Leading for Quality in Healthcare:
Development and Validation of a
Competenqr Model
Andrew Garman, PsyD, MS, CEO, National Center for Healthcare Leadership,
and professor, health systems management. Rush University; and Linda Scribner,
BA, CPHQ, director of quality and clinical outcomes management, Methodist
Dallas Medical Center
E X E C U T I V E S U M M A R Y
Increased attention to healthcare quality and impending changes due to health
reform are calling for healthcare leaders at all levels to strengthen their skills in
leading quality improvement initiatives. To address this need, the National Asso-
ciation for Healthcare Quality spearheaded the development and validation of a
competency model to support healthcare leaders in assessing their strengths and
planning appropriate steps for development. Initial development took place over
the course of several days of meetings by an advisory panel of quality profession-
als. The draft model was then validated via electronic survey of a national sample
of 883 quality professionals. Follow-up analyses indicated that the model was
content valid for each of the target samples and also distinguished differing levels
of job scope and experience. The resulting model contains six domains spanning
three organizational levels.
For more information on the concepts in this article, please contact Dr. Carman
at [email protected] or [email protected]
373
JOURNAL OF HEALTHCARE MANAGEMENT 5 6 : 6 N O V E M B E R / D E G E M B E R 2 0 1 1
I N T R O D U C T I O N
As delivery of high-quality healthcare
continues to grow more complex, so
do the roles of the professionals lead-
ing these efforts. Recent years have seen
increased focus on the leadership ele-
ments ofthe quality professionals' roles;
initiatives such as the Comprehensive
Unit-Based Safety Program (CUSP; Pro-
novost et al. 2005), crew resource man-
agement. Lean Six Sigma, and Malcolm
Baldrige emphasize the key elements
of leadership and management needed
for success (see Carman et al. 2011).
Civen the impending changes associated
with the Affordable Care Act, leaders are
likely to be charged with implementing
these quality improvement initiatives
within a context of increasing emphasis
on resource efficiency. While the oppor-
tunities to improve may be tremendous,
threading the value needle will likely
test the mettle of all leaders of quality
efforts in the years to come.
In preparation for this new era for
the quality professional, the National
Association of Healthcare Quality
(NAHQ) began an initiative to investi-
gate the leadership development needs
ofthe profession. Their efforts yielded
a competency model that is specific to
leadership in quality and holds implica-
tions for professionals across the career
path. Development and validation of
this model are described in the follow-
ing section.
METHOD
Development of the competency model
began in lune 2008. Members ofthe
NAHQ board agreed to serve as the
advisory panel for developing a ...
Competency Validation: An Advisory Board ApproachAPI Healthcare
Over the past decade competency has gone from buzzword to requirement in healthcare. The Joint Commission, along with federal and state regulatory agencies, has increasingly focused on staff competency with each coming year. Why this focus on competency?
The document summarizes a study that examined intersections between quality initiatives and sustainability best practices in 10 Wisconsin enterprises. The study found many parallels between quality and sustainability approaches, including senior management support, employee engagement, and use of awards programs. Differences included quality initiatives having broader deployment while sustainability initiatives were more project-based. The study reinforced findings from previous ASQ research on links between quality, social responsibility, and organizational success.
This study examined the formative impact of general practice appraisals through a questionnaire given to GPs who had undergone appraisal at a primary care trust in Wessex, UK. The study found that appraisals increased GPs' confidence, improved patient care, and contributed to delayed retirement. Appraisals helped identify clear and achievable learning goals in areas like clinical skills, practice management, and personal development. Regular appraiser training and experience with multiple appraisals helped increase GPs' comfort with the process. The study provides insight into the educational benefits of appraisals when separated from revalidation requirements.
Outcome Measures Issues Opportunities in Healthcare Organizations.docxsdfghj21
The document provides guidance for a 6-page report on outcome measures, issues, and opportunities in healthcare organizations. It outlines competencies the report should demonstrate, such as analyzing quality outcomes from an administrative perspective and determining how organizational functions affect measures. The report should identify relevant outcomes and measures, performance issues, and a strategy for change using a model. Resources are provided on quality improvement, measures, and writing.
