thank you so much. The lessons and wisdom you share can be applied to so much more than healthcare. I even took parenting and general life lessons from here. Than you, really.

[@bobemerson3279]

Bob Emerson I am currently working on my degree in Healthcare management. There are many articles and publications available for research. This information is direct and to the point. As a healthcare provider and manager we put too much emphasis on the big picture. I enjoyed this article because the Patient Discovery and Motivational Interviewing is it is what is all about. Thank You

[@grahamblackburn2284]

I love the connection made between motivational interviewing with quality improvement.

[@TessVawser]

Still extremely relevant and a powerful education tool to share to understand QI in Healthcare. Congratulations

[@Zanyotaku]

Wanted an overview that wasn’t the rambling 58 minute uploaded lecture that got straight to the point without a ton of tangents, thanks for making this.

[@juvelito21]

Being a system thinker is definitely useful in QI initiatives. Constant curiosity and asking how we can improve makes us better leaders. Quality Improvement is a continuous process. Always finding ways how we can do things better.

[@tinarice9303]

A very insightful video and applicable to more than just the healthcare system. The methods discussed can be used in people's day to day lives to achieve personal goals, as well as to improve business productivity, and processes involved in specific industries. It seems a huge problem we have is to focus on the problems but we forget that we have the power to change them. It may not be possibly to implement a quick fix to rectify an issue, however, with small steps that lead to a planned goal, change can be implemented.

[@tinarice9303]

Oh, and I found the 'video within a video' quite appealing and thought it was beneficial to put a quote from another thinker in there.

[@judyweimer1418]

Fantastic presentation. Will share with my nursing students.

[@RhondaReed-s2x]

Great video! The illustrations were wonderful and kept it interesting - thanks for the encouragement!

[@ajgazaway9660]

Watching for my QI in healthcare class in 2017, still relevant, glad I found it!! Thank you!

[@JonathanHerbert-d9m]

This gave me a better understanding of QI and the processes involved to bring about change. I highly recommend this to everyone, not just those who are working in healthcare, but those in other industries working towards making them better.

[@_sumuomedical1448]

Thanks Dr Evans for making it easy to understand QI and how to apply PDSA in practice

[@user-bf5oj8rl6c]

Watched this video for a class and it is the most helpful video I have seen on QI! Thank you so much Dr. Mike! Your messages are very crucial to the healthcare system.

[@jessicamoanasandbrook2597]

I saw this 4 years ago and it really helped me, and I just watched it today, and its still very good information. Thank-you, and I like the video in the clip it does make it better.

[@kaytlen.bruck1287]

I agree with this video. If doctors and physicians expect their patients to adjust their daily life, patients should be able to expect health care professionals to do the same. There is a difference between recognizing something is wrong in healthcare, compared to knowing how to prevent it. Seemingly small behaviors such as improving hand washing technique can have a positive ripple effect throughout the healthcare system. Healthcare needs to be able to measure if changes actually lead to improvement. In the video they discussed the PDSA cycle and I highly agree with it. However, I feel that most hospitals either disregard or slack when it comes to this cycle. If hospitals are motivated enough to see improved they will do this cycle of planning a change, doing the change, study the change results, then act on those results. Health care professionals need to adapt, adopt, or discard the results of these changes. I believe hospitals and their employees need to view this video and learn more about quality improvement.

[@somiajamma7429]

Well well done! the video provides an insightful overview of how quality improvement imitative in healthcare can transform patient care by focusing on efficiency, safety, and patient satisfaction. This video was particularly insightful, as it aligns with my own experiences and goals as public health professional striving to improve health outcomes in my community.

[@nataliesamarin4032]

My professor recommended this video! I enjoyed Thanks!

[@beanrkar]

"Some is not a number and soon is not a time."

[@00oPinkGirlo00]

Congrats! This video was very instructional and fun at the same time. I find the way you included the video was great: short, right to the point and it felt like it belonged with the drawings.

[@chanm2388]

I liked the video and the illustrations are fantastic. Very informative.

[@gwendolynhoward1653]

Enjoyed your Video!!! I'm a visual learner. The concepts and images you used created a mental picture of what continuous quality improvement means.Good Job!

