FRI-QI Continous Quality Improvement approach that works for local health department staff

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Margaret Jahn
FRI-QI Continous Quality Improvement approach that works for local health department staff
What’s On Your Mind?: 

WHY YOUR STAFF WILL THANK YOU WHEN YOU IMPLEMENT THIS IN YOUR DEPARTMENT TODAY: Freehold health department has discovered that regular weekly AM meetings with entire staff helps them make measurable progress on projects, staff members know what each other is working on and now actively provide manpower to help in other areas, front end staff know who is working on projects, and these meetings build team cohesion and accountability. Not to mention you have documentation for PHAB accreditation...this is a win-win situation.

What we've been doing:

Over the last 2 years Freehold Health Department has been using a "FRI-QI" approach to work through a variety of quality improvement projects. On almost all Friday mornings, our staff of 3-7 meets for 1-2 hours max to tackle a part of QI project. We work through the QI project over the course of one or more of these meetings (it can take a while to work through some projects). We keep the meetings informal & casual - staff take turns leading meetings, so the Health Officer isn't always running the show and so everyone gets a chance to contribute what they think. We mandate that there are NO interruptions during a FRI-QI process meeting, and we don't talk other business - the FRI-QI meetings are focused on the current QI project only. We keep a sign-in sheet for each meeting with the date, project topic, and where we are in the QI process. For each meeting, someone takes notes, and transcribes any chart notes (we use an easel) and info into our project tracking binder. Reasonable objectives that can be completed within the next week are documented. These objectives are reviewed the next Friday at the FRI-QI meeting and modified/ updated as needed.

What's working well:

-Making little quality improvement projects a part of the regular workflow has helped us fix problems and improve how we do our work - it forces us to spend a little time each week making ourselves better, and even if it takes a little time up-front, it pays off in better work processes, morale, and customer satisfaction.

-By documenting these QI projects, we're working towards our national accreditation requirements (PHAB). [Want to mention adapting structured QI approach from Rutgers?]

-Giving staff an opportunity to lead QI projects helps develop their leadership skills and confidence, and gives them ownership of the improvements. Leadership participation / support and staff buy-in / meaningful contributions improves workplace communication, productivity, and efficiency.

-Meeting in the morning works best, because everyone is awake, more receptive to new ideas and outside-the-box thinking, and there are generally less interruptions.

Outcomes we've seen from this:

-We've become more methodical in answering and responding to community phone calls/ messages and scheduling appointments (one of our QI projects).
-Staff have a fuller understanding of the various projects occurring simultaneously at the office on a daily basis.
-Role and project assignments are more clearly delineated and defined. And when we need to respond to an emergency or time-sensitive issue, project priorities can be managed across our entire staff, not just those in that particular department.
-We're able to meet newly established inspection quotas in a timelier fashion (another one of our QI projects).
-This regularly-scheduled face-to-face time as an entire agency allows for staff input to identify problems and solutions faster and with more agreement (and staff take leadership responsibility for their work).

Thinking of trying this out? Here's our advice / two-cents:

-Stay the course - don't give up if the first few meetings don't seem to work. Agency staff need to persevere and work through negativity or inertia (positive change / improvement is possible!). Allow 'nay-sayers' to pick a process to improve or give them a significant role to play, and highlight their contribution and any positive outcomes as a result.

-Pick "winnable battles" first to build up your confidence. Start with things that you are pretty sure you can improve.

-Right now, we don't have a written "Continuous Quality Improvement" plan, but the FRI-QI meetings are basically our unwritten CQI plan in action.

Margaret Jahn

I was set up...

We made her do it!

Margy was very reluctant to post FRI-QI as a Promising Practice, but at Rutgers, we all agreed we had that coercion was justified for the greater public good :-) It's too good and too practical not to share, and it is natural stepping stone toward PHAB accreditation. Seriously consider adopting it at your department.

Candice Davenport
Check out the NJLMN Forum video feat. the Freehold Health Dept

Check out the NJLMN Forum video featuring the Freehold Health Department in the NJLMN Library under NJLMN Newsletter Articles, Current Issue.
•"Video - Health Dept uses NJLMN to share Process Improvements"

Show this video at your next professional organization meeting.