Design and Development of Daily Morning Surgical Rounds in ICU by Quality Function Deployment.

Abstract

Most healthcare quality improvement projects focus on change management rather than the design of the process. In this article, we describe the development of a new rounding model based on quality function deployment, a Design for Six Sigma tool. We used affinity diagram, focus groups, and Kano analysis to identify critical customer requirements. We also used Kano analysis to determine the design team's ability to meet the requirements. We then completed a correlation matrix (House of Quality). Fifteen quality characteristics were analyzed on a correlation matrix to meet 15 demanded qualities. Numerical values were calculated based on the interactions identified by the design team. We designed a new rounding model based on the House of Quality; this new rounding model resulted in higher provider satisfaction (median 76-80%, P = 0.06). We have described a sophisticated approach to the design of a new change strategy/intervention. This technique can be used as a starting point for other projects attempting to implement meaningful changes for complex processes of medical care.