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Well Designed Using a Quality Improvement Process
PDSA Example

AIM: Develop and use written care plans for a select population of children/children and youth with special health care needs (~ 20% most complex or high need; by January 10, 2009); thereby improving communication and collaboration among families, the practice and community partners, and reducing redundancy in care planning and process.

Plan: Select summative care plan and use with 2 CYSHCN/SCD per week for 4 weeks

Do: Results-Used care plan with 3 children/families
Study: Feedback from families, providers, and community partners
Data: Family liked the information and repeating concerns less when the care plan was in place
Data: Clinicians like better back-up information; time to complete plan must be built into workflow with a business plan (coding for care plan oversight) for the time involved to develop, use and update
Data: Both make content improvement suggestions

Act: Integrate suggestions, revise care plan, test again before creating electronic version. Possible addition of a specific visit to the care coordinator for completion and /or update of the plan, preliminary discussions about electronic links and how to make notations in the practice registry regarding availability of care plan for which children and youth.
Plan second test (Note: there is a distinct difference between completing a test (try a care plan with someone) and carrying out a task (planning a meeting).

Cycles of Improvement