Alternative Model to the Plan-Do-Study-Act: Evidence-based Research
Channel: Monika Wahi
Date: 2021-09-11

Read about the SPRAB approach and download the slides here: https://buff.ly/3EusniT
Try Monika’s new FREE course, “Understanding Research Forms, Surveys, and Instruments” where you can learn DATA ABSTRACTION (as mentioned in the video!):
https://buff.ly/3eTtiOw 
Connect with Monika on LinkedIn: https://www.linkedin.com/in/dethwench/
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Here are links mentioned in the lecture:
00:28 Outline of the lecture
01:53 The move in the 1990s toward measuring quality-of-life, implementing evidence-based medicine, and consensus on what constitutes “evidence”
03:26 Challenges with implementing “patient-centered medicine”
04:38 Self-quiz: What’s the relationship between health quality and cost when implementing improvements?
05:59 Self-quiz answers revealed
08:47 Diagram explaining why it is so hard to reduce cost by improving quality in a fragmented healthcare system
10:59 Discussion of setting KPI’s – How do you set them on the whole system, measure them, then improve the system?
12:12 Argument for a focus on quality improvement (QI) rather than cost reduction
13:06 How do you improve healthcare quality in practice? Hypertensive patients case study.
14:46 Explanation of “administrative data” vs. “production data” as sources of QA/QI data in healthcare.
16:20 Link to Monika’s course where she covers data abstraction: https://buff.ly/3eTtiOw
17:24 History of the Plan-Do-Study-Act (PDSA) model, and why it rose to prominence
18:19 Conceptual problem with applying the PDSA, which is meant for engineering settings/workflow, to healthcare settings/workflow
20:08 Elements and issues missing from the PDSA that need to be addressed in QA/QI in healthcare
22:23 What we know from implementing the PDSA in healthcare since the 1990s – the current evidence in peer-reviewed literature. Link to article “The problem with Plan-Do-Study-Act cycles”: https://qualitysafety.bmj.com/content/25/3/147.short
25:19 Presentation of the SPRAB model, which considers all the functions of a healthcare quality assurance/quality improvement (QA/QI) department. Read more here: https://buff.ly/3A2xtk2
26:17 S = Surveillance/Monitoring explained
26:55 P = Prioritize Issues explained
27:49 R = Research Studies explained
28:39 Reasons why every time you do research in QA/QI, you should write a research protocol – ethics board approval, epidemiology, biostatistics, evidence-based medicine, causal inference, and peer-reviewed journal publication
29:46 A = Action to Introduce Change explained
30:43 B = Benchmark Change explained
31:19 Reason for the ultimate failure of the PDSA model
31:56 Advantages of the SPRAB model or approach over the PDSA
32:45 Data collection burden on chronic disease patients from the PDSA vs SPRAB
33:35 PDSA required too much unnecessary data collection and storage, which was unfair to chronic disease patients. SPRAB fixes this issue.
34:57 Conclusion – summary of presentation

Alternative Model to the Plan-Do-Study-Act: Evidence-based Research