Description Objectives Prerequisites Grading Policy Required book Assignments   Personal improvement   Satisfaction survey project Syllabus Recent questions Team members Suggestions for improvement More Recently asked:  "I just registered to attend an Industry Solutions Webinar - Addressing Electronic Health Record Privacy and Compliance Challenges through HIMSS, will this count as my event? I can't find any events in this area.  " See answer to this and other questions.

Course Number & Title

HAP 586 (3:3:0) Process Improvement

Course Placement

• Required for Certificate in Quality Improvement and Outcomes Management
• Required for Certificate in Health Information Systems
• Required for Master of Science in Health System Management
• Recommended elective for students in nursing, health science, epidemiology, social work and other health care fields
• Open to students not in a health care major but with a focus on improving quality of a service industry.

Faculty

• This course is based on input from a large number of instructors More►

Course Description

This course examines the operations and quality management functions of a health care/service organization from a strategic viewpoint.  Explores the contributions of operations research and quality management to improve delivery and production of health services and business processes from the perspective of the health care manager. Explores contemporary performance measures (quality and productivity) useful for improving process performance and selected decision support system methods from operations management.

Course Objectives

At the conclusion of the course participants should be able to:

• Discuss the rationale for a quality improvement process and the key factors involved in the organization of change.
• Apply quality improvement tools and techniques to improvement tasks, including control charts.
• Construct a quality improvement storyboard.
• Utilize the Internet and World Wide Web as a means of information exchange, professional networking, and project collaboration.
• Conduct a personal quality improvement project.
• Analyze risk adjusted outcomes of care.
• Plan efforts to assess patients' satisfaction or health status.
• Plan for organization wide implementation of quality improvement efforts.

Required Textbooks

• Required reading are posted to the course web page.
• The personal improvement project requires access to the following book:  Farrokh Alemi Ph. D. and Duncan Neuhauser PH.D.  A Thinking Person's Step by Step Guide to Weight Loss & Exercise Program.  If you prefer not to buy the book, you can also print the book out (154 pages).  Buy► Print►

Recommended Textbooks

• Recommended readings are posted under the section titled "More" within each lecture.

Course Requirements

To benefit from this course you need to have the following:

• A bachelor or higher degree from an accredited University. The course is limited to graduate students.

• Familiarity with the US health care system. All examples are from the US health care system.

• Computer, modem, microphone, speaker, phone line and Internet connection.  A fast computer and modem will save considerable time in this course.

• A frame-based browser such as Netscape 6.1 or Internet Explorer 3.0 or better.

• Both clinicians and managers are encouraged to enroll.

• Previous background in analysis of data and working knowledge of Microsoft Excel.  If you do not have experience with use of Excel, please take free introductory courses available at your University prior to or concurrent with enrollment in this course.

• Microsoft Power Point is needed for viewing some portions of reading and lectures. 

• Flash reader is needed and provided in the course site.

Course Assignments

There are six assignments in the course that are used to evaluate student's learning:

1. A personal improvement project
   In this project you apply concepts you have learned in the course to improve yourself, e.g. to exercise more.  You are expected to make a resolution to change a habit that you have not been able to change for sometime.  Next, you analyze your lifestyle using tools we provide and  implement a system-wide change.  In this project, you will also gather data on whether the change you have introduced has helped you succeed.  You will need to analyze the data using tools provided in the class.  Personal improvement projects are due at end of semester but you are expected to report progress on it as you go along.  The final report is a narrated storyboard.   More►
    

2. Plan a satisfaction survey 
   The purpose of this project is to help you design and put in place satisfaction surveys.  The purpose is to plan for the surveys but not to do the survey.  You share your plans with a peer evaluator midway through the course.  The peer evaluator uses a rubric prepared by the instructor to provide you with feedback.  Several tools to guide you through your planning effort are available.  Students hand in a final report as well as a narrated media.  More►  
    

3. Weekly assignment:  Each week, you are asked to answer questions about the reading (you can paste relevant sections into the answers) and analyze some data.  Late weekly assignments are not accepted.  If your weekly assignment is not done well, the instructor may return it to you for revisions, in which case the maximum grade you may receive is 80% of the grade for the assignment.
    
