Table 2.
Key elements of the model for improvement | Specific and measurable aims (N)1 | Measures of improvement1 | Key changes1,2,3 | PDSA1,3 | Effect measurement (collaborative goals reached?)?4 | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Provided by external change agent | Established by the project team | Evidence for improvement (one-stop-shop) implemented in redesign? | Supplied change concepts used? | ||||||||
No. | Patient Group | Outcome | Inter-mediate | Outcome | Process and/or intermediate | Yes/No | Comments | ||||
1. | Acute stomach complaints | + (1) | + | n.a. | + | + | - | n.a. | + | - | - (?) |
2. | Breast cancer | - (0) | + | + | - | - | - | Already implemented | + | - | - (?) |
3. | Breast cancer | + (1) | - | - | - | - | - | Already implemented | + | . | - (?) |
4. | Chronic Obstructive Pulmonary Disease | + (1) | + | - | - | + | - | One-stop-shop is no solution for the existing bottleneck | + | + | - (?) |
5. | Colon cancer | + (4) | + | + | + | - | + | - | + | - | - (?) |
6. | Colon cancer | + (1) | + | + | - | - | + | - | + | - | - (?) |
7. | Colon cancer | - (0) | + | + | + | - | + | - | + | +/-* | - (?) |
8. | Head- and neck cancer | + (7) | + | + | + | + | + | - | + | - | - (?) |
9. | Hematuria | + (2) | + | + | - | - | + | - | + | . | - (?) |
10. | Lung cancer | + (2) | + | - | + | - | +/- | Three-stop-shop | + | + | - (?) |
11. | Oesophageal atresia (children) | - (0) | + | n.a. | - | - | - | n.a. | + | - | - (?) |
12. | Open Chest Surgery | + (6) | + | n.a. | + | + | - | n.a. | + | - | - (?) |
13. | Small Orthopaedic interventions | + (2) | + | + | + | + | + | - | + | + | - (?) |
14. | Small Orthopaedic interventions | + (3) | + | + | - | + | + | - | + | + | - (?) |
15. | Benign Prostate Hypertrophy | + (2) | + | + | - | - | + | - | + | - | + (+) |
16. | Colon cancer | + (5) | + | + | + | - | +/- | Three-stop-shop | + | - | + (+) |
17. | Varicose veins | + (5) | + | + | - | - | + | - | + | - | + (+) |
1 Data source: survey among project staff members. 2 Data source: survey among project leaders. 3 Data source: interviews among project staff members. 4 Data source: Sneller Beter database. + Yes, - No, . missing data, n.a. non applicable, because project only involves in-hospital care. * This project team used PDSA for testing and implementing a selection of the changes.