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Week5hcs451 presentation1
- 1. E-Manual SignatureAssignment Ana JacobsLPN HCS-451 May02, 2016 Professor JacquelineSommerville
- 2. Core Concepts: Overview Basic concepts of quality improvement and risk management in the health care industry
- 3. CQI and Risk Management Core Concepts • PHI: Data and information • Electronic Medical Record • Risk Management • CQI Plan Do ActStudy
- 4. Six Quality Dimensions (Sollecito& Johnson, 2013). Purpose Quality management (CQI) Timely, Effective, Patient centered; Efficient, Equitable, Safety. The six quality dimensions are a model for quality control measures for patient care.
- 5. PDSACycle (Sollecito& Johnson,2013). Purpose Quality management (CQI) Plan - Do – Study –Act. The PDSAcycle helps Quality Control Managers to plan and implement changes that are short term or long term; effectively deliver quality care to patients.
- 6. S.W.O.T.Analysis (Sollecito& Johnson, 2013). Purpose Strengths Weakness Opportunities and Threats. S.W.O.TAnalysis: Atool utilized by QM to assess internal and external organizational factors that affect patient care negatively or positively. Risks are effectively managed based on this risk assessment tool. Risk Management
- 7. StatisticalAnalysis, Benchmarking, Customer Satisfaction Measures (Sollecito& Johnson, 2013). Tools utilized by QM to assess quality in the delivery of care and further manage risks in health care. Surveys are utilized for the purpose of assessing patient’s perception about quality and safety. Surveys assist with planning and Risk Management. Purpose
- 8. SevenCQITools Seven Continuous Quality Improvement Tools I. Flowcharts II. Cause-and-effect diagrams, III. Histograms, IV. Pareto charts, V. Run charts, VI. Control charts VII. Regression analysis (Haas, Swan & Haynes, 2014).
- 9. SevenToolsof CQI (Sollecito& Johnson, 2013). Purpose The seven tools gives CQI management effective strategies to measure, assess, and analyze data. For example: the charts and diagrams reflect data extracted from PHI within the E.H.R and E.M.R. the information is used to make changes that are necessary to achieve improvement goals; and adhere to state and federal laws and regulations that govern patient care. Quality management (CQI)
- 10. Reporting Incidents In health care, incident reports are tools that are used as a part of research and root cause analysis. Reports identify what the problem and nature of an incident, accident or complaint is.An incident/accident report is one of the first attempts of communicating any occurrence of system failure that are due to technical, equipment related; or involves issues with patient care. Root CauseAnalysis will also include an in depth investigation of independent or dependent variables, along with the incident report. (Sollecito & Johnson, 2013).
- 11. Summary Data Collection Continuous Quality Improvement Risk Management Data assessment Patient Health Information Health Information Systems Electronic Medical Record Electronic Health Record
- 12. References Agency for Health Care Research and Quality.AHRQ (2016).The Six Domains of Health Care Quality. Retrieved from website onApril 29, 2016 from: https://cahps.ahrq.gov/consumer reporting/talkingquality/create/sixdomains.html Haas, S., Swan, B., Haynes, T. (2014). Care Coordination andTransition Management (CCTM) Core Curriculum text (1). (2014). Pitman, NJ, US:AmericanAcademy ofAmbulatory Care Nursing. Retrieved from http://www.ebrary.com Sollecito, W.A., & Johnson, J.K. (2013). McLaughlin and Kalunzy’s continuous quality improvement in health care (4th ed.). Burlington, MA: Jones & Bartlett Learning. Langley G.J., Moen R.D., & Nolan K.M. (2009).The improvement guide:Apractical approach to enhancing organizational performance (2nd ed.). Hoboken, NJ: Jossey-Bass.
Editor's Notes
- An online learning tool (e-manual) for Continuous Quality Improvement and Risk Management. Core concepts overview CQI and Risk Management: Core concepts Six quality dimensions PDSA Cycle SWOT Analysis Statistical Analysis, Benchmarking, Customer Satisfaction Measures Seven CQI Tools Seven CQI Tools (cont’d) Reporting Incidents Summary References
- Core concepts in Quality Improvement and Risk management are adding value to customer service while controlling costs, adding value to an improved experience; improving the health status of patients. Another core concept is reducing per capita costs. (Sollecito & Johnson, 2013). Elements of effective quality control and risk management are structural, philosophical, and health specific. Core concepts are based on the Six Domains of Health Care Quality and Patient Rights, which will be further touched upon later in this on-line learning manual. “Safe: Avoiding harm to patients from the care that is intended to help them. Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively). Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care. Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy. Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.“ (cahps.ahrq.gov, 2016).
