Written by: Abier Hamami. RPH. CPHQ
FOCUS - PDCA is an extension of the Plan, Do, Check, Act (PDCA) cycle sometimes called the Deming or Shewhart cycle. During the 1980s, the Hospital Corporation of America (HCA, now part of Columbia Health Care Corporation) incorporated Deming’s concepts into its FOCUS-PDCA model, providing the healthcare industry with a common language and framework for CQI.
How the model is used
FOCUS-PDCA is an acronym that describes the basic components of the performance improvement process. It includes the following steps:
Find an opportunity to improve
This could be determined by variation in data collection on key indicators and measures, or sentinel events, and morbidity & mortality reviews.
Organize a team who understands the process
The team consists of people directly involved in the process being improved.
Clarify the current knowledge of the process
Collect data regarding the process using a run chart or pareto chart, or brainstorm and complete a flow diagram of what is the current procedure, and determine where the defects are.
Understand the cause of process variation
Use a cause and effect diagram to know why isn’t the process working effectively.
Select the process improvement
The team selects the most appropriate solution keeping in mind the cost and difficulty of implementation.
Plan the improvement
Develop an action plan for how the process will be improved. Also data collection for monitoring the improvement and change is planned at this stage.
Do the improvement
Implement the improvement and change first as a pilot on small scale.
Check the results
Evaluate the effect of the improvement and change through data collection and comparison with baseline data or data collected prior to the improvement.
Act to hold the gain
Do whatever is necessary to maintain the improvement, as education and training, policies development, and share lessons learned.
Guidelines for using FOCUS-PDCA:
· If a problem analysis is needed,
· If a task at hand is either new or unique. A routine task normally doesn't warrant a PDCA unless a major new factor is introduced,
· If uncertainty exists in a proposed implementation plan for either something new or for correcting something already in place,
· If the implementation plan should have sufficient complexity. If the corrective steps were clear then PDCA would be a wasted effort,
· If measurement is needed,
· If stakes of failure are potentially high,
· If efficiency of the implementation must be critical.
· Walgreens Health Initiatives. FOCUS-PDCA Evolving from Fire Fighting to Problem Solving. Mary Anne Adler, MHA, RRT https://webapp.walgreens.com/cePharmacy/programsHTML/FOCUS.html
· Janet A.Brown, Performance Improvement. The Healthcare Quality Handbook. 2002