- Owns Twiford Consulting.
- 2014's focus is on nationwide benchmarking studies and assisting center managers with their quality studies.
- Former director of clinical support for Physicians Endoscopy.
Unsure about how to plan and execute the kind of quality improvement study that's really worth your time and effort? Bunny Twiford, RN, is uniquely qualified to help you "Shake the QI Quakes" with her presentation at OR Excellence. Ms. Twiford brings a strong clinical and business background to her role as president of Twiford Consulting in Warminster, Pa. In a special breakout session, she'll share her insights on creating both facility-focused quality studies and benchmarking studies that follow accreditation guidelines. You'll see examples of how she works through a study and how you can use them to improve and excel in an increasingly competitive environment. Here are some of the ideas she'll be elaborating on:
- Give studies the time they deserve. It's important to set aside time to work on studies, as opposed to waiting for opportunities to arise. Manage your studies by working backwards from your projected survey date. For example, if you expect to see an accreditation surveyor next November, and you haven't done any continuous quality improvement studies, you should be starting now.
- On getting your study off the ground. It's important that you spend enough time organizing and clarifying your thoughts before you get started. Think about your "customers" patients, physicians, staff, accreditation organizations, CMS. What does quality mean to them? Is there an everyday problem that you might be able to solve and by so doing, reduce stress? Involve the staff to find the problems and to work through solutions. Staff members who are detail-oriented can help extract data from documentation.
- Don't let studies become too broad. Keep them simple and focused. Don't get bogged down with too much data. If you're looking at one problem for example, overtime look at the starting times of the first cases of the day, not every case. Did you change physicians in Room 2? Was he or she late? Tell the back story of why you are doing the study.
- Know the parameters of your study. Knowing the basic components of a quality study is key. Accreditation organizations have their guidelines. You need to set goals for the study. Let's say your goal is to decrease the time before physicians come into the recovery room by 10%. You should decide on a time frame for the study maybe it's a 6-week study, for example, or maybe you want to examine data you collect over an entire quarter. Create a Word document and the framework for collecting data maybe you'll want to use a questionnaire or a spreadsheet that can be graphed. Which staff members can help you?
- Stay on track. Don't fall behind. Stick to the schedule you've laid out and make sure you're extracting the data you need. If you fall behind, it can be extremely stressful. And don't let extraneous information that inevitably filters in distract you. If appropriate, set that data aside for another study or restudy. Also, be willing to adapt, and if necessary, switch to Plan B. It's not unusual for studies to need tweaking to stay on, or get back on, track.
- On wrapping things up. Review your data. Did you get an answer to the problem you were addressing? Think about the best way to present the data. Docu-ment the results and explain how what you've learned will improve some area of activity. Finally, present the study to both the physician group and the staff, and document it in your meeting minutes.