Improvement Interventions and the IOM Aims for Quality: STEEP-7
Discussion
The STEEEP-7 analysis is in its infancy and has not been evaluated using projects or interventions outside of the organization where it was developed. It has been tested only on a limited number of projects and improvement interventions. However, its early use has been promising and well received based on verbal feedback by organizational administrators, nursing managers, and faculty and graduate students at the school of nursing who have seen or used the tool. Of note, although the tool has not undergone formal evaluation, it is currently being provided to Doctor of Nursing Practice students for use and feedback during a translation of evidence course in the spring 2016 semester.
This tool was developed in a similar format to the FMEA. Like the FMEA, while there is a quantification of the analysis, the underlying scoring is based upon subjective elements and determinations of the individuals using the tool. This individualization may lead to outcome variations specific to a group’s subjectivity, but it also provides a quantification that would not exist otherwise.
The tool is also flexible. For example, it may be used without scoring (i.e., qualitative format only), with scoring only on the STEEEP elements (i.e., omitting the sustainability component), or with full STEEEP-7 scoring.
Conclusions
The STEEEP-7 is a tool that may be used to assist in the evaluation of improvement interventions against the IOM quality aims. It has been used successfully with interprofessional groups to make decisions on selecting the most appropriate improvement intervention, meeting organizational goals, and ensuring measurable comparison to the IOM aims for improvement.
As with all tools, more user friendliness is better. As such, the STEEEP-7 has been converted to a Microsoft® Excel® file for ease of storage and scoring calculation. Please contact Shea Polancich if you have interest in using the STEEEP-7 in Excel format.
Shea Polancich has been practicing in quality and patient safety for over a decade. She is currently an assistant professor at the University of Alabama at Birmingham (UAB) School of Nursing with a primary practice at the UAB Medical Center as a director specializing in nursing improvement and data analytics. Formerly, her roles included the director for quality and patient safety at Vanderbilt University Medical Center, director of data analysis and measurement at Texas Health Resources, NIH/NINR research intern, and health policy fellow at George Mason University. She served on an NQF advisory group specific to patient safety and adverse events and may be contacted at polancs@uab.edu.
Terri Poe is the chief nursing officer (CNO) and senior vice president at UAB Hospital, where she served as director of emergency services for over five years before becoming CNO in August 2014. Her degrees include Bachelor of Nursing, Master of Public Administration, and Doctor of Nursing Practice, all from UAB. She has a Nurse Executive Board Certification. Poe is the president of the Birmingham Regional Organization of Nurse Leaders and president of the Alabama chapter of the American Organization of Nurse Executives. She may be contacted at terripoe@uabmc.edu.
Rebecca (Suzie) Miltner is an assistant professor at the UAB School of Nursing and a nurse scientist at the Birmingham VA Medical Center. She completed a post-doctoral fellowship with the VA National Quality Scholars Program as well as an executive fellowship in patient safety at Virginia Commonwealth University. She has extensive clinical and leadership experience in military, private, and VA acute care settings as well as experience in nursing education in both academic and organizational settings. Her research areas of interest are the quality of nursing care in acute care settings, practice variation in bedside nursing, and the science of quality measurement. She teaches in the nursing administration and Doctor of Nursing Practice graduate programs at the UAB School of Nursing. She may be contacted at smiltner@uab.edu.
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