International Journal of Engineering Research and Development (IJERD)IJERD Editor
This document describes research conducted to develop and validate a tool to measure total quality management (TQM) practices in organizations. Through a literature review, 13 critical factors of TQM were identified. A questionnaire with 85 items measuring these factors was developed and tested on 20 organizations to evaluate reliability and validity. Reliability was high based on Cronbach's alpha scores. Validity was confirmed through factor analysis and a multitrait-multimethod matrix. The validated tool was used to survey 104 manufacturing and service organizations in India and compare their TQM practices using the Mann-Whitney U non-parametric test. Significant differences were found between the sectors.
This document discusses quality assurance and continuous quality improvement in healthcare. It defines quality assurance and continuous quality improvement, and outlines the differences between the two approaches. Quality assurance focuses on inspection and reaction, while continuous quality improvement emphasizes prevention and proactive problem solving involving all levels. The document also covers the objectives, principles, approaches, elements, standards, areas of focus, models, tools and process for quality assurance and improvement in healthcare.
As hospitals and health systems continue managing the transition to delivering greater value to patients and populations in the midst of reimbursement degradation, legal and regulatory changes, industry consolidation, and massive workforce demographic shifts, the role and impact of talent management and succession planning practices have come under greater scrutiny. In order to proactively prepare for the unprecedented departure of executive talent while also developing future leaders to address the many implications of the Affordable Care Act, including much greater pressure to demonstrate the value of healthcare services via clinical quality metrics, many hospital organizations have invested in the development of talent management and succession planning capabilities.
This webinar presents findings and practical applications from the semi-annual Healthcare Talent Management Survey, which provides HR executives and senior management teams with direct evidence of the impact of talent management and succession planning capabilities on hospitals’ financial, workforce, and value-based purchasing performance metrics. Webinar participants will learn a practical framework of best practices across a series of capabilities, including talent assessment, role-based leadership development, and onboarding practices. The webinar will conclude with presentation of several case studies highlighting the execution of talent management and succession planning best capabilities at prominent health systems.
This document discusses reliability and validity, which are two important concepts for evaluating data collection methods in human services. Reliability refers to the consistency and dependability of measurements or assessments, and there are different types of reliability such as inter-rater reliability and test-retest reliability. Validity refers to whether a measurement or assessment accurately measures what it claims to measure. The document emphasizes that reliability and validity are crucial for human services to obtain accurate information through effective data collection methods when evaluating programs and services.
Competency Validation: An Advisory Board ApproachAPI Healthcare
Over the past decade competency has gone from buzzword to requirement in healthcare. The Joint Commission, along with federal and state regulatory agencies, has increasingly focused on staff competency with each coming year. Why this focus on competency?
The document summarizes a study that examined intersections between quality initiatives and sustainability best practices in 10 Wisconsin enterprises. The study found many parallels between quality and sustainability approaches, including senior management support, employee engagement, and use of awards programs. Differences included quality initiatives having broader deployment while sustainability initiatives were more project-based. The study reinforced findings from previous ASQ research on links between quality, social responsibility, and organizational success.
This study examined the formative impact of general practice appraisals through a questionnaire given to GPs who had undergone appraisal at a primary care trust in Wessex, UK. The study found that appraisals increased GPs' confidence, improved patient care, and contributed to delayed retirement. Appraisals helped identify clear and achievable learning goals in areas like clinical skills, practice management, and personal development. Regular appraiser training and experience with multiple appraisals helped increase GPs' comfort with the process. The study provides insight into the educational benefits of appraisals when separated from revalidation requirements.
Outcome Measures Issues Opportunities in Healthcare Organizations.docxsdfghj21
The document provides guidance for a 6-page report on outcome measures, issues, and opportunities in healthcare organizations. It outlines competencies the report should demonstrate, such as analyzing quality outcomes from an administrative perspective and determining how organizational functions affect measures. The report should identify relevant outcomes and measures, performance issues, and a strategy for change using a model. Resources are provided on quality improvement, measures, and writing.
International Journal of Engineering Research and Development (IJERD)IJERD Editor
This document describes research conducted to develop and validate a tool to measure total quality management (TQM) practices in organizations. Through a literature review, 13 critical factors of TQM were identified. A questionnaire with 85 items measuring these factors was developed and tested on 20 organizations to evaluate reliability and validity. Reliability was high based on Cronbach's alpha scores. Validity was confirmed through factor analysis and a multitrait-multimethod matrix. The validated tool was used to survey 104 manufacturing and service organizations in India and compare their TQM practices using the Mann-Whitney U non-parametric test. Significant differences were found between the sectors.
