Case study in using value stream mapping in online graduate education.

Given the rise in demand for online, graduate degree programs there is a need to guide program planning and evaluation professionals within institutions of higher education to utilize continuous quality improvement (CQI) strategies. Using principles of design thinking and CQI, the purpose of this case study was to describe a CQI project that sought to develop a better understanding of adult students' experience progressing through their plan of study in an online doctoral program. As part of the CQI project, value stream mapping (VSM) was used to gain visibility and perspective on the actions required by faculty and staff to guide students through their plan of study. The VSM process provided information that led to conversations that furthered the CQI efforts and led to changes in the adult education program that would benefit all students. Improvement processes that lead to better quality and more positive experiences for users are valuable. This case study demonstrates the processes, challenges, lessons, and future directions in the use of VSM to better understand online graduate programs designed for adult learners.

Do We Make a Difference? The Effect of a Doctor of Physical Therapy Program Curriculum on Student Cultural Competence.

INTRODUCTION: Doctor of Physical Therapy (DPT) education programs have been charged with developing a culturally competent health care workforce to better meet the needs of diverse communities and reduce health inequities. The purpose of this longitudinal, quasi-experimental educational intervention study was to examine the effects of an integrated DPT program curriculum on student cultural competence at a public, midsize, midwestern university. REVIEW OF LITERATURE: There is an abundance of research on conceptual models and frameworks for the development of cultural competence within health care education with many studies relying on self-perception to measure outcomes. Using the Model of Interculturalization as a theoretical framework, this study explored the development of cultural competence among DPT students using the Intercultural Development Inventory (IDI). SUBJECTS: A purposeful convenience sample of DPT students ( n = 177) was used. METHODS: The IDI was administered to 3 student cohorts. One cohort had data at 4 different time points, including upon entry into the program (baseline) and at the end of the first, second, and third year. Two cohorts had data for 2 time points. IDI Developmental Orientation (DO) and Orientation Gap (OG) scores were used to measure cultural competence and accuracy of self-perception of cultural competence. Data analysis was performed using descriptive statistics, independent and dependent sample t -tests, and analysis of variances. RESULTS: There were no differences between the cohorts. There were statistically significant improvements in both cultural competence (DO scores) and accuracy of self-perception of cultural competence (OG scores) for 2 cohorts. However, significant change only occurred during year 1. No other differences across time for any of the cohorts were significant. DISCUSSION AND CONCLUSION: Findings can be leveraged and incorporated into recommendations for curricular revision and program reform targeting cultural competence development among DPT students.

Applying quality improvement strategies within Canadian population health promotion.

This article describes how quality improvement (QI) methodology was applied to partnership work in a population health promotion unit within a health care system. Using Kolb's experiential model of learning, we describe and reflect on our experience as a population health promotion unit working on a QI initiative focused on community partnerships for intersectoral collaboration. We identify contextual factors that can guide QI for population health promotion work. The three main lessons we identified were to (i) frame the need for improvement effectively, (ii) start by setting the conditions for others to lead and (iii) be people-focused as well as process-focused. Health care systems can apply QI methods to improve and strengthen their role in working with partners to improve population health. By sharing our experience with other practitioners, we hope to find support and allies as we learn together to improve quality in population health promotion settings.

Quality improvement as a population health promotion opportunity to reorient the healthcare system.

BACKGROUND: A quality improvement (QI) focus in systems strategically investing resources to achieve the Quadruple Aim (i.e., better population health, lower system costs, improved patient care, and an engaged and productive workforce) presents an opportunity to reorient health services towards population health promotion. SETTING: An interdisciplinary team linked across a large regionalized healthcare system engaged in a (Saskatoon) Region-wide 90-day QI initiative focused on patient safety. INTERVENTION: The team worked directly with healthcare teams to link cultural safety, patient-centeredness, and health equity to other dimensions of healthcare quality. The team provided data from health status reports, equity analyses of healthcare utilization, and stakeholder consultations and adapted QI methods, including A3 thinking and Plan-Do-Check-Act (PDCA) cycles. OUTCOMES: Throughout the 90 days, use of the terms "health equity" and "cultural safety" increased among healthcare teams and in region-wide communications. Within the year following the initiative, the Region made public and ongoing commitments to address health inequities. IMPLICATIONS: System-wide QI initiatives present opportunities to promote population health approaches, shift perspectives and language, and ultimately influence organizational culture. Learnings are relevant to health promotion practitioners attempting to engage healthcare partners, and for health systems strategically investing for improved population health.