How does a continuous improvement process (CIP) work?

If you want to systematically improve your day-to-day work, the so-called “PDCA” cycle is very helpful. PDCA stands for Plan, Do, Check, Act. First you plan a change (plan), then you carry it out (do). Then you check the results (Check) and adjust the measures to improve them (Act). When you do a business excellence assessment, the assessment team will ask questions that address this systematic approach.

The PDCA cycle is explained below using the example of a nursing team.     

Plan (planning): A nurse recognizes that there are difficulties in documenting patient data in the daily workflow. The aim is to find a more efficient method of documentation in order to reduce the workload. So the plan always includes a goal!

Do: The nursing professional suggests an improvement to the electronic documentation software that enables patient data to be recorded more quickly and easily. The nursing team is trained on the new functions and learns how to use the software optimally.

Check: The nursing team checks whether the new software is effective. In the pilot, the team establishes that the documentation can actually be carried out faster and more accurately. The team also checks the benefits by means of feedback in everyday life. The feedback is that the new software is well received overall, as it is faster and more effective than the previous system. However, employees still have difficulties using certain functions and there are still some areas that can be further improved. Among other things, the current training courses and training materials do not describe the new functions.

Act: Further improvements are made based on feedback from the care team from their day-to-day work. The software manufacturer makes further desired adjustments for ease of use and the IT department ensures that the training courses take the new functions into account appropriately.

The following examples make the improvement process much more tangible and target-oriented:

Concrete goals:

• Reduction of time for documentation by 50%.
• Improve the accuracy and completeness of documentation by 30%.

Suitable measured variables:

• Average time for documentation per patient.
• Percentage of complete documentation.
• Percentage of incorrect documentation.

Suitable measuring instruments:

• Stopwatch for measuring the time for documentation.
• Review of random samples of patient documentation.

Examples of measurement results:

• The average time for documentation per patient was reduced from 30 minutes to 15 minutes.
• The proportion of complete documentation rose from 70% to 90%.
• The proportion of incorrect documentation fell from 20% to 5%.