Performance Improvement Strategy

This webinar was a team effort by Tagoras and Dr. Andy Hicken from Web Courseworks.

In this Performance Improvement webinar, Andy kicks off the session by giving a list of key terms in the field of Performance Improvement.

  • HPI – Human Performance Improvement
  • PI CME – Performance Improvement Continuing Medical Education
  • MOC Part IV – Maintenance of Certification Part IV

Andy began explaining how PI ideally would work like a FitBit. A FitBit records real world performance data of the individual wearing it. The wearable technology gives constant feedback about your activity levels and performance and it provides rich analysis of the user’s data. This then helps the wearer plan how they will improve as it targets specific performance gaps. The key to the FitBit and its success is that it is personalized to the individual wearing it. Just as the FitBit gives constant feedback and is personalized, Performance Improvement should also have these qualities to make it more effective.

Performance = Work Activity + Results

When thinking of this equation, it is important to think of the activity you want to improve to get the desired results. For example, the activity could be “Treating a Patient” and the wanted result would be “Getting the Patient Healthy.”

It is important to keep these both in mind when thinking of performance and how you would strategize a PI plan. When creating this Performance Improvement strategy, there are a few key terms that should be identified:

  • PI Statement: Where can we make a real difference?
  • Metrics: What’s most important to measure?
  • Benchmarks: How will we know we’re effective?
  • Learning Interventions: How will we create the needed change?
  • Potential Partners: Who else cares and can help?

In addition to these key strategy components, there is a three stage process for implementing PI:

Stage A: Performance Assessment

Stage B: Implement Interventions

Stage C: Reassess

After explaining the basics of PI, Andy went on to explain how PI is currently used with a couple of different case studies. We will highlight one of them below:

The National Board of Osteopathic Medical Examiners (NBOME) implemented a system for Performance Improvement among their doctors in hopes to improve the process of doctors instructing the use and side effects of a prescription to a patient. This is one of the classic examples of performance improvement for CME. Before NBOME began the three stage process of PI, they took some initial steps to make sure they implemented the strategy correctly. In this pre-development stage, they mapped learning interventions to performance measures based on recognized best practices and current research.

Stage APerformance assessment:

  • How doctors would explain medication/prescription
  • Assess current performance through patient surveys
  • Compare performance to national benchmark

Stage BImplement Interventions:

  • Assess performance gaps
  • Learning Interventions
    • Chunking – short <5 minute videos focused on certain areas of performance
  • Practice Interventions
    • Takeaway tools – quick reference, performance support to help bridge performance gap
  • Practitioners plan own goals for improvement

Stage CReassess:

  • Practitioners re-assess their performance once they see their results in comparison to benchmark

Results: Average learner improved 10% on all performance measures. Patients felt that the side effects were explained 16% better and they felt 23% more educated on interactions with other medications.

performance improvement at nbome


So where is performance improvement headed?

The goal is to be like a FitBit by using tools like EHRs (Electronic Health Records) and CDRs (Clinical Data Repository) to record real time performance of doctors and then use that data within a learning technology to create performance goals.

What is a good instructional design for your performance improvement strategy?

  1. Personalized (to each learner)
  2. Learner driven (learners take initiative)
  3. Performance phased (no knowledge based)
  4. Measurable
    • Metrics
    • Benchmarks

Web Courseworks has more information on the roadmap for authoring PI with a white paper. Download it here if you would like to learn more on PI strategy.

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