- Organizations utilize CQI and Risk Management in health care not only for customer satisfaction. Accreditation requirements are assessed, cost containment. competition; added pressure from shareholders and employers are various reasons facilities use quality control teams and risk managers. (Sollecito & Johnson, 2013). Continuous quality improvement focuses on customer satisfaction with a philosophical baseline as well as methodological processes such as risk management protocol / procedures. Risk management is paired with CQI, in the process of maintaining best practices in the delivery of health care to the patient population. Tools are necessary to identify, assess, and measure system failures or risks; in order to achieve the best outcomes for patient - centered care - while also meeting regulatory requirements and organizational objectives. The PDSA (plan-do-study-act )cycle, Statistics, and the Seven Tools of CQI are examples of structural elements. Teamwork, organizational learning and customer strategic focus (patient – centered care), are philosophical elements. Risk adjustment outcome measures; epidemiological studies; and medical records/data are examples of health specific elements in CQI. Health information systems (E.M.R/E.H.R.) and data extracted from patient health information are the main tools necessary in Risk Management strategies.
- The six dimensions are used as a guide, and direction for quality control standards. The six dimensions assist with directing the CQI team and health care workers with quality and risk management initiatives for health care that is satisfactory from the customer point of view. Training staff in each area of the six dimensions is ongoing and continuous. If there are barriers in the process it can be challenging. Every area needs to be stressed as being important to deliver quality care with a focus on “patient – centeredness.” (Sollecito & Johnson, 2013).
- The PDSA cycle is used by health care organizations as a starting point when planning the implementation of a system for quality control measures. Planning can be the most difficult phase. Everyone must cooperate for a plan to be effectively carried out. All of the initial efforts for planning have a domino effect on whether or not a goal will be accomplished – the best interest of the patient has to be kept first and foremost in mind throughout all of the phases. Plan- Do –Study- Act (PDSA) • Consider what you want to accomplish • Implement measures to assess when changes become an improvement • Predict what changes will bring improvement • Testing improvements • Learning from testing the improvements • Learn from data collected • Sustainable Risk Management • Negative results – what to do • Review processes for quality and risk management. What can you do better? (Sollecito & Johnson, 2013).
- The SWOT analysis can be used to plan strategies to achieve goals. Identify strengths that support any weaknesses within an organization. Eliminate any weakness by making necessary adjustments or changes. Determine threats and utilize opportunities to engage and collaborate with shareholders, and affiliates any common goals or interests. Data can become obsolete and outdated. Data and information is gathered from a subjective point of view. The information will often times reflect the bias of individuals involved in the decision making process. (Sollecito & Johnson, 2013).
- Statistics are a number #1 tool in CQI and Risk Management. By analyzing statistical data, information is obtained to make important decisions and improvements on the delivery of care to patients. Statistics, surveys, benchmarking; are all effective research tools that help Risk Managers to identify negative trends, or pinpoint a problem. Each individual customer has a different opinion on what their perception of quality is. That needs to be kept in mind with the use of surveys for measuring customer satisfaction. Quality can be difficult to define, and gauge because of differences of opinions.
- There is a great advantage to using the seven CQI Tools. These tools give a visual map of measurements for critical analysis during specific times – that can be compared against each other to assess, and discover needs. The measurements can determine if goals are actually being met efficiently. The information has to be collected accurately to capture the best picture; also, analyzed from a professional in depth perspective. The flowcharts and other tools can give a shorter look (hours, days, weeks) at benchmarks, and scores or a longer outlook in (months to annually). Accurate predictions are needed to map out a goal, or institute a plan.
- Incident reports give a clear and accurate picture of the problem. A date, time, detailed documentation enable Risk Managers to group together similar incidents for the implementation of quality control measures to rectify a small problem and prevent it from becoming a major problem. For example: a ‘skin assessment’ sheet is a form of incident reporting for wound care nurses. New skin tears, and bruises are documented in detail with measurements for follow up by a treatment/wound care nurse or team. The skin assessment sheets are also reviewed by a Risk Manager, or QI team for the purpose of 1) identifying the cause and 2) preventing future incidents or risks of the patient acquiring any skin tears. Incident and accident reports have to be consistent with information that is not conflicting if more than one report is filled out for the same incident or occurrence. Investigations involving patient neglect and abuse incidents can be lengthy – over an extended period of time. The domino effects of adverse and negative findings of incident reports – depending on the situation - may be prolonged over an extended period of time whenever there is an immediate need to replace staff. Measurements for a new skin tear or open area must be consistently measured using the same method and treated.
- Learning opportunities, in-services that are required; and continued education for employees include the use of online manuals communicated in the form of published manuals, and power point presentations. Individual on - line education that is self paced is another way health care organizations use health information systems to promote best practices. Data collection continues to be the main tool for effective risk management strategies in health care today. Core concepts in continuous quality improvements include team work; and overcoming barriers that present challenges for a health care team such as: cultural differences conflicting interests poor communication – or lack of communication Tools that are utilized in CQI teams for the purpose of managing risks are Data and patient information Plan –Do-Study-Act Statistics, benchmarking, measurements SWOT Analysis Seven CQI Tools Incident Reporting, Root Cause Analysis, and Research The purpose of continuous quality improvement / risk management are to implement measures that give assurance to patients and their families that they are receiving the safest care possible; while remaining compliant with regulatory requirements that are issued to providers of health care services by local, state, and federal agencies. CQI and Risk Managers instill values in health care employees that reflect the use of best practices as it applies to the delivery of patient care at all times in the workplace.