4. Class participation:  Class participation means that in each section, you should either ask a question or complete the minute evaluation for the session and rate the session.  If you ask a question, your question will be answered on the same web page within 48 hours and the question and the answer would be available for all students to read and benefit from.  How to ask?►

5. Professional Activity:  You need to become a member of a professional organization and participate in at least one session of their local meeting or help organize a professional student meeting.  Many local organizations exist and welcome your participation:  HIMSS►, ACHE►, IHI► 

5. Final exam:  The final exam is a comprehensive take home exam that focuses mostly on statistical process control tools. 

Here are grades received in Fall 2003.  Besides grades posted, two students received incompletes. 

Teaching Methods/Strategies

• Learn one, do one, teach one.  Students learn better when they do projects and teach the concepts covered in the lectures.  For selected assignments, students are asked to comment on the work of their colleagues using a rubric provided by the instructor. 
  
• Use technology. This course actively uses technology to help improve interaction among the students and the faculty.
• Active participation.  This course requires active participation of all students.  Students are asked to complete a group project, they are asked to comment on or ask a question about every lecture. 

Course Topical Outline (See course description, objectives and project assignments above.↑↓ Read weekly syllabus below.)

Date	Reading	Survey of time to dissatisfied patient (due at end of semester)	Personal Improvement (due at end of semester)	Other assignments
Jan 22	Take a tour of the course. More► Read more about and listen to lecture on personal improvements  More► Review Excel if you do not know how to create a chart   More►	Organize into a team of no more than 2-3 people.  Make sure that at least one member works in an organization willing to be the focus of the planning effort. Draft your semester long project in several discrete steps.  First, discuss your intent with the instructor and then update and send a letter of introduction from your instructor to the project sponsor.  Letter► Let your  instructor know that you have sent the letter and to whom it has been sent.  Email►Due on Jan 29 Before it gets too late, set a date for the team to report its plans to the sponsor.  The entire team should be present.	Complete your semester long personal improvement by following several discrete steps.  Read the Introduction in the book "A thinking person's guide to weight loss and exercise."  Sign an informed consent.  Fax a paper copy of the signed consent to 703 993 1953.  Consent► Make a resolution.  Decide what is it that you want to accomplish and why.  Start collecting data as soon as possible -- even if you do not make any changes in your life style.  You can keep  this data in your diary. Read► To think through your resolution, use Figure 1 in Chapter 1 in the book: Thinking Person Weight Loss & Exercise Program.  Email► Due on Jan 29	Provide us with your email address.  More►Due on Jan 29
Jan 29	Read more about and listen to lecture on leading change More►	Review the literature on satisfaction surveys (2-3 pages).  See Medline bibliography.  See free full text articles.  Or search full text journals in online university library.   Google search on satisfaction surveys. Students can help each other in identifying relevant resources. Bibliography► Full text►  H-CAPH► Library► Google►	Put together a team.  Even though the problem focuses on you and how you can improve, the solution is likely to involve "process owners,"  people who live with you and who help you carry out daily living activities.  Read Chapter 4 to get the idea of who should help.  Read► Test if the person you have in mind is a process owner by completing Table 1 in Chapter 1 of the book Thinking Person Weight Loss & Exercise Program. Email► Due on Feb 5 Begin your unfolding storyboard.  Create the title page and start data collection before you implement any changes.  Storyboard►	"What do you know?" about leading change Due on Feb 5 Analyze data for leading change lecture Due on Feb 5
Feb 5	Read more about and listen to lecture on cycles of improvement  More► Read about and listen to lecture on 92 quality improvement efforts.  More►	Review the questionnaires available for doing satisfaction surveys (1-2 pages).  See Medline bibliography.  More about CAHPS.   Bibliography► CAHPS► Minute Survey►	Describe life processes.  Take a scientific approach to accomplishing your resolution.  Start by understanding your habits and events that trigger them.  Make   sure you are aware of how you live and how various parts of your life are interconnected.  You can learn how to use lists and flow charts to describe your life style by reading Chapter 5.  Read► Complete Table 3 and Figure 2 in Chapter 1 of the book Thinking Person Weight Loss & Exercise Program. Email►Due on Feb 12 See examples of system changes introduced by others.  Examples►	"What you know?" about change cycles Due on Feb 12   Analyze data for change cycles Due on Feb 12