[@buchayjames5033]

I love this, simple and understandable thank you

[@noname-bf1ob]

A retired nurse here ~Just as an aside: while it's necessary to have "thinkers" (i.e. in boardrooms & on their laptop computers)...can someone not get a warm blanket for those seniors on stretchers awaiting care? or stop to ensure they are sipping a drink (flds)? or just bending over to make eye contact with them & offer a warm smile? "Doing the right thing" isn't just about systemic changes, it's about patient-focused practical care. And that starts with ME and it starts with YOU. But yes, please sanitize or wash your hands before giving any care; & wear a mask as appropriate; & get inoculated to protect others & just live what you preach by example. 👍

[@tammyralls757]

this was great, very thought provoking and interesting!

[@aggeyboii1753]

I think "dropping a vid in a vid" worked very well here!

[@ophan3536]

The videos are perfect to reach a wide audience. Thank you for these.

[@danielclark1314]

Vids in Vids work when kept short and relevant. Sometimes the best way to say something comes from the person who said it. I say keep it. Of note, I've been involved in QI in US Navy hospitals for years. Your talk describes Franklin Covey's 4 Disciplines of Execution approach (similar to your PDSA) and the end of your video describes Appreciative Inquiry (building on the ideas of others). I've seen many ways to slice it, but in the end, you nailed it with staff attitude. 20% of your staff are the go-getters trying to influence 60% of the staff to think like they do. (The last 20% are averse to change and generally can't be helped). Great videos - keep them coming!

[@jepipie]

this is really nice!! glad i found your channel dr.mike. keep ‘em coming!

[@Jasmyne444]

This was a great video! Definitely gets you thinking about how big changes can be made in small practical steps!

[@asmith7094]

A career in this field would be amazing!

[@whengetonrx8]

This was a very helpful video to me by teaching me, by thinking about how every step no matter how small is, is a step towards future end goal.

[@romzaish]

Great video and good examples. I actually discovered I actually discovered IHI during my MBA and used QI techniques partly learned from the organisation.

[@janetaylor4277]

I like the link between MI and QI; I have found it useful in my practice, especially when combined with teach back.

[@ITSCHRIIIIS]

I love these videos so, so much. I agree video in video is fine but so long as short and not detracting from Liisa's amazing work. :-)

[@MhiszPritteeGrl]

amazing video, current mhs student specializing in leadership. very helpful video, alot of insight!

[@bhumikananda4832]

Very interesting approach .

[@rat7ism]

OMG!!!- your introduction to QI ia faaaaantastic. Its just what I was looking for. A breif intervention for QI ludites. EVERYONE should watch it.

[@delightful5165]

Thank you Dr. Mike that was wonderful!

[@w.g.whitney7350]

Dr Mike; An excellent and "good news" presentation. Some of the improvements obtained were really amazing. The dropped-in video was a very good idea. It lets us see the human face of improvement. One comment about quality improvement and control. In industry, the word quality means making sure that the standards and procedures are followed exactly.But when this word gets it out of its cage and into the hands of non technical and or non business types like medical practitioners, its meaning changes. This is no surprise, the general population thinks of quality as well designed, effective, reliable and even beautiful. What you are really talking about with these improvements, as Deming would say, is "continuous improvement" of a delivery system, or "kaizen" in Japanese. As examples, quality control of handwashing is making sure that doctors and nurses do this exactly as instructed. Quality improvement and continuous improvement gets more interesting. Now you ask are they all using enough soap and washing long enough? Do all the dispensers contain the same soap? Are the ingredients really anti-bacterial? Are there better, more expensive ingredients that are much more effective? Some harmful ingredients were removed from the dispensers in hospitals last year. There are no signs or recordings warning people with colds to wear masks as they enter the hospital !! Now when we come to continuous improvement, you touched on this in your video, when you said we must be sure that the handwashing really works. A systems approach would look at all factors that cause illness in the hospital setting. This gets back to what you did in your 23-1/2 hour video. Viruses are very common causes of diseases in emergency rooms. Why don't doctors and nurses wear masks when they themselves are breathing the air around patients and carrying the viruses from room to room? Why are old bandages, pads and syringes often seen on the floor of emergency rooms? Are the rooms really cleaned thoroughly? What are the most effective ways to really scrub C. Diffficile and other nasty viruses from rooms? Hydrogen peroxide? Irradiation of rooms? What about the air filtration systems in hospitals? Yes, it gets very complicated and expensive quickly. But some of the low hanging fruit is not being plucked. Doctors and nurses do not wear masks all the time, probably because they don't wearing them. When they tried to force nurses who didn't get the flu shot to wear masks, this was more about forcing everyone to comply and support the drug industry than help patients.The chemicals used to wash floors and walls do not appear to be especially effective. Like you say, it's actually very fascinating, not boring.