This document discusses quality assurance and continuous quality improvement in healthcare. It defines quality assurance and continuous quality improvement, and outlines the differences between the two approaches. Quality assurance focuses on inspection and reaction, while continuous quality improvement emphasizes prevention and proactive problem solving involving all levels. The document also covers the objectives, principles, approaches, elements, standards, areas of focus, models, tools and process for quality assurance and improvement in healthcare.
As hospitals and health systems continue managing the transition to delivering greater value to patients and populations in the midst of reimbursement degradation, legal and regulatory changes, industry consolidation, and massive workforce demographic shifts, the role and impact of talent management and succession planning practices have come under greater scrutiny. In order to proactively prepare for the unprecedented departure of executive talent while also developing future leaders to address the many implications of the Affordable Care Act, including much greater pressure to demonstrate the value of healthcare services via clinical quality metrics, many hospital organizations have invested in the development of talent management and succession planning capabilities.
This webinar presents findings and practical applications from the semi-annual Healthcare Talent Management Survey, which provides HR executives and senior management teams with direct evidence of the impact of talent management and succession planning capabilities on hospitals’ financial, workforce, and value-based purchasing performance metrics. Webinar participants will learn a practical framework of best practices across a series of capabilities, including talent assessment, role-based leadership development, and onboarding practices. The webinar will conclude with presentation of several case studies highlighting the execution of talent management and succession planning best capabilities at prominent health systems.
This document discusses reliability and validity, which are two important concepts for evaluating data collection methods in human services. Reliability refers to the consistency and dependability of measurements or assessments, and there are different types of reliability such as inter-rater reliability and test-retest reliability. Validity refers to whether a measurement or assessment accurately measures what it claims to measure. The document emphasizes that reliability and validity are crucial for human services to obtain accurate information through effective data collection methods when evaluating programs and services.
Best Practices of Total Quality ManagementImplementation in .docxikirkton
Best Practices of Total Quality Management
Implementation in Health Care Settings
FAISAL TALIB
Mechanical Engineering Section, University Polytechnic, Faculty of Engineering and
Technology, Aligarh Muslim University, Aligarh, India
ZILLUR RAHMAN and MOHAMMED AZAM
Department of Management Studies, Indian Institute of Technology Roorkee,
Roorkee, India
Due to the growing prominence of total quality management
(TQM) in health care, the present study was conducted to identify
the set of TQM practices for its successful implementation in
healthcare institutions through a systematic review of literature.
A research strategy was performed on the selected papers published
between 1995 and 2009. An appropriate database was chosen and
15 peer-reviewed research papers were identified through a
screening process and were finally reviewed for this study. Eight
supporting TQM practices, such as top-management commitment,
teamwork and participation, process management, customer focus
and satisfaction, resource management, organization behavior
and culture, continuous improvement, and training and educa-
tion were identified as best practices for TQM implementation in
any health care setting. The article concludes with a set of recom-
mendations for the future researchers to discuss, develop, and work
upon in order to achieve better precision and generalizations.
KEYWORDS health care institutions, total quality management,
TQM implementation, TQM practices
Address correspondence to Faisal Talib, Assistant Professor, Mechanical Engineering
Section, University Polytechnic, Faculty of Engineering and Technology, Aligarh Muslim
University, Aligarh-202002, Uttar Pradesh, India. E-mail: [email protected]
Health Marketing Quarterly, 28:232–252, 2011
Copyright # Taylor & Francis Group, LLC
ISSN: 0735-9683 print=1545-0864 online
DOI: 10.1080/07359683.2011.595643
232
INTRODUCTION
The health care and medical services are growing immensely due to a high
influx of the private sector, changing disease patterns, medical tourism,
and demographic variations. Development of new and advanced techniques,
increased awareness on patient’s safety, intensity of competition in health
care market, and new generation of purchasers and providers have forced
the health care institutions to improve the efficiency and introduce a
consumer culture in their institutions for effective cost and quality of care
(Mosadegh Rad, 2005; Lee, Ng, & Zhang, 2002; Short, 1995). Quality of care
is the vital issue for every health care institution and there is an immediate
need for health care reforms in order to address and resolve the problems
associated with quality of care, as well as patient preferences, safety, and
choice (Koeck, 1997). Another critical issue is the consistently increasing
operating costs of health care institutions. Rising health care expenditures
have created serious financial burdens for the ex-chequer (government
department in charge of national revenue or national ...