Feb 12	Read more about, listen to lecture on and see video on time between charts More►	Describe who, what, where, when the survey will be done (4-5 pages).  Think through sampling issues.  Example►  More►	List possible changes & select solutions. Make sure that you come up with more than one solution.  Wait and do not rush into a decision.  Select several solutions at once and bring about multiple changes in your environment.  Keep in mind that we are   looking for system solutions and not a renewed or increased effort.  We want you to succeed by changing your environment and not your motivation.   Read about system change in chapter 3.  Read► Check if your solutions are system changes by completing Table 4 in the book Thinking Person Weight Loss & Exercise Program.  Email► Due on Feb 19	Analyze data for time between charts  Due on Feb 19
Feb 19	Read more about and listen to lecture on risk assessment  More►	Obtain sample data from the instructor.  Assume this is the data you would have received if you had collected it yourself.  Show how the data will be analyzed (2-3 pages).  Include the table of data, the charts produced from the table and describe the method of analysis.  Make sure that you describe time to dissatisfied customer and not average satisfaction of patients.  Data►	Monitor progress.  You need data to see if changes you have introduced have led to improvement.  Learn about data collection and analysis in Chapters 6 of the book Thinking Person Weight Loss & Exercise Program. If you relapse to old habits, keep asking yourself what led to it and what needs to change to reduce future relapses.  Read►	"What do you know?" about risk assessment Due on Feb 26
Feb 26	Read more about, listen to lecture on and see videos on probability charts and risk adjusted probability charts  More►	Email instructor your draft report.  Obtain a copy of the report of another student and comment on it using the rubric provided.  Contact your instructor if you need additional time. Due on Mar 4.   Rubric► Email►	Engage in cycles of improvement.  Plan for, do, check and act again.  Go through cycles of changing your environment and checking to see if it has led to better lifestyle.  For more details see workbook in Chapter 1 of the book Thinking Person Weight Loss & Exercise Program. Read►	Analyze data for probability charts Due on Mar 4
Mar 4	Read more about and listen to lecture on effective teams More►	Prepare media that will promote your plan using the voice of the customer.  Obtain feedback from others within the organization, other students and the instructor.  Make corrections to your plans.	Tell your story. By now you have made  an unfolding storyboard.  Email first draft of personal improvement storyboard.  Storyboard► Email► Due on Mar 18	"What you know?" about teamwork Due on Mar 18
Mar 18	Read more about, listen to lecture on and see videos of X-bar charts and risk adjusted Xbar charts  More►		Continue monitoring progress.  Engage in additional cycles of improvement.  Continue posting your data to your personal storyboard.	Analyze data using X-bar charts Due on Mar 25
Mar 25	Read more about and listen to lecture on psychology of change More►	Prepare your final report.  Discuss why time to dissatisfied customer is more informative than average rating of satisfaction.  Discuss the relationship between data collection and improvement teams.	Continue monitoring progress.  Continue posting your data to your personal storyboard.	What do you know about psychology of change?  Due on Apr 1
Apr 1	Read more about and listen to lecture on benchmarking  More►	Read how to talk about quality without making people defensive.  More►	Continue monitoring progress.  Engage in additional cycles of improvement.  Continue posting your data to your personal storyboard.	What do you know about benchmarking  Due on Apr 8
Apr 8	Read more about, listen to lecture on and see videos of  XmR charts  More►		Continue monitoring progress.  Continue posting your data to your personal storyboard.	Analyze data with XmR charts  Due on Apr 15
Apr 15	Read more about, listen to lecture on and see videos of Tukey chart  More►	Plan to present your work to your sponsor around  this date.  Send to your instructor the project's final report and the project's media.  If your group needs to make an exception, please contact the instructor.  Email►	Continue monitoring progress.  Continue posting your data to your personal storyboard.	Analyze data with Tukey charts  Due on Apr 22
Apr 24	Improvement of the Year Award.  The banquet will be held at Marriott International on April 24, 2008 at 7 p.m. The location is 3111 Fairview Park Drive, Falls Church, VA 22042.			Analyze more data using various charts  Due on Apr 29
Apr 29	Read more about and listen to lecture on rapid change  More► Play the jeopardy game for process improvement  Jeopardy►		Projects are due on this date.  If you need to make an exception, please contact the instructor. Email►
	Online students (even if they attend some or all classes) are asked to evaluate the course online.  The university will send you an email.  Face to face students are asked to evaluate the course using paper forms available at end of class.
	Download take home final exam after May 6th due on May 13	Send a thank you letter from the instructor to your sponsor. Complete course exit and personal improvement exit interviews.   Letter► Course exit► Personal improvement exit►

