The Model for Improvement (MFI)
The Model for Improvement is a systematic approach to analyse, understand and improve processes.
This model has been largely utilised in the healthcare industry, but it is also applicable to any process that requires system-wide improvement.The Model for Improvement is a framework developed to drive continuous improvement. It is used in many countries around the world.It was developed by Associates in Process Improvement (API), based on the work by W. Edward Deming.
The Model for Improvement is an iterative framework consisting of 2 parts. The first part, is three questions to help you define:
• What you want to achieve (Your Aim)
• What will you measure to understand if a change is an improvement (Your Measures)
• What ideas you think might make a difference (Your Change Ideas)
Each part has a set of set of distinct steps that need to be undertaken in order for the model to be effective.In the first part, you must establish the aim. The aim will describe the desired outcomes, such as more efficient operations, improved patient satisfaction, or better cost control.The aim is a clear statement of the problem or issue that you are trying to address. It should be specific, measurable, achievable, relevant, and time-bound (SMART). In order to measure and track progress, measures must be defined that align with the aim .
Choosing and defining your measures might sound easy, but those two tasks cause problems for improvement teams all the time. You should discuss the importance of developing a clear operational definition (i.e.how to apply the measure in the real world) for any improvement measure.
THINK
- Why is it important we have a shared definition of a measure among the members of an improvement team and the staff who are collecting data.
- How would you find out if you have defined a measure well enough to be clear to all the people who are collecting data?
The second part focuses on implementing tests of change ideas using a PDSA cycle for each test, the team must define a logical model, viable interventions, and what needs to be monitored and how. The tests of change should take place over a predetermined timeline and should be carefully monitored so that the team can track progress and make the necessary adjustments.
The Plan-Do-Study-Act cycle is a useful tool for documenting a test of change. You develop a plan to test your change (Plan), test the change (Do), analyse, and learn from the test (Study) and determine whether to adopt, amend or abandon the change (Act).Each PDSA outlines the steps for the actual tests of each change idea.Each PDSA should be a small test ,refining your idea through each test.It is likely that several PDSAs will need to be completed before your improvement is ready for full implementation
It is best to adopt a team approach when completing a PDSA cycle. In most improvement projects, teams will test several different changes, and each change may go through several PDSA cycles as you test, evaluate, and decided how to progress your changes.
You should fill out one PDSA worksheet for each change you test. This will allow you keep track of all the changes you have tested and have a record of your learning.
State the question you want to answer and make a prediction about what you think will happen
Plan: What will be tested, who will test the change, when and where it will be tested Identify what data you will need to collect
Do: Run the test on a small scale.Document what happened, including problems and unexpected observations Collect and begin to analyse data
Study
- Complete your analysis of the date
- Compare the data to the prediction
- Summarise and reflect on what happened
Act: Make a plan for your next steps based on what you learnt from the test. You can either:
- Adopt - test the change on a larger scale; plan for the next PDSA cycle
- Adapt – make modifications and run another test; plan for the next PDSA cycle Abandon – don’t do another test on this change as it has been.
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