The mission statement sets the direction and priority for developing and implementing the quality plan. It clearly states the nature of the organization’s commitment to quality and should then be tied to the organizational operations through programs, projects, actions and rewards/recognition.
This document summarizes the updated Health Leadership Competency Model 3.0 from the National Center for Healthcare Leadership. The model was revised based on input from hundreds of healthcare leaders through interviews, focus groups, and surveys. The updated model contains 4 "action" domains related to direct leadership work (Execution, Relations, Boundary Spanning, and Transformation) and 3 "enabling" domains related to professional development (Values, Health System Awareness & Business Literacy, and Self-Awareness & Self-Development). In total it includes 28 competencies organized to guide leadership development and assessment.
The document summarizes the National Center for Healthcare Leadership's (NCHL) updated Health Leadership Competency Model 3.0. The model is organized into 4 action domains (Execution, Relations, Transformation, Boundary Spanning) and 3 enabling domains (Health System Awareness & Business Literacy, Self-Awareness & Self-Development, Values). It includes 28 competencies across the domains. The revision involved interviews, focus groups, and surveys with healthcare leaders to validate changes from the prior version. The goal is to provide a framework to guide leadership development and performance.
Methods Of Program Evaluation. Evaluation Research Is OfferedJennifer Wood
This document discusses different approaches to evaluation research and program evaluation. It provides examples of different types of evaluation research, such as problem analysis, evidence-based policy, and evidence generation. It also discusses publication bias in medical informatics evaluation research and evaluates the training evaluation process for a dinner event. Key aspects of performance evaluations and the challenges associated with the performance evaluation process are outlined as well. Different participant-oriented approaches to evaluation like participatory evaluation, developmental evaluation, and empowerment evaluation are also presented.
Assessing Quality Outcome And Performance ManagementKelly Taylor
This document discusses the evolution of performance management from its origins to its current conceptualization and practice. It begins by defining performance management and outlining how the concept has changed over time from focusing on individual outputs and rewards to emphasizing a flexible, developmental process oriented around both individual and organizational goals. The document then examines different performance management approaches and how they have been applied in healthcare organizations to improve quality and outcomes through human resource interventions and performance indicators.
The Quality of Care Committee (QCC) at Arrowhead District Hospital implemented several strategies to improve healthcare quality, including:
1) Educating leadership and staff on quality initiatives, metrics, and processes.
2) Adopting best practices from other high-performing facilities through site visits and conferences.
3) Implementing crew resource management, rounding, and a just culture approach to reduce errors and improve safety.
As a result, Arrowhead saw a 25% reduction in mortality, improved scores, and shared their successes in publications.
Total quality management (TQM) is a methodology that aims to continually improve processes and quality by drawing on principles from various fields like behavioral sciences, data analysis, economics, and process analysis. TQM focuses on meeting and exceeding customer expectations through quality planning, assurance, and control throughout the project lifecycle. It considers factors like customer satisfaction, teamwork, and continuous improvement. The implementation of TQM principles can help organizations improve quality, productivity, and competitiveness.
DHA7002 Walden University Improving Healthcare Quality Discussion.pdfsdfghj21
The Quality of Care Committee (QCC) at Arrowhead District Hospital implemented several strategies to improve quality of care, including crew resource management, rounding, and a just culture approach to errors. As a result of these efforts, the hospital demonstrated significant improvements such as a 25% reduction in mortality and improved core measure scores. Key strategies that helped drive quality included engaging physicians in quality goals, overseeing credentialing, and adding a family member to the QCC.
QI PLAN PART 22QI PLAN PART 25Running head QI.docxamrit47
QI PLAN PART 2 2
QI PLAN PART 2 5
Running head: QI PLAN PART 2 1
QI Plan Part 2
This methodology is chosen because in performance improvement it entails satisfactory of the patients, the process of delivery and improvement of the processes. The quality improvement (QI) is identified to focus on bringing out the gap in between the current levels of quality and the expected quality levels. The Quality Improvement uses the tools for managing quality together with the principles towards understanding and address systems deficiencies hence improving or re-designing efficiently the effective healthcare processes (Scales, 2014). Moreover, setting up a Quality Improvement process is termed to be an easy task but in order to integrate these processes in day to day activities, there have to be effective implementation via the leadership dedication, empowering of the employees, the healthy culture of business and the effectiveness of strategic planning that management has been embraced along with the desired performances.