Enter Your Email Address

If you are enrolled in this course, you would receive weekly communications from the course faculty.  In order to make sure that you receive the information on time, please provide us with your email address.  More►

More Information

This is an open environment course.  Faculty and students from other universities are welcomed to use this course.  Do not assume that comments and questions you see are from your classmates.  For more information send email to Farrokh Alemi, Ph.D.  More► 

Honor Code

“To promote a stronger sense of mutual responsibility, respect, trust, and fairness among all members of the George Mason University community and with the desire for greater academic and personal achievement, we, the student members of the university community, have set forth this honor code: Student members of the George Mason University community pledge not to cheat, plagiarize, steal, or lie in matters related to academic work” (George Mason University Catalog, 2006-2007, p. 31).

Disability Accommodations

If you are a student with a disability and you need academic accommodations, please contact the Disability Resource Center.  At George Mason University, contact Debbie Wyne and the Disability Resource Center at 703 993-2474.  All academic accommodations must be arranged through the Disability Resource Center.

George Mason University is committed to complying with the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 by providing reasonable accommodations for disabled applicants for admission, students, applicants for employment, employees, and visitors. Applicants for admission and students requiring specific accommodations for a disability should contact the Disability Resource Center at 703-993-2474, or the Equity Office at 703-993-8730. Applicants for employment and employees should contact Human Resources at 703-993-2600 or the Equity Office. Students and employees are responsible for providing appropriate documentation and requesting reasonable accommodation in a timely manner (George Mason University Catalog, 2006-2007, p. 55).

Recently Asked Questions

Ask your question and we will post your answer here.  Alternatively read answers to questions asked by others. 

Question: I just registered to attend an Industry Solutions Webinar - Addressing Electronic Health Record Privacy and Compliance Challenges through HIMSS, will this count as my event? I can't find any events in this area.   Answer: Yes it probably will, please send an email to your instructor about it and see if she will accept it.   This question was asked on 3/6/2008 10:46:09 PM and answered on 3/7/2008 7:01:58 AM.

Question: One of the requirements for the class is to join and professional organization and attend one of their events. If you have done so already, what do we need to do so we can get credit?  Answer: You need to attend a Professional organization's session or participate actively in organization of a session and email the instructor that you have done so.  This question was asked on 2/22/2008 1:48:13 PM and answered on 2/22/2008 3:04:24 PM.

Question: If Bathesba's mailbox is over quota, should we email the assignments to your email address?  Answer: Please do so.  This question was asked on 2/12/2008 11:57:05 PM and answered on 2/13/2008 8:08:09 AM.

Question: With regards to joining a professional organization, what kind of "proof" would you be looking for that we have joined and/or participated in an activity (if possible or available) during the period of the semester?  Answer: Your word is what is needed. But the activity must be a professional activity that makes sense to me and you need to tell me what it is.   This question was asked on 2/6/2008 9:46:12 AM and answered on 2/6/2008 9:49:08 AM.

Question: I understand what you meant about we need to change our environment and not blame people but blame the system, BUT what if you have the perfect system in place but you just don't want to do what you have to do because you were forced to operate in that system? What then? Do you then blame the person or is it still the system? For example, if I want to loose weight and I put myself in an environment where everyone eats healthy foods and I make up a system "lifestyle" where I exercise everyday, but one day I just get tired and say forget this, this is too much work I really don't want to do this anymore. Is that the person or the system? Can you ever just chalk it up to someone being lazy or stubborn?  Answer: Yes you can hold people and yourself accountable but when you do you are judging one instance in a long series of events. When you look at patterns across time, you see that motivation waivers and you then look for factors in the environment that affect one's motivation.   This question was asked on 1/31/2008 9:01:25 PM and answered on 2/1/2008 7:17:07 AM.

Question: about this weeks lecture, you talked about external and internal environmental changes that effects the current system of a negative habit. can the system be changed only with external forces or it must be external as well as internal?  Answer: Yes of course both sets of factors matter, but to achieve sustainable change, lasting change, one always needs to change more than internal motivation and make sure that external environmental changes also change.  This question was asked on 1/31/2008 1:41:17 PM and answered on 1/31/2008 4:29:56 PM.

