Conducting Health Literacy Quality Improvement
Activity 16: Designing a QI Project for Teach-Back
Topic: Conducting Health Literacy Quality Improvement
Use in:
- Didactic (in class or assignment).
- Experiential education (APPE).
- Project (residency project).
Time: 30 minutes (in-class); 1 hour (assignment); 8-12 hours (APPE); 40 hours (residency project)
Learning Objectives:
- Demonstrate how to develop a quality improvement (QI) project using the Plan-Do-Study-Act (PDSA) model to implement teach-back in a pharmacy or pharmacy practice.
Activity Description:
In-class: Break into groups of three to five. You have 30-45 minutes to develop a PDSA cycle for a busy retail pharmacy that wants to incorporate teach-back into counseling on prescriptions, using one of the following PDSA worksheets from the Institute for Healthcare Improvement (IHI) or from the ´óÏóÊÓƵHealth Literacy Universal Precautions Toolkit (go to resources below). Pick a person to present to the class.
Assignment: Develop a PDSA cycle for a busy retail pharmacy that wants to incorporate teach-back into counseling on new prescriptions, using one of the PDSA worksheets.
APPE: Develop a PDSA cycle for your rotation site pharmacy to incorporate teach-back into their counseling or pharmacy practice. Use one of the PDSA worksheets. Then execute the plan and study the results. Based on the PDSA, develop a report summarizing what you intended to do and why, how you did it, how you studied the results, what were the results, and what next steps you would recommend to move teach-back forward in the pharmacy. To obtain further guidance look to Chapter 5, Figure 5-3: Quality Improvement Planning Worksheet in Warholak and Nau (2010).
Project: Develop two to three PDSA cycles for your residency site pharmacy or pharmacy practice to incorporate teach-back into their counseling or pharmacy practice (e.g., MTM practice). Go to examples of the three PDSA cycles used to implement teach-back into a medical practice (go to Universal Precautions Toolkit, page 91). Use one of the PDSA worksheets to develop the first cycle—to test a small change in teach-back in the pharmacy. Execute the plan and study the results. Based on the first cycle results, determine what should be done in the second cycle to make further progress in incorporating teach-back into the pharmacy. Again, execute the plan and study the results, and based on the results develop a third cycle to make even broader changes. Execute the third cycle plan and study the results. Based on the three PDSA cycles, develop a report summarizing what you intended to do and why, how you did it, how you studied the results (i.e., methods), what was involved in each cycle, what were the results, and what next steps you would recommend to move teach-back forward in the pharmacy. Also describe the types of challenges you encountered in doing the quality improvement project. Include a reflection on your experience conducting the PDSA cycles, and what you learned.
Relevant PowerPoint® Slides:
- Advancing Health Literacy Practices in Pharmacy through Quality Improvement—Part I.
- Advancing Health Literacy Practices in Pharmacy through Quality Improvement—Part II.
Evaluation Criteria: Students will be engaged as part of an in-class activity. Each student will have participated in completing a PDSA cycle for teach-back. For the assignment, the student will have developed a PDSA using one of the two worksheets, and provided a reasonable and complete PDSA cycle. For the APPE, the student will successfully develop and execute a PDSA cycle to implement teach-back in the pharmacy. For the residency project the resident should successfully develop and execute three PDSA cycles (if three were needed) to implement teach-back into the pharmacy or pharmacy practice. The report should provide a thorough overview of the PDSA cycles and results, and include a reflection on the student's experience and what he/she learned.
Resources:
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- Institute for Healthcare Improvement (IHI)—.
- Warholak TL, Nau DP. (2010). Quality and safety in pharmacy practice. McGraw-Hill; New York, NY. Go to: Chapter 5, Figure 5-3 Quality Improvement Planning Worksheet.
Activity 17: Designing a Quality Improvement (QI) Project
Topic: Conducting Health Literacy Quality Improvement
Use in:
- Experiential education (APPE).
