In order to drive systems change, an organization must establish a culture of continuous process improvement. All of us work within some kind of system and have a role in the system. In order to improve the system and the outcomes, we have to make changes. But not all changes are good, so we must measure them.
At PCC, we use the Model for Improvement to increase work efficiencies. This model was developed by Associates in Process Improvement and is promoted by the Institute for Healthcare Improvement. It involves small tests of change (or Plan-Do-Study-Act cycles) to drive improvement. The model is especially good for safety-net clinics where resources are scarce. Using the Model for Improvement, we can test on a small scale, see what works, and then scale up. Small scale testing can mean anything from starting with one patient to see how a certain referral form works, to scheduling 9 patients for block scheduling before jumping up to 26.
For a culture of process improvement to take root, the whole clinic must be engaged. PCC staff work to gain support from senior leadership, train the entire clinic staff, and create a clinic project team to meet on a monthly basis. In the Breast Health Initiatives, the focus is on breast health measures, and the identification and evaluation of tests of change to improve referral and follow-up processes. In addition, PCC works to streamline communication with the entire clinic, share successes, and inform staff about protocols to be scaled up.