[@longduongdinh5395]

so touching for an excellent video

[@marthaanthony7551]

I enjoyed watching and learning from your video. The drawings along with the words and narration made it very easy to understand and apply the knowledge. Thanks!

[@utegopher]

Great presentation. Very practical & effective.

[@lyndamerzlikoff4672]

What a great video. The ideas to adapt into practice simple and realistic and I feel would be very effective, will be adapting my practice to include these ideas.

[@sassytee0722]

Appreciate the video. A lot covered with use of the drawings. Starting simple is best. Making small incremental steps is what many of us overlook. Thanks for reminding me of what is necessary to be a change agent. keep them coming.

[@maryw.7604]

thanks, this helped with my HIT course

[@GetUpAndGoGaming]

I think it would be good to include videos into your videos. Just make sure there are not too many and they're kept short. I still want to see your drawings!

[@maryw.7604]

I second this

[@andrewrosen113]

Great, succinct, engaging video

[@rebbiburdett3495]

The video drop was good. Not too long but added a change up in delivery.

[@hannahfabb]

Love this!!! Will use all that I learn from this on my nursing licensure exam, and in my day to day activities!

[@RakeshGupta-rs6oq]

Great video as always! Do you happen to have a link to the study you mentioned (at 5:35) regarding a handwashing poster creating a 1/3 improvement in handwashing over a 2 week period?

[@RPMAcademy]

A wonderful video with a great message. Thank you, Dr. Mike! I will be sharing this and your other videos with my healthcare students in the future.

[@emilyestelle7471]

Still absolutely relevent, and a great summary of quality improvement.

[@Lesley.h]

This was good. Wow some pretty crazy statistics in this video. Got me thinking

[@catherinec.mcguinness6919]

Loved this video - really simplifies and takes the mystery out of QI . Thought the video inside the video was great example of mixed media

[@21stCenturyGirly]

Loved the video! As a Public Health student studying for an upcoming exam on quality of care, hearing about quality improvement in an easily understandable way is quite helpful. :)

[@tommybees441]

Nice!! well done -- learn a lot, difference point of view on healthcare improvements

[@fetabrown]

Thanks for this intro to QI in healthcare, a nice overview

[@ScaseFacetime]

Great, very helpful for my healthcare project 👍🏻 thanks

[@kerimolloy9574]

While it may seem that both the pros and cons of screening seem almost hand in hand, the choice to do annual screening tests. Even though sometimes these test can be a little misleading and not as black and white as we hope. But some knowledge is better than no knowledge. Also even though some of the test that are run are not very beneficial for those who are not at risk, it does help those who are. By getting screened for certain diseases the general knowledge of the overall health of people can be better looked upon. With some of the test creating false advertising of a patient's health, I believe that it is worth the time and effort. If I am misdiagnosed with something that I do not have, is definitely better than not taking the chance to even knowing where my health is even at. As far as being misdiagnosed with nothing when actually there is something wrong, that is just the something that comes with life. No one is ever perfect, and most diseases are hard to catch to begin with. It is just the chance that you are willing to take if you are willing to benefit and further your knowledge of your own personal health.

[@peacevkw]

very good presentation. thx

[@marieclairekasyl2399]

Thanks, this is very understandable and relates to my career

[@ruthxuebourassa4507]

1. Aim 2. measure for improvement 3. test one change PDSA 4. adapt/adopt/dischard

[@dgdivoky1]

A very thought provoking and engaging video! Thank you!

[@JehovahTsidkenu]

Thank you for the information. I am looking for information on the Donebedian model and found this. You make the process a little easier to understand. Just need more input at this time. P.S. The vid-in-vid is a nice touch.

[@raipaynter3588]

Great I loved the animation and the video within the video worked, very engaging!

[@michellerad4420]

This video is priceless. Thank you

[@emmatalbert5803]

I know this is a little late...but I liked the video in a video. Helps put pieces together as I've used some IHI stuff before. Thanks!

[@joselynhernandezgalvan8926]

i really liked the video within the video to help clarify!!! plus your voice is so soothing thank you so much for that clarification

[@rshamman1981]

The video definitely helps. Thanks

[@toddviv]

can i get a reference list this is really excellent

[@gregcichlids7660]

Thanks Dr. Evans for making an entertaining and very educational and thought provoking video. This has change my attitude about QI and it was a delight to learn through your fun presentation. Love the drawings :-) God bless you and your team. Que Dieu vous benisse... ;-)

[@Ladyhawk113]

This is also applicable to animal medicine as well. Great information here! Thanks!