The information technology applications include the Hospital Admission Risk Prediction (HARP) and the Episheet. In terms of improving the performance area, the HARP aims in predicting the future events, creating the intervention mechanism to the health care providers and generating the information regarding patient risk within future framework (Scales, 2014). The other application tool named Episheet is a qualitative tool which is applied in epidemiologic data analysis. It will help improve the performance area through gathering of the information and ensuring the priority of the healthcare organization.
In order to meet the performance improvement plan, innovation technology has to be considered in all applications. The IT applications are applied in an object oriented technology as well as in a computerized patient records systems and might also be used in the specific components of IT. Certainly, the object oriented technology would ensure that all different systems within the organization are connected and proper management (Hermann, 2005). The information technology entails the management of the patient’s records through computerization in order to prevent loss or from being accessed by the illegitimate persons. Furthermore, this aspect explores that for the use of the specific IT components, it is quite easy to monitor an organizational quality performance because the organization does not need change from the component directly to the other when delivering its services.
The quality indicators are identified as the guide to evaluation of the appropriate performance of an organization. The reason is that the performance is always evaluated continuously and at last at the end of the projects in a way that the organization carries out the process. Therefore, the benchmarks are termed as the programs as well as the operations which are set in order to make assessment of organizational performances. It is ideally ach ...
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
HS410 Unit 6 Quality Management - DiscussionDiscussionThi.docxAlysonDuongtw
HS410 Unit 6: Quality Management - Discussion
Discussion
This is a graded Discussion
. Please refer to the Discussion Board Grading Rubric in Course Home / Grading Rubrics.
Respond to all of the following questions and be sure to respond to two of your other classmates’ postings:
1.
What are the steps in the quality improvement model and how is benchmarking involved?
2. What are the stages in which data quality errors found in a health record most commonly occur?
3. What is the definition of risk management?
4. What are the parts of an effective risk management program?
5. What is utilization review and why is it important in healthcare?
6. What is the process of utilization review?
Please paper should be 400-500 words and in an essay format, strictly on topic, original with real scholar references to support your answers.
NO PHARGIARISM PLEASE!
This is the Chapter reading for this assignment:
Read Chapter 7 in
Today’s Health Information Management
.
INTRODUCTION
Quality health care “means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results.”1 The term quality, by definition, can mean excellence, status, or grade; thus, it can be measured and quantified. The patient, and perhaps the patient's family, may interpret quality health care differently from the way that health care providers interpret it. Therefore, it is important to determine—if possible—what is “right” and what is “wrong” with regard to quality health care. The study and analysis of health care are important to maintain a level of quality that is satisfactory to all parties involved. As a result of the current focus on patient safety, and in an attempt to reduce deaths and complications, providing the best quality health care while maintaining cost controls has become a challenge to all involved. Current quality initiatives are multifaceted and include government-directed, private sectorsupported, and consumer-driven projects.
This chapter explores the historical development of health care quality including a review of the important pioneers and the tools they developed. Their work has been studied, refined, and widely used in a variety of applications related to performance-improvement activities. Risk management is discussed, with emphasis on the importance of coordination with quality activities. The evolution of utilization management is also reviewed, with a focus on its relationship to quality management.
In addition, this chapter explores current trends in data collection and storage, and their application to improvements in quality care and patient safety. Current events are identified that influence and provide direction to legislative support and funding. This chapter also provides multiple tips and tools for both personal and institutional use.
DATA QUALITY
Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of.
Mh0059 – quality management in healthcare servicessmumbahelp
DRIVE WINTER 2013
PROGRAM MBA/MBAHCSN3 - Sem 4 / PGDHSMN - Sem 2
SUBJECT CODE & NAME MH0059 – Quality Management in Healthcare Services
BK ID B1323
Credit and Max. Marks 4 credits; 60 marks
Common Competencies for AllHealthcare ManagersThe Healthc.docxpickersgillkayne
Common Competencies for All
Healthcare Managers:
The Healthcare Leadership
Alliance Model
MaryE. Stefl, PhD, professor and chair. Department of Health Care Administration,
Trinity University, San Antonio, Texas - - • .
E X E C U T I V E S U M M A R Y
Today's healthcare executives and leaders must have management talent sophisti-
cated enough to match the increased complexity of the healthcare environment.
