A Step-by-Step Guide to Understanding and Conducting Quality Improvement Initiatives in Orthopaedic Surgery

Figures

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  Figure 1. Six Domains of Health Care Quality: Institute of Medicine. Figure developed from the Agency for Healthcare Research and Quality. Six Domains of Health Care Quality. Published 2018. https://www.ahrq.gov/talkingquality/measures/six-domains.html.

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  Figure 2. Differentiating Quality Control, Quality Assurance, and Quality Improvement. Figure adapted from the American Society for Quality. Quality Assurance & Quality Control. Published 2018. https://asq.org/quality-resources/quality-assurance-vs-control.

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  Figure 3. Sample A3 Template.

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  Figure 4. Impact-Effort Matrix. Figure adapted from the American Society for Quality. Impact Effort Matrix. https://asq.org/quality-resources/impact-effort-matrix.

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  Figure 5. Value-Risk Matrix. Figure adapted from: Method Grid. Value - Risk/Complexity/Effort - Matrix. https://methodgrid.com/examples/value-matrix-risk-template-example/.

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  Figure 6. Roles of QI Team. Figure adapted from (1) Wolfstadt JI, Ward SE, Kim S, Bell CM. Improving Care in orthopaedics: How to incorporate quality improvement techniques into surgical practice. The Journal of Bone and Joint Surgery. 2018;100(20):1791-1799. doi:10.2106/JBJS.18.00225 and (2) Stanford Medicine Center for Improvement. Building an Improvement Project Team. Published 2021. https://youtu.be/BUnKeKMNSYM.

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  Figure 7. Documenting QI Team Members on A3.

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  Figure 8. Tuckman's Model of Group Development. Figure adapted from (1) Tuckman BW. Developmental sequence in small groups. Psychol Bull. 1965;63:384-399. doi:10.1037/h0022100 and (2) Manges K, Scott-Cawiezell J, Ward MM. Maximizing Team Performance: The Critical Role of the Nurse Leader. Nursing Forum. 2017;52(1):21-29. doi:10.1111/nuf.12161.

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  Figure 9. Documenting Problem Statement on A3.

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  Figure 10. Developing a Problem Statement: Case Example. Hypothetical problem statement developed for Winslow L, Holstine J, Samora JB. Samora. Jt Comm J Qual Patient Saf. 2020;46(10):581-587. doi:10.1016/j.jcjq.2020.06.010.

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  Figure 11. TIMWOODS: Eight Sources of Waste. Figure developed based on Hines P, Nick R. The seven value stream mapping tools. Int J Oper Prod. 1997;17:46-64.

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  Figure 12. Developing a Process Map: Case Example. Hypothetical process map developed for Winslow L, Holstine J, Samora JB. Reducing the Use of Opioids for Pediatric Patients with Supracondylar Humerus Fractures. Jt Comm J Qual Patient Saf. 2020;46(10):581-587. doi:10.1016/j.jcjq.2020.06.010.