A problem is a visible performance deficiency in an important manufacturing, service, or business process or product. A problem statement is a description in visible and measurable terms of how a particular deficiency affects the performance of an organization. There are several “rules of thumb” that apply to problem statements. Effective problem statements should:
Describe how the problem relates to the performance of the organization.State the problem in terms that are visible, specific, and usually measurable.
Be of a size and complexity that is manageable.
Problem statements should never:
Give any preconceived indication of what the root cause might be;
State or imply a particular type of solution;
Affix blame for the problem;
Read through the following problem statements. These are good examples of statements that follow the rules stated above.
“In the opinion of the Operating Room (OR) physicians and staff, the first procedure in each room of the OR starts late and the room turnover times are too long. This is leading to physician dissatisfaction, staff tension, inaccurate scheduling, delays in patients| cases, and possibly additional cost in the delivery of operating room services.” —Operating Room First Case Late Start/Room Turnover Process Action Team
“Currently no money is collected at the time of service for care rendered in Emergency Department. This results in financial losses and increased usage of Emergency Department for non-emergency complaints.” — Emergency Department Cash Collections Process Team
“The efficiency and timeliness of patient transfers between areas (Cardiac Catheterization Laboratory, Emergency Department, Evaluation Center, Intensive Care Unit, Medical/Surgery Nursing Unit, Operating Room, Post-Anesthesia Care Unit, Ambulatory Care Center, Radiology, Same Day Surgery, Special Procedures) does not meet the expectations of patients, physicians, or staff. The result is longer patient waiting time, longer physician waiting time, delayed patient procedures, inappropriate patient procedures, poor communication between staff members, and confusion and conflict over roles and responsibilities.” — Hospital Patient Flow Team.
You probably noticed that the problem statements you just read involved a number of people and sometimes a number of departments. The best way to approach the problem and take steps toward improvement is to involve representatives from each department or a group of people directly involved with the problem. Gathering a team of people familiar with the problem and its underlying elements is an excellent approach to CQI. Create a CHARTER for your process action team.
Discuss how you will coach your team through the issues/steps above. Indicate the performance indicators/hoped for outcomes.
Indicate how you will maintain a high level of involvement on the part of staff and what mechanisms/strategies you will use to keep them on track. Indicate how you will assist them with collecting their data.
Summarize the benefits the organization will receive from this approach. Essentially, you are creating a proposal so that others will understand why this team approach is necessary.
A team charter defines the purpose of the improvement team and is often published in a single document. Whether published or not, teams should ensure that there is a common understanding of the charter both within the team and between the team and those that chartered the team. Components of the charter usually include:
Problem Statement – This is the core of a team charter and defines the fundamental reason for the team’s existence.
Team members – This defines the permanent membership of the team and designates the team leader and facilitator.
Expected Output of the Team – This defines what those that chartered the team expect the team to produce as a result of its work.
Anticipated Measures of Success – This defines the measurable factors that should be used to determine the effectiveness of the team’s recommended solutions.
Constraints – This defines the limits of the process the team will work with or specifies other limitations that the team will work under, for example, time and cost.
Expectations and Support – This defines other expectations and specifies any resources assigned specifically to the team.
You probably noticed that the problem statements you just read involved a number of people and sometimes a number of departments. The best way to approach the problem and take steps toward improvement is to involve representatives from each department or a group of people directly involved with the problem.
Gathering a team of people familiar with the problem and its underlying elements is an excellent approach to CQI. Create a CHARTER for your process action team.
Discuss how you will coach your team through the issues/steps above. Indicate the performance indicators/hoped for outcomes. Indicate how you will maintain a high level of involvement on the part of staff and what mechanisms/strategies you will use to keep them on track. Indicate how you will assist them with collecting their data. Summarize the benefits the organization will receive from this approach. Essentially, you are creating a proposal so that others will understand why this team approach is necessary.
Once the team charter is complete, it’s time to start work! The best way to approach any project is with a plan.
A work plan defines the tasks, timelines, and responsibilities for the major items work facing the team. It is a “living document” that is usually modified as the team performs its work. Teams also use work plans to track the actual accomplishments of the team. The following format provides a sample work plan to which teams can adapt to meet their needs.
