Ronni Graham Booth, UNC Healthcare
Practice Quality & Innovation partners with faculty, leaders, and staff throughout UNC Health Care’s ambulatory settings. We work directly with local quality champions to design visual management boards that will assist in improvement efforts by using the team’s collective knowledge. Using visual management boards as an anchor for daily huddles reinforces, coaches, and teaches the PDSA thought process and establishes the daily discipline of identifying and prioritizing defects, assigning resources, and reviewing work in process through completion. The board presents many opportunities for engaging staff in problem solving and in helping team make connections between their work and system initiatives. Specific benefits cited by a few of our clinic partners: • “…improved quality outcomes; visually reminded us of how we are doing with our quality metrics (i.e. areas to improve and/or celebrating our successes); and created a centrally located place to share important information (vs. getting lost in many emails).” • “…displaying provider level quality data and encounter closure improves transparency and sparks provider competition. Clinical teams use management-for-daily-improvement boards which help indicate how many patients we anticipate on that day, on that team, with open quality gaps. We have other boards that display staff kudos, assigned lunchtimes, provider-staff dyads, and pass/fail audit measures for internal processes.” • “…reduction in noise and improved ability to approach competing demands; enhanced discussions addressing barriers, gaps, problems, stresses and struggles; improved collegiality; increased sense of team membership and belonging; and increased focus on the problems, processes and root causes while shifting away from culture of silos.”