A Management System to Sustain Safety Improvements
Several recent tests to sustain safety improvements in ambulatory surgical centers emerged from the development of our IHI white paper, Sustaining Improvement (http://www.iecodesign.com/index.php/272-sustaining-improvement).
The improvements were promoted through an AHRQ sponsored program for ambulatory surgical centers as described here.
I've already sketched the initial tests and lessons in the use of daily huddles (here and here).
The daily huddles are just one part of a system of management actions aimed at sustaining and improving safety work by ASC staff.
The map shows the management actions organized into a couple of chunks, control and improvement.
(Thanks to my colleague Richard Scoville, Ph.D., for important clarifying edits to the original picture.)
As many managers and consultants have figured out over the past 75 years, continuous improvement with no backsliding seems to require a system for control that is integrated with a system for improvement, which includes ways to surface and solve problems small and large.
In fact, there's another critical system, quality planning, that complements systems for quality control and quality improvement; an early description of the three systems comes from Joseph Juran and is known as the Juran Trilogy, www.juran.com/elifeline/elifefiles/2009/09/Juran-Trilogy-Model.doc.)