Program planning and Quality Improvement: Introducing the SAPD* cycle

On June 13th, 2017, over 50 Quality Improvement Professionals – including QIDS Specialists, interprofessional health care providers, and partners from Health Quality Ontario and OntarioMD -- gathered for a day of networking and learning. The theme for this Knowledge Translation Exchange (KTE) day was Program Planning and the SAPD* cycle.  You may already be familiar with the Plan-Do-Study-Act (PDSA) cycle.  SAPD is the same cycle – it just starts at “Study” or measurement, instead of at “Plan," to build on the momentum in measurement that AFHTO members have achieved. The day began with a primer on the SAPD cycle. Delegates then discussed three scenarios presenting opportunities for ways to use measurement to support quality improvement in primary care:
  • When looking for ways to improve Medication Reconciliation After Hospitalization, even the smallest step makes a difference, whether it be getting just a little bit of data or creating just a little bit of engagement. Most importantly, when implementing a change idea, the reason for the change is as important as the result. “Why?” is the lens to look through, always looking for reasons “Why not?!”.
  • In measuring the success of One-Time Workshops, consider choose measures that match the workshop. Clinical outcomes may not be likely to change based on one workshop – but readiness to change might.  Consult subject-matter experts, attendees and patients to find out what would tell them a workshop was a success.  To increase feedback and completed evaluations, try fun, accessible ways such as tennis-ball voting. Follow up with patients to show them what you are doing based on their feedback.
  • To be more proactive in evaluating Acute and Episodic Care, consider it as a program that delivers care to your population. Consider your goals for this program as for any other program and choose measures that reflect progress with these goals. A good place to start is to ask patients about their goals and how they would measure progress towards them. Staff and providers may be able to define goals beyond number of patients seen or other process measures that don’t really show the value of acute and episodic care.
“A-ha” moments that surfaced consideration of the scenarios were:
  • When facing barriers to measurement and quality improvements, we can take comfort in knowing that we are not alone. Others are facing, or have already faced, the same barriers, and they may have already developed tools and resources to overcome them.
  • Don’t dwell on dead ends or get “stuck on an escalator.” Sometimes a simple solution exists but is overlooked; it may become apparent when we examine the situation from a new angle or through a new lens.
  • Don’t forget to measure provider satisfaction!
Please see the links below for slide decks and other resources from the KTE day. They are intended to help you move beyond measurement to improvement with the SAPD cycle!