CLAR 3 GOALS & OBJECTIVES

Transcription

1 CLAR 3 GOALS & OBJECTIVES Identify points of leverage for change and improvement (SBP, PBLI) (1, 5, 6, 8) Ascertain stakeholders and understand priorities (SBP, ICS, P) (1, 4, 5, 6, 8) Use value compass thinking to develop balanced measures (PBLI, MK, PC) (1, 2, 7, 9) Describe/model interactions of clinical microsystem with other microsystems, organizational context, and community (SBP, ICS, PC) (1, 4, 6, 8) Develop balanced measures and analytic methods for outcome assessment (MK, PC, PBLI) (1, 2, 7, 9) Develop methods for collection/validation of additional data (PBLI) (2, 3, 7, 9) Enumerate community resources available to/used by the microsystem (SBP, PC) Identify potential linkages of microsystem to community, other systems (SBP, P, PC, ICS) (1, 4, 6, 9, 10) Design and test interventions for improvement of care (PBLI, SBP) (1,2, 8) Develop change ideas and implement tests of change (PBLI, SBP) (1, 4, 5, 6, 8) Present and share results with microsystem (SBP, PBLI, ICS) (1, 2, 6, 9) Identify handoffs between Microsystems (SBP, PC) (1, 6, 8) Work with multidisciplinary teams (SBP, P, ICS) (4, 5, 8) PH/PM Competencies 1. Communication, program, and needs assessment 2. Computer applications relevant to preventive medicine 3. Interpretation of relevant laws and regulations 4. Identification of ethical, social, and cultural issues relating to public health and preventive medicine contexts 5. Identification of organizational and decision-making processes 6. Identification and coordination of resources to improve the community s health 7. Epidemiology and biostatistics 8. Management and administration 9. Clinical preventive medicine 10. Occupational and environmental health 1

2 CLAR 3 PROPOSAL What is the patient population that will be the focus of your work? Based on the ABNA (Achievable Benefit Not Achieved) you identified, current processes, your review of the literature, and your understanding of possible changes, what change(s) do you propose? Why is this an important problem to work on now? Who will need to be involved? What will their roles be? Who will be supervising you? Who are the stakeholders? What measures do you currently have? How will you collect/validate additional data? How and when will you pilot the data collection? What other microsystems will be involved? Timeline: Deliverables:

3 CLAR 3 WORK PRODUCT TEMPLATE Patient population: Microsystem(s) involved: Colleagues: Please answer the questions below. You may use this template and may upload additional materials into work products as needed, referring to them in this document. A brief (two paragraph) summary of your work as a whole is appreciated, followed by more expansive answers to the questions below. Executive Summary: Describe the ABNA (Achievable Benefit Not Achieved) in the system of interest. What does this mean for an illustrative patient? Describe why this is an important problem to work on now. Estimate the potential benefit to patients. (and ways patients might be able to notice the benefit) Describe the current process. Present a model of the microsystem and its interactions with other microsystems, the organization, and the community. You may use materials from ECS 124. Describe the changes that you think might be made. Discuss why it makes sense to make these change(s) now, and how you would prioritize them. Present your timeline. Identify the performance measures you feel will be important. Please provide operational definitions, including how the data will be collected, validated and piloted. Use the value compass to show balance among the measures. How will these metrics help you to know that progress is being made? Describe the stakeholders and their priorities. List key personnel who will be involved and what their roles will be. Describe how you have developed this team.

4 What are the points of leverage for improvement? Describe factors that might impede your progress. Describe how you designed and implemented a test of change. (Early PDSA) How have you shared this information with the microsystem(s)? Please upload any presentation materials as separate work products. Reflect on the effect of your PRB experience on your planning. What else has been helpful to you in designing your practicum?

5 CLAR 3 REFLECTION Please comment on how what you thought you would do (i.e., your CLAR proposal) and what you did (i.e., your CLAR products) compare. How did your experiences in your Winter and Spring term classes help (or hinder) your work in this CLAR? How has the experience of presenting to the PRB affected your practicum plans?

6 CLAR 3 GLOBAL Item 1 Did the resident identify options to improve the identified local process of care? 1. Did not identify or describe process of care 2. Described process but identified inappropriate and/or unrealistic change options 3. Clearly described process and delineated an appropriate change option 4. Clearly described process and delineates several realistic and appropriate change options 5. Demonstrated deep understanding of care process and identifies multiple options for change Item 2 Using the Achievable Benefit Not Achieved, description of current processes, and relevant literature, did the resident identify a change worth making at this time? 1. No possible changes proposed 2. Change proposed, but not related to ABNA, current processes, or literature 3. Change identified and rationale relating to ABNA, processes and literature described 4. Worthwhile and workable change proposed with clear rationale 5. Innovative, high-yield change proposed with rationale as above and evidence of benchmarking Item 3 Did the resident identify how patients would benefit? 1. Impact of change on patients not described 2. Cursory description of benefit to patients 3. Describes patient benefit including estimate of magnitude 4. Provides both qualitative and quantitative description of patient benefit 5. Provides thoughtful description of patient benefit using balanced measures CLAR 3 global 1

