Monitoring and Learning from Variation in the Process

AFTER THE LAUNCH OF YOUR ORDER SETS AND PROTOCOLS: JUST THE BEGINNING!

• The protocol does not adequately address the special needs of a given patient.
• Old physician habits/ignorance/unwillingness to change.
• The order set/protocol is too hard to use.
• More familiar, well-known, or simpler routes to order insulin are available.

Your goal should be to continually modify the protocol to address valid issues on ease of use and individual patient needs. Look and listen for this feedback. Solicit it. You should give your own feedback and apply peer pressure to reduce undesirable variability that stems from physician style.

TASK: Devise methods to track deviation from your protocol. Revise your protocol on the basis of feedback from users and patient needs.