Lumacare's Insights on their QI Project
Please describe the challenge or opportunity for improvement in your organization and why it was important to address it.
Lumacare is a community support agency located in the North York area of Toronto. The organization serves over 3000 individuals annually, many of which are frail seniors. One of the services offered by Lumacare is our Assisted Living Services Program (ALS) which provides 24/7 in-home support to high risk seniors. The clients include those residing in apartment buildings and homes within a certain distance from the program Hub sites. The in-home support is provided by personal support workers (PSW). The team identified Lumacare often receives complaints about the PSWs for various reasons. As client satisfaction is paramount to us, our improvement team set out to decrease the number of client complaints regarding personal support worker staff at ALS by 50% by March 31st, 2016.
Who was involved in your improvement project?
Our quality improvement team was composed of the following individuals:
- Client Service Coordinator
- ALS Team Lead
- ALS Care Coordinator
- Adult Day Program Team Lead
- ALS PSW
- Manager of Community Services (Project Lead)
- Director of Client Services (Executive Sponsor)
What client outcome was your project intended to improve?
The outcome that we aimed to impact was a reduction in the number of client complaints, therefore increasing client satisfaction. To calculate a baseline measure of client complaints we utilized reports from our client database
What processes and tools did you use to truly understand the challenge you were addressing and the ideas that would lead to improvement? How did you determine the changes you needed to make to improve your program?
Our group utilized two of the QI diagnostic tools, the Fishbone Diagram and the 5 Why’s. The fishbone diagram was useful because it allowed us to look at the six different categories (equipment, process, people, materials, environment, and measurement) and help identify multiple factors that were contributing to our problem statement of client complaints about PSWs. The 5 why’s helped us break down issues by continually asking “why” until we reached a root cause. The team enjoyed using these two QI tools and found them both very helpful. The tools really help you “dig deeper” and look beyond the obvious reasons that contribute to your problem statement.
What was your biggest a-ha moment during your project?
The biggest “a-ha moment” was realizing the amount of time and resources needed to be devoted to this project. However, we have seen the value in allocating appropriate time and resources to specific QI initiatives and having actions plans comprised of multiple PDSA’s.
What impact did this improvement project have on your clients and your organization?
The project brought attention to the important and at times complex issue of personal support worker complaints. Through our 5 whys we were able to determine that one of the root causes was a misunderstanding of service expectations. As of the end of Q3 2015-16 complaints are down by 25% and we have also enhanced our staff and client knowledge and leveraged our technology better. Staff involved on the team shared that the project gave them a lens to see how a simple issues has many layers and improving quality is not as simple as changing a form or process.
If you had to give advice to others starting on a project, what advice would you give?
Ensure you have committed team members who are able to devote the time needed to follow through with the project amidst regular duties. It is also helpful to look ahead at other planned initiatives/agency-wide initiatives to ensure alignment, proper resource allocation and communication.