7 Item 4 Did the resident appreciate and describe the interactions between microsystems and between microsystem, organizational context, and community/public health? 1. No interactions outside of microsystem of interest described 2. Describes interaction between Microsystems only 3. Able to describe interactions between Microsystems and with organizational context 4. Able to describe interactions between Microsystems and beyond, including with community 5. describes and appreciates potential benefits and constraints of interactions at all levels Item 5 Did the resident identify performance measures for both outcome and process? 1. Did not identify any performance measures 2. Identifies minimal set of measures 3. Identifies readily available process and outcome measures 4. deeper exploration of available data 5. comprehensive search for measures and innovative use of existing data Item 6 Did the resident use value compass thinking to develop balanced measures? 1. No measures proposed 2. Minimal set of unbalanced measures 3. Balanced set of measures proposed 4. Balanced measures described with rationale for choice 5. Operationally defined, appropriately balanced measures described Item 7 Did the resident demonstrate ability to operationally define balanced measures and means for data collection/validation? 1. No operational definitions offered 2. Inadequate operational definition proposed CLAR 3 global 2

8 3. Acceptable operational definition including data sources and collection methods 4. Operational definition includes data sources, collection methods and plan for validation 5. Clear operational definition which describes both data collection, plan for validation and has conducted a pilot test of the data collection, display. Item 8 Did the resident describe why this is an important problem to work on right now? 1. Cannot articulate why this is an important issue. 2. Can describe problem s importance but not timeliness. 3. Describes importance of issue and addresses timeliness. 4. Describes importance and timeliness including local context consideration. 5. Describes importance and timeliness including local, organizational, and community/national opportunities. Item 9 Did the resident describe which change makes the most sense to start with? 1. Proposed changes not prioritized 2. Changes prioritized by no or clearly inappropriate rationale offered 3. Rationale behind prioritization of changes described 4. Rationale behind prioritization of changes references local context 5. Rationale behind prioritization incorporates understanding of local and non-local context and appreciation of subtleties in environment Item 10 Will the measures proposed by the resident help him/her to know that progress is being made and that the intended changes are occurring? 1. No measures proposed, or proposed measures do not relate to intended change 2. Proposed measures may be helpful to delineate final outcome, but do not help to gauge progress 3. Proposed measures useful to gauge progress and see effects of change 4. Proposed measures are useful and can be readily collected and analyzed CLAR 3 global 3

9 5. Proposed measures are realistic, timely, and will aid in modifying change process as needed Item 11 Did the resident describe limitations in the proposed path forward? 1. No evidence resident considered any possible limitations 2. Resident demonstrated superficial understanding of possible limitations 3. Resident described possible limitations to progress 4. Resident demonstrates understanding of multiple perspectives and how these may affect limitations 5. Resident demonstrates deep understanding of system(s) and limitations and has begin to consider countermeasures Item 12 Did the resident describe how microsystem has changed successfully in similar ways before? 1. No evidence resident investigated other similar change attempts 2. Superficial description of change attempts by others 3. Resident described previous experiences with change in this setting 4. Resident described how others have made changes and related to local context 5. Resident described both local and national change efforts and how these lessons learned will inform his/her leadership of change. Item 13 Did the resident identify who will need to be involved and what they think of their roles? 1. Resident does not identify specific individuals who will be involved 2. Incomplete identification of involved personnel 3. Resident has identified and met with specific individuals involved 4. Resident has appropriately identified specific individuals and negotiated their roles 5. Resident has identified important individuals at multiple levels, sought their input and understanding of their roles, and worked to build an effective, comprehensive team Item 14 Did the resident identify points of leverage for change and improvement? CLAR 3 global 4

10 1. Resident is unable to identify leverage points 2. Resident identified minimal set of leverage points 3. Resident identified multiple, appropriate leverage points 4. Resident identified leverage points and described their importance and relative priority 5. Resident has identified key leverage points and can describe both why they are important and how change can best be facilitated at that point Item 15 Does the resident know the stakeholders and understand their priorities? 1. Resident has not identified stakeholders 2. Resident incompletely identified stakeholders 3. Resident described stakeholders and met with them 4. Resident has met with stakeholders and displays understanding of priorities 5. Resident has met with stakeholders, understand their priorities, and has incorporated this into his/her planning Item 16 Did the resident design and test interventions for the improvement of care? 1. No interventions designed or tested 2. Intervention designed but not piloted 3. Designed and tested an intervention 4. Designed and tested an intervention and used results to inform future plans 5. Resident completed multiple small test of change which built on each other Item 17 Did the resident present and share results with the microsystem? 1. Resident has not presented to microsystem 2. Resident has presented to microsystem, but presentation incomplete or not timely 3. Resident presented and shared results of intervention with microsystem in a timely manner 4. Resident presented results in a timely fashion and elicited feedback and suggestions 5. Resident presented results and worked with team to incorporate their feedback to move forward CLAR 3 global 5

11 Item 18 Did the resident satisfactorily reflect on the relationship between the CLAR proposal and actual work completed? 1. No evidence of reflection 2. Superficial reflection 3. Reflected on proposal and CLAR work 4. Reflection links proposal to completed work and demonstrates learning as a results 5. Reflection displays new insights into personal and professional development Please comment on any score lower than 3 or higher than 4. CLAR 3 global 6