A CLINICAL ANALYSIS of surgeons' preference cards was initiated in one hospital as part of a comprehensive analysis to reduce medication-error risks by standardizing and simplifying the intraoperative medication-use process specific to the sterile field. THE PREFERENCE CARD ANALYSIS involved two subanalyses: a review of the information as it appeared on the cards and a failure mode and effects analysis of the process involved in using and maintaining the cards. THE ANALYSIS FOUND that the preference card system in use at this hospital is outdated. Variations and inconsistencies within the preference card system indicate that the use of preference cards as guides for medication selection for surgical procedures presents an opportunity for medication errors to occur.

This article discusses performance improvement (PI) data collection processes and the various tools that can be used to analyze and display data through the duration of a PI project. It describes the importance of data, how to determine the required amount of data, how to collect and analyze data, and in what format data should be presented. Personnel involved with PI projects may need to use various data collection methods and tools to ensure an effective project with a successful outcome. This article includes examples of how PI project team members can implement various data collection and analysis tools. After reviewing this article, the reader should have a better understanding of this part of the PI process.

This article discusses performance improvement (PI) and the various methods that PI teams can use to provide a framework for improvement. Teams that complete successful PI projects use a systematic methodology that guides them through the process in a step‐by‐step manner, with each step building upon the previous one using data collection methods and analytics. Personnel involved with PI projects may need to use various methodologies to achieve improvement. These tools range from Plan‐Do‐Study‐Act cycles to more complex methods such as Six Sigma, which uses a define, measure, analyze, improve, and control process as its foundation. This article includes examples of how PI project team members can implement various methodologies and analysis tools to improve processes across the PI project continuum. After reviewing this article, the reader should have a better understanding of the systematic methodologies supporting the PI process. This is the third article of a six‐part series about performance improvement.

This article discusses the history and background of performance improvement (PI) processes and describes the creation of the foundational document for a PI project: the project charter. It is important for PI teams to create a complete charter before the project begins to give structure to the project. Teams involved in PI should use the charter as a roadmap for project completion because it helps to keep the team focused on issues within the scope of the project. This article reviews the steps to begin creating the charter and provides examples of the various sections that should be included. By reviewing this article, the reader should have a better understanding of this part of the PI process.Editor's note: This bimonthly article series is designed to provide a practical guide regarding the fundamentals of performance improvement (PI) and will focus on the specific steps and components of the PI process. The purpose of this series is to help readers who have not had experience learning or using PI techniques and those who need a refresher on the fundamentals of PI. The series will address the following topics: starting a PI process, including creating a charter, purpose, and business case; reviewing the tools (ie, data collection and analysis, process mapping, cause and effect or fishbone diagrams, 5 Whys, run charts, Pareto charts, check sheets); and using various meth odologies (ie, PlanDoStudyAct, Six Sigma, Lean management, failure modes and effects analysis, root cause analysis). HISTORY OF PIOne of the pioneers of quality improvement was William Edwards Deming, who focused on the idea that quality improvement is all about managing the process. 1 The concept of PI has been in existence since the 1920s, and

The Organ Donation and Transplantation Collaboratives that occurred within the United States from 2004 to 2008 helped contribute to a significant increase in organ donors and transplants across the country. Centers were needed to accommodate and maintain this increase in capacity to perform successful transplantations for candidates on the waiting list. The Transplant Growth and Management Collaborative was created to help fulfill this new performance level expectation. In 2007 the US Department of Health and Human Services, Health Resources and Services Administration published a best-practice report based on high-performing centers that experienced a significant increase in volume while maintaining expected, or higher than expected, outcomes. The report produced a change package that outlined common strategies, key change concepts, and actions used at the best-practice centers that could be adapted by other transplant programs by using Plan-Do-Study-Act cycles to test the impact of the changes. This change package and use of the Plan-Do-Study-Act cycles formed the foundation of the Collaborative that occurred from October 2007 through October 2008 to spread best practices to transplant programs willing to commit to making changes that could result in a 20% increase in transplant volume. More than 120 transplant centers participated at some point in the Collaborative. Although preliminary results of the Collaborative show that only a few participating programs achieved the 20% volume increase goal, many participating centers reported putting successful models in place for each of the strategies identified in the best-practice change package.