Question: I had submitted a question regarding the use of MS Excel prior to the last class. However, I did not fully understand the process: therefore, my question was not received. My question started out with a statement that I have a basic understanding of creating tables, columns, rows, formatting,etc. I also have no problems with the addition, subtraction, multiplication or division functions built into Excel. However, I am concerned about the equations necessary for statistical analysis required in the course. I have not been exposed to algebra in over twenty years. Since the last class meeting I have discovered that GMU offers free training on various applications such as Excel, Word, Access, etc. via ittraining.gmu.edu. So I basically answered my own question by doing a little research but believe that this information may be beneficial to other students.  Answer: Good point, thanks for sending this in.  This question was asked on 1/30/2008 4:05:16 PM and answered on 1/30/2008 8:36:35 PM.

Question: Please clarify what you mean by "the importance of examining time to dissatisfied customers" in the literature review section. Thank you.   Answer: Time to dissatisfaction is a new method of analysis of data. I will send you a paper on it within the next two weeks.  This question was asked on 1/30/2008 12:18:59 PM and answered on 1/30/2008 8:35:44 PM.

Question: The syllabus says 'first discuss your intent with the instructor and then update and send a letter of introduction to the project sponsor". i understood this to mean that I need to meet with you to clarify what I propose to do before sending the letter to the sponsor org. But your answer to the last question suggests that this is not necessarily so... that we can simply send out the letter. Can I would like to meet with you first, and get my ducks lined up, before sending out the letter?  Answer: Yes please let me know first.  This question was asked on 1/28/2008 5:39:51 PM and answered on 1/29/2008 9:00:14 PM.

Question: The syllabus says 'first discuss your intent with the instructor and then update and send a letter of introduction to the project sponsor". i understood this to mean that I need to meet with you to clarify what I propose to do before sending the letter to the sponsor org. But your answer to the last question suggests that this is not necessarily so... that we can simply send out the letter. Can I would like to meet with you first, and get my ducks lined up, before sending out the letter?  Answer: Yes please let me know first.  This question was asked on 1/28/2008 5:39:39 PM and answered on 1/29/2008 8:59:48 PM.

Suggestions for Improvements

Add your own suggestions or read below suggestions made by others regarding how to improve this session:

Suggestion: I am recognizing the TQM process at work. This class is really informative and incredibly useful in the workplace.   This comment was left on 2/15/2008 8:24:21 AM.

Suggestion: It was very helpful to get the feedback on what you felt were the most appropriate answers to the homework assignments. This is a good way to help reinforce our own critical thinking skills and open us to other tangents that we may not have yet discovered in the TQM process. I am really enjoying the class.   This comment was left on 2/12/2008 2:34:48 PM.

Suggestion: excelent   This comment was left on 2/6/2008 1:06:17 AM.

Suggestion: I didn't like this class....we didn't even spend sufficient amount of time on the lecture. It was a waste of time. I wish some questions were asked after class such as how to work things in excel or alot of input about job experience that wasn't relevant. The class needs to be controlled more...when people ask questions like that Dr. Alemi should say see me after class instead of using up other students time for irrelevant things. Is it possible for Dr. Alemi to mark on the syllabus which lectures would be beneficial for us to show up to class to because I know some material can be difficult.   This comment was left on 2/4/2008 9:13:24 PM.

Suggestion: I am really excited about this class and look forward to learning more about process improvement.   This comment was left on 2/4/2008 8:03:28 AM.

Suggestion: I have forwarded some information about an available download to create .pdf files. It specifies for Office 2007, but I would think there should be something available.   This comment was left on 2/3/2008 9:42:25 PM.

Suggestion: The course is very stimulating and thought provoking. It is interesting to take the concept of one's own personal improvement and break it down to a system level.   This comment was left on 2/3/2008 9:39:48 PM.

Suggestion: The lecture was good this week. It helped to clarify a few questions. Looking forward to a fun semester!   This comment was left on 2/1/2008 5:20:22 PM.

Suggestion: the hands on experience during your lecture was excellent way to ensure the appropriate way of describing problems in the organization. Thank you   This comment was left on 1/30/2008 12:23:13 PM.

Suggestion: It was good to see that the in class lecture provided same content as on-line course. I am more comfortable about making my decision to do the on-line section and am glad that I have opportunity to go to class as needed.   This comment was left on 1/26/2008 9:29:57 AM.

This page is part of the course on Quality / Process Improvement, the section on "About the course."  It was first created in 1996.  It was last edited on 08/29/2007 by Farrokh Alemi, Ph.D.  © Copyright protected.