- Project (PharmD or residency project).
Time Commitment Estimate: 8-12 hours (APPE);
Learning Objectives:
- Name a potential problem or area for improvement in a pharmacy's health literacy practices.
- Explain how QI projects can be used to improve pharmacy services or practice.
- Use a QI PDSA process to implement in a pharmacy or pharmacy practice.
Activity Description: First identify potential problems or opportunities for improvement in a pharmacy's health literacy practices (go to Activities under Section 4.3 Assessing the Health Literacy Practices of Pharmacies). Consider whether the pharmacy's written materials are appropriate for individuals with limited health literacy or whether the pharmacy's verbal communication strategies follow best practices or whether the pharmacy staff are aware and knowledgeable about health literacy issues and their importance for pharmacists. Also consider doing an assessment of the pharmacy using AHRQ's assessment tool, Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide (go to resources below), or Activities 12-15. Once you select or identify an important problem or area for improvement, follow the steps outlined below.
Assignment: Develop a quality improvement (QI) project PDSA cycle for a pharmacy that would make the changes to potentially address the health literacy practice issue. Use one of the PDSA worksheets.
APPE: Develop a quality improvement (QI) project PDSA cycle for your rotation site pharmacy to implement and test a change to improve the identified issue in the pharmacy. Use one of the PDSA worksheets (see below). Execute the plan and study the results. Based on the PDSA, develop a report summarizing what you intended to do and why, how you did it, how you study the results, what were the results, and what next steps you would recommend to further improve upon the select health literacy practice issue or what other potential solutions should be explored.
Project: Develop a quality improvement (QI) project using two-three PDSA cycles for your residency site pharmacy or pharmacy practice to implement and test a change to improve upon the identified issue in the pharmacy. See examples of the three PDSA cycles used to implement teach-back into a medical practice (go to Universal Precautions Toolkit, page 91). Use one of the PDSA worksheets to develop the first cycle—to test a small change in practices in the pharmacy. Execute the plan and study the results. Based on the first cycle results, determine what should be done in the second cycle to make further progress in incorporating the change into the pharmacy. Again, execute the plan and study the results. Based on the results, develop a third cycle to make even broader changes. Execute the third cycle plan and study the results. Based on the three PDSA cycles, develop a report summarizing what you intended to do and why, how you did it, how you studied the results (i.e., methods), what was involved in each cycle, what were the results, and what next steps you would recommend to further improve the select health literacy practice issue or what other potential solutions should be explored. Also describe the types of challenges you encountered in doing the quality improvement project. Include a reflection on your experience conducting the PDSA cycles and what you learned.
Evaluation Criteria: Students will be engaged as part of an in-class activity. Each student will have participated in completing a quality improvement (QI) project PDSA cycle for their selected issue. For the assignment, the student will have developed a PDSA using one of the two worksheets, and provided a reasonable and complete PDSA cycle. For the APPE, the student will successfully develop and execute a PDSA cycle to implement the change into the pharmacy. For the residency project the resident should successfully develop and execute three PDSA cycles (if three were needed) to implement the change into the pharmacy or pharmacy practice. The report should provide a thorough overview of the PDSA cycles and results and include a reflection on the student's experience and what he/she learned.
Relevant PowerPoint® Slides:
- Advancing Health Literacy Practices in Pharmacy through Quality Improvement—Part I.
- Advancing Health Literacy Practices in Pharmacy through Quality Improvement—Part II.
Resources:
- Jacobson K, Gazmararian J, Kripalani S, McMorris KJ, Blake SC, Brach C. (Prepared under contract No. 290-00-0011 TO7.) ´óÏóÊÓƵPublication No. 07-0051. Rockville, MD: ´óÏóÊÓƵ. October 2007.
- Institute for Healthcare Improvement (IHI)—
Go to Activity Guides 1-7.
Go to Activity Guides 8-11.
Go to Activity Guides 12-15.
