Wecanuseoutcomemeasurestoidentifywhether the mostbeneficial and leastharmfuloutcome is beingmet, whenbeingappliedtohealthcare provision.The main concern is to ensurethat the services provided are of the highest possible standard and meet theneeds of those included in the microsystem.Adapted from:American College of Emergency Physicians, (2011). Quality of care and the outcomes management movement . Retrieved December 15, 2011, from Clinical Practice & Management : http://www.acep.org/content.aspx?id=30166World Health Organisation. (2006). Quality of care: a process for making strategic choices in health systems. Geneva: WHO Press.
Image sourced from: Mohr JJ, Barach P, Cravero JP, Blike GT, Godfrey MM, Batalden PB, Nelson EC: Microsystems in Health Care: Part 6. Designing Patient Safety into the Microsystem.The Joint Commission Journal on Quality and Safety. Volume 29 (8):401-408
What does patient focused care encompass and why is it an important factor when determining the level/quality of care provided?Meet the changing needs of individual patients as these people’s conditions, self management skills, and desires change over timeInformation sourced from: Mohr JJ, Barach P, Cravero JP, Blike GT, Godfrey MM, Batalden PB, Nelson EC: Microsystems in Health Care: Part 6. Designing Patient Safety into the Microsystem.The Joint Commission Journal on Quality and Safety. Volume 29 (8):401-408Godfrey MM, Nelson EC, Wasson JH, Mohr JJ, Batalden PB: Microsystems in Health Care: Part 3. Planning Patient-Centered Services. The Joint Commission Journal on Quality and Safety. Volume 29 (4):159-170. Reprinted with PermissionA-M. J. Audet, K. Davis, S. C. Schoenbaum, Adoption of Patient-Centered Care Practices by Physicians, Archives of Internal Medicine, April 10, 2006 166(7):75459
Why is the prevention/reduction of readmission an important factor and measure in the outcome quality of care??Adapted from:Minott, J. (n.d.). Reducing Hospital Readmissions. Retrieved from Academy Health: http://www.academyhealth.org/files/publications/Reducing_Hospital_Readmissions.pdfMurphy, M, E. &Noetscher, C, M. Reducing hospital inpatient lengths of stay.Journal of Nursing Care Quality. 1999 November; Spec No: 40–54.
An important factor in regards to the issue of reducing length of stay is improving levels of care so that patients recover more quickly..Adapted from:Institute for Innovation and Improvement. (2006). Length of stay- Improving length of stay. Retrieved December 16, 2011, from Fundamentals in quality improvement: http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/length_of_stay.html
Adapted from:Crede, W., & Hierholzer, W. (1988). Mortality rates as a quality indicator: A simple answer to a complex question. Infection control and hospital epidemiology, 9(7), 330-332.
STATEMENT OF THE PROBLEM:The deficits in quality of health care have been documented and made evident within the current research. Yet there is little research on the sustainability of the tools and methods in place to improve the quality of the outcome in the long term.. METHODS etc:The clinic redesigned processes of care to intentionally improve referrals to Psychologists, for the patients that are referred to their clinic. The percentages of patients being referred in relation to their mental health assesment scores, were followed over a period of The initiative was accepted by the centre however, there were severalelements that influenced the decline of the referrals, after the increase in referrals (13months) after the initial implementation of the redesigned processes, then slowly decreased for the next 18 months.. The rate stabilised at slightly higher than the previous referal rate, yet it was not significant. It is reported that a lot of work and effort went into the process initiative but there are several factors that influenced the decline of referals back to the pre-initiative figure.. “Slowly faded into the background as other improvement initiatives emrged” change over of staff & loss of initiative of the staff to keep up with the redesigned process to improve patient referral rates & reports for the study dataArticle: Homa, K. (2006). Evaluating the sustainability of a quality improvement model. Dartmouth College.Image sourced from:http://www.t-m-partners.net/&docid=-W6kj5YKMCr6wM&imgurl=http://www.t-m-partners.net/tmpbiz/Portals/19/improving_quality_4.jpg&w=330&h=329&ei=Q07rTqfaCqL_4QS086SXCQ&zoom=1
Initial broad spectrum orientation search
Outcomes of Quality care
What is quality of care? Patient ReadmissionfocusedLength of Morbidity & stay Mortality Outcome measures
Patient focused Establish patient & Empowerment family partnerships SafetyEducation Support disclosure Coordination of care & truth around medical error Respect Partnership Meet the changing needs of individualParticipation patients Autonomy
Readmission Primary contact Places pressurePatient Satisfaction on all systems CostsEfficiency Does not support patient centred Care co-ordination care Education Education/access to primary care Pressure on the system facilities
Length of stay Patient Satisfaction Higher risk of hospital acquiredPlanning infection Financial Burden Affects both the Hospital & microsystem Co-ordination of care PatientHospital Acquired Infection satisfaction
Morbidity & Mortality Morbidity is often a Mortality is generallycontributing factor to accepted as an adverseincreasing the risk of outcome of care Mortality Satisfaction within the microsystems are generally affected negatively by the impact of Morbidity & Mortality
What next?ARTICLEEvaluating the Sustainability of a Quality Improvement Initiative Karen Homa, Ph.D.
The Process – How did we get here? Isolation and Brainstorming Orientation delegation of and organisation search topics for further of information research