PI Projects – How to survive the “process”

PI Projects – How to survive the “process”

By: Koren Way

Say the word “PI project” and you are almost guaranteed to hear the audible groan come from your team.  As team leader, you see people slide down in their chairs hoping not to be chosen to be on the workgroup.   Don’t take it personally.  Everyone associates a PI with lots of meetings – complete with fishbones, chart audits, and discussion of recent literature searches.  All this adds up to lots of time with little to show for the effort except for the frustration of the group.  So how do we make this process less work and more improvement? And do so while still meeting regulatory requirements?

Begin by recognizing all the great improvement work that is happening in your center every day.   I am sure that there are improvement projects happening all around you, and with just a little work they can be complete PI projects.  For example, the secretaries began staggering their lunch hours to accommodate the influx of calls they receive from 12-1 when patients are taking their lunch breaks and are able to call.  Or the pharmacist has begun completing the medication reconciliation at discharge because it is too difficult to keep the revolving door of interns trained on the immunosuppression protocols.  In each case, patient satisfaction and patient safety have been improved.  And there were no meetings held, no data collected.  Instead people recognized a problem and they fixed it.  That is the definition of improvement work.  So, with a little structured documentation, these become PI projects.  If you can monitor one or two metrics over the next 3-4 months to ensure that an improvement has taken place, you can demonstrate a positive impact for patients and team members. At one informal meeting, you can review and document the issue, assess improvement made, and make any additional changes needed to further refine the process.  And there – you have a PI project!

A few other tips, or words to remember;

Keep it simple.  When choosing a project, remember to KISS – keep it simple.  It is about demonstrating continuous improvements.  These generally happen in small steps.  And yes, while the big projects like accepting Hep C positive donors for Hep C negative recipients are exciting, they don’t all have to be that big.  Often, it is the small, simple changes we make that have the big impact on outcomes.

AIM.  When designing the project, define your AIM All projects, no matter how large or small, need to have a clear purpose or a defined goal.  This should be just one or two sentences that provide a focus for the project.   As you refine your goal down to just two sentences, you may find you actually have several projects all wrapped into one!

SMART.  When deciding what to measure, remember to be SMART – specific, measurable, attainable, relevant and time-bound.  Yes, you do need to decide on a few metrics to watch for a defined period of time following your implementation.  This helps to ensure that the right changes were made, and that additional improvements are not needed to attain the goal.

Document.  That is, write it down.  Be sure to document how/why the project was chosen, who was involved in the project, what methodology you used, and when the staff were educated about any changes that were made.  For methodology, it is OK to use “rapid cycle” or “just do it,” as long as you can explain how that methodology works in general.

The End.  Know when to say The End.   Unfortunately, all good things must come to an end, and PI projects are no different.  You are no longer making continual improvement if all of the metrics you have been tracking have been at 100% for over a year.  We like to hold on to our successes, and we definitely do this with PI projects.  But when the improvement has occurred and is sustained, it is time to close that project, and move on to the next one.  I promise you will be successful again!

Variety.  They say it is the spice of life, and it is definitely important in PI projects.  Be sure that you have something happening in all phases of transplant and donation, and that you have a mix of clinical and process improvements.

Most importantly, make the goals real and celebrate the successes.  It is OK to congratulate ourselves when we do something well.  And reaching a goal is no easy task. None of us have really left elementary school, so we all like to see the thermometer on the wall grow, or the star chart get filled it.  And who doesn’t like cupcakes when you win?!  By keeping the team focused on the goals and allowing them to celebrate the successes, you keep everyone interested in and energized for the work of a PI project.  And you can turn those audible groans and hiding team members, into cheers and enthusiastic volunteers!


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