An introductory overview of the basic concepts of Healthcare Quality, a starter for beginners.
Prepared in 2014 for the new staff of the Quality Management Department in King Saud University Medical City in Riyadh as a part of their capacity building plan.
Acknowledgments:
*Dr. Magdy Gamal Yousef, MBBCh, MS, CPHQ - for his contribution in the scientific content
**Ms. Maram Baksh, MS, CPHQ - for the design of the full HCQ capacity building plan in KSUMC
This presentation tells us about what are the medication errors and how we differentiate between them as per the National Accreditation Board for Hospital & Healthcare Providers standard for hospitals 5th Edition.
Presentation contains detailing details of medication error.
Some GIFs may not be seen.
Healthcare organizations including hospitals were founded to give care to those who need it and to keep patients safe.
It is generally agreed upon that the definition of patient safety is…
"DO NO HARM"
An introductory overview of the basic concepts of Healthcare Quality, a starter for beginners.
Prepared in 2014 for the new staff of the Quality Management Department in King Saud University Medical City in Riyadh as a part of their capacity building plan.
Acknowledgments:
*Dr. Magdy Gamal Yousef, MBBCh, MS, CPHQ - for his contribution in the scientific content
**Ms. Maram Baksh, MS, CPHQ - for the design of the full HCQ capacity building plan in KSUMC
This presentation tells us about what are the medication errors and how we differentiate between them as per the National Accreditation Board for Hospital & Healthcare Providers standard for hospitals 5th Edition.
Presentation contains detailing details of medication error.
Some GIFs may not be seen.
Healthcare organizations including hospitals were founded to give care to those who need it and to keep patients safe.
It is generally agreed upon that the definition of patient safety is…
"DO NO HARM"
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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How many patients does case series should have In comparison to case reports.pdfpubrica101
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Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
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In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
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8. What is Quality
The Institute of Medicine defines quality as:
"The degree to which health care services increase the
probability of desired health outcomes and are
consistent with current professional knowledge of best
practice."
9. Accreditation
– Usually a voluntary process by which
a government or non-government
agency grants recognition to health
care institutions which meet certain
standards SHANGRI-LA HOSPITAL
El Dorado, Republic of Freedonia
Paul
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Wils
on
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10. What Is a Standard?
A statement of the
safety And quality
expected
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11. Components of Standards
1
2
Standard ACC.1.1
Patients with emergent, urgent, or immediate needs are given priority for assessment and treatment.
Intent of ACC.1.1
Whether in the emergency department or outpatient urgent/immediate care clinic, patients with emergent,
urgent, or immediate needs are identified by a recognized triage process. Included in the triage process is
the early recognition of the signs and symptoms of communicable diseases.1–3 Once identified as emergent,
urgent, or requiring immediate needs, these patients are assessed and receive care as quickly as necessary.
Patients identified with potential communicable diseases are segregated and/or isolated as needed. (Also see
PCI.8, ME 2) Patients may be assessed by a physician or other qualified individual before other patients,
receive diagnostic services as rapidly as possible, and begin treatment to meet their needs.
The triage process may include physiologic-based criteria, where possible and appropriate. The hospital trains
staff to determine which patients need immediate care and how their care is given priority. When the hospital
is not able to meet the needs of the patient with an emergency condition and the patient requires transfer to
a higher level of care, the transferring hospital must provide and document stabilizing treatment within its
capacity prior to transport.
Measurable Elements of ACC.1.1
1. The hospital uses a recognized triage process that includes early recognition of communicable diseases,
to prioritize patients with immediate needs. (Also see PCI.8.2, ME 2)
2. Staff are trained to use the criteria.
3 3. Patients are prioritized based on the urgency of their needs.
4. Emergency patients are assessed and stabilized within the capacity of the hospital prior to transfer.
(Also see COP.1)
5. Stabilizing treatment provided prior
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12. Hospital Standards
6th Edition Chapters
Patient-Centered Standards
– International Patient Safety Goals
– Access to Care and Continuity of Care
– Patient and Family Rights
– Assessment of Patients
– Care of Patients
– Anesthesia and Surgical Care
– Medication Management and Use
– Patient and Family Education
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13. Hospital Standards
6th Edition Chapters
Health Care Organization Management
Standards
– Quality Improvement and Patient Safety
– Prevention and Control of Infections
– Governance, Leadership, and Direction
– Facility Management and Safety
– Staff Qualifications and Education
– Management of Information
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14. Hospital Standards
6th Edition Chapters
Academic Medical Center Standards*
– Medical Professional Education
– Human Subjects Research Programs
*only applicable to hospitals that meet JCI’s eligibility criteria for the
Academic Medical Center Hospital accreditation program.
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15. Accreditation Preparation Process
Cre te New prcesses Monitor Progress and Adjust
Develop and implement new
policies, plans, and procedures
Evaluate effectiveness of
processes and
refine as necessary
18-24 Months
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16. The Accreditation Journey
First Steps
. Evaluate and support the commitment of
the leadership
. The board or governance team,
. The CEO and the executive team
. Clinical leaders
. Middle managers
The organization that succeeds best is the
organization with a committed leadership
team
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17. The Accreditation Journey
. Education of the standards is key
. To all levels of leadership
. Clinical and non clinical services
. Physician staff, nursing and allied health
. Contracted services
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18. The Accreditation Journey:
Baseline Assessment
Determine the organization’s current adherence to the
standards and each measurable element.
. Use the tracer methodology
. Stay away from a check list
. Develop your Chapter teams to do tracers
. Cite specific findings and recommendations.
. Include all areas of the organization in the assessment.
. Start to map out what is missing to meet the standard
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19. The Accreditation Journey
Action Planning
Using the findings of the baseline assessment, develop a
detailed project plan with assigned responsibilities,
deliverables, and timeframes.
. Example: Revise informed consent policy, develop a
new informed consent statement, educate staff by 30
August. Responsibility: One Person
. Action plan should identify the issue, the possible
solution, the time frame and implementation plan, by
who or which team
. List all barriers and strengths to success and plan
strategies for each
. Hold leaders and staff accountable to plan.
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20. The Accreditation Journey
Policies and Procedures
In addition to an overall project plan, it is often helpful to
compile a list of all required policies and procedures that
will need development or revision.
. It may take more time than you think to write, have
organizational review, and get final approval on policies.
. Be certain that your policy reflects your actual practice.
This is how surveyors will evaluate your organization.
. Plan time for education of new policies. Test
understanding and compliance.
. Create, refine and/or test your document management
system. (Policy on Policies)
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22. Culture of Safety
.Also known as a safe culture,
.a collaborative environment in which skilled clinicians treat
each other with
•respect,
•effective teamwork
•promote psychological safety
•learn from errors and near misses, caregivers are
•aware of the inherent limitations of human performance in
complexsystems (stress recognition), and
•there is a visible process of learning and driving
improvement
23. Elements of a Culture of Safety
Shared beliefs and values about the health care delivery system
Recruitment and training with patient safety in mind
Organizational commitment to detecting and analyzing patient
injuries and near misses
Open communications regarding patient injuries
Establishment of a just culture
26. CORE CONCEPTS
• CULTURE OF SAFETY
• PROACTIVE REISK ASSESSMENT
• MEASUREMENTS
• STANDERDIZATION OF PRACTICE
• EVIDENCE BASED BRACTICE
• DATA DRIVEN DECISIONS