[@kenhmusik]

What kinds of Software did you use to make this animation video sir? So fantastic !

[@vikramgupta3827]

This is so helpful, pls make more videos.on the topic

[@MarkGraban]

Is hanging a different handwashing sign really something that gives a sustained effect, or is that a short-term "Hawthorne Effect" at work? Dr. Deming would have taught to look at data over time, not just a two data point comparison of before and after.

[@BobBruer]

+Mark Graban... 'sustained effect' only matters if you are eager to eliminate the cost of Logo Writers and Poster Painters. But re the video, I suspect "regularly changing the hand-washing sign" is the intervention.

[@RyanWeaver-fp5kq]

When we consider alignments of industry and providers and systems… many times over; change in reality requires impetus of sorts.

[@bdulrhman5412]

i have a 10 powerpoint presentation in university, I have to think of a service improvement and talk about it... so worried as i have no idea; especially since i havent had any experience...

[@hermes616]

Add the video to the video was a nice touch, however your time lapse drawing is a very interesting approach

[@BobBruer]

+James Jacquet Always a good time for a little Berwick

[@chrisj3028]

Very informative video, thank you

[@JehovahTsidkenu]

Is there a way to review the study you reference about the hospital in Timmins? I am working toward my MPH and writing a piece on using the Donebedian Model to improve patient outcomes. Thank you for your help.

[@alonrasooly4451]

This is great! thank you!

[@juandavidospina8328]

this has helped me in my meeting as I suggest improvements in workflow!

[@RyanWeaver-fp5kq]

Good video.

[@mariaeskandar5441]

You are very easy to listen to.

[@jupiter909]

Great video and videos overall. Topics that make one think and superbly presented. Embedded videos are fine as long as they contextual snippets kept at a reasonable length.

[@kayleeroebuck3282]

I find it of the upmost importance to ensure that healthcare improves. Many people are killed or injured from simple error of healthcare professionals. I understand some mistakes can simply not be avoided and we are indeed human, but many mistakes are just careless error and I find this unacceptable. I believe healthcare workers should always make quality healthcare their first priority, and do their best to leave their personal lives 'at the door' as they walk into work. I found it astonishing that one study showed that 247 deaths happen each day from hospital infections in the US from inadequate hand washing. This is an area that can easily be fixed by paying close attention to basic standards of healthcare. I agree with the videos three standards of change. Simple practices such as documenting hand washing can make a huge difference in the future. I also agree with how difficult it may be to get people to change. With collaboration and time, I believe it can get done. One study showed the importance of patient centered care, and how it increased quality improvement in healthcare. As a future OT, client centered practice is one area that we always focus on. My professors always stress the importance of making the treatment meaningful to the individual for maximal benefit. I am glad to see that other practices are adopting this mindset as well.

[@fionasimons1337]

Thank you I really enjoyed this. It was fast paced (I had to press pause a few times to make notes !!) but that wasn't a problem and the cartoons provided energy. I thought a video within this video worked well.

[@margaritag9818]

Excellent simple video, thank you!...wish this could be the intro to the QI concept in medical school and residency as this is so much more engaging than that with which we're usually presented!

[@phungphan2245]

How does the pain scale continue to be mandated by the VA and The Joint Commission even though Opioid Crisis started around the same time as the initiation of the pain scale requirement? I think the pendulum swung too hard on this QI. There are so many regulations are not continued to be monitored for desired affecting wasting physician time and risking patient's health as well.

[@jaredyeung1068]

I love this video! It also led me to IHI

[@ECUNurse05]

Loved this! ,

[@liasosa4100]

Thank you, awesome video, on target with message.

[@Bjalawi]

can you give me the link to the article about timmins

[@megrosen7707]

Great video with great concepts and illustrations. Video in video was fine - I enjoyed putting a face with a name. I appreciated that you highlighted the potential for innovation fatigue. As an RN, I am often "overloaded with requests for practice change" as you mentioned. I would venture to guess that innovation fatigue is directly related to nurse fatigue... I guess I have my next quality improvement project. :)

[@stcdancer3]

thank you!

[@kmarshal101]

Great Video. Very Informative.

[@dungnguyenthithuy6012]

very good, thanks a lot

[@xyz9413]

I hate doing group project