Executives are expected to demonstrate measurable outcomes and effectiveness and
to practice evidence-hased management. At the same time, academic and profession-
al programs are emphasizing the attainment of competencies related to workplace
effeaiveness. The shift to evidence-based management has led to numerous efforts to
define the competencies most appropriate for healthcare.
The Healthcare Leadership Alliance (HLA), a consortium of six major profession-
al membership organizations, used the research from and experience with their indi-
vidual credentialing processes to posit five competency domains common among all
practicing healthcare managers: (1) communication and relationship management,
(2) professionalism, (3) leadership, (4) knowledge of the healthcare system, and
(5) business skills and knowledge. The HLA engaged in a formal process to delin-
eate the knowledge, skills, and abilities within each domain and to determine which
of these competencies were core or common among the membership of all HLA
associations and which were specialty or specific to the members of one or more HLA
organizations. This process produced 300 competency statements, which were then
organized into the Competency Directory, a unique and interactive database that can
be used for assessing individual and organizational competencies. Overall this work
helps to unify the field of healthcare management and provides a lexicon and a basis
for collaboration among different types of healthcare executives.
This article discusses the steps that the HLA followed. It also presents the HLA
Competency Directory; its application and relevance to the practitioner and academ-
ic communities; and its strengths, limitations, and potential.
For more information on the concepts in this article, please contact Dr. Stefi at
[email protected]
360
COMMON COMPETENCIES FOR ALL HEALTHCARE MANAGERS
P eter Drucker (2002) has said thatlarge healthcare institutions may be
the most complex in human history and
that even small healthcare organiza-
tions are barely manageable. Some time
has passed since Drucker's observation,
but the complexity of healthcare orga-
nizations, along with the demands on
managers and leaders, has not dimin-
ished in any way. Today, executives in
all healthcare settings must navigate a
landscape influenced by complex social
and political forces, including shrinking
reimbursements, persistent shortages of
health professionals, endless require-
ments to use performance and safety
indicators, and prevailing calls for trans-
parency. Further, managers and.
The document discusses various approaches to quality improvement in healthcare, including Six Sigma, Total Quality Management (TQM), and the FADE model. Six Sigma uses statistical methods and aims for near-zero defect rates. TQM takes a customer-focused approach to continuous process improvement through methods like scientific problem-solving and participation at all levels. The FADE model outlines five steps for quality improvement projects: focus, analyze, develop, execute, and evaluate. Microsystems thinking views individual care units as the building blocks for organizational outcomes.
Measuring What Counts in HIS - Balanced ScorecardsSudhendu Bali
This study aimed to develop a balanced scorecard (BSC) for a tertiary care private university hospital in Pakistan using a modified Delphi technique. An expert panel of clinicians and hospital managers identified and rated potential performance indicators according to importance, scientific soundness, relevance to strategy, feasibility, and modifiability. Of an initial 50 indicators, the panel selected 20 indicators across the four BSC domains of financial, customer, internal processes, and learning/growth. The resulting scorecard will be implemented to monitor performance, address measurement issues, and enable benchmarking with other settings. This represents one of the first attempts to implement BSC in a low-income country hospital setting.
Exploratory factor analysis identified six key challenge dimensions of implementing hospital accreditation in Iran:
1) Implementation challenges, 2) Evaluation challenges, 3) Challenges related to accreditation content, 4) Structural challenges, 5) Psychological challenges, and 6) Managerial challenges. These six dimensions accounted for over 63.2% of the total variance among challenges. The scale used to assess challenges showed strong validity and reliability. Addressing these implementation challenges will be important for the successful deployment of hospital accreditation in Iran.
SAFE 1 - Introducing Quality Improvement - a presentation.pptxJABEED P
This document provides an introduction to quality improvement methods. It discusses key quality domains, defines quality improvement, and outlines some common QI tools like the Model for Improvement, PDSA cycles, driver diagrams, and stakeholder maps. Deming's profound knowledge theory emphasizes systems thinking, variation, psychology, and knowledge theory in quality improvement work. The document advocates applying these methods to assess and enhance microsystems of care delivery.
This document discusses critical success factors for implementing total quality management. It analyzes 14 TQM frameworks and identifies common critical success factors across the frameworks. Through frequency analysis of the frameworks, it determines that the top critical success factors are: top management commitment, quality culture, strategic quality management, design quality management, process management, supplier quality management, education and training, empowerment and involvement, information and analysis, and customer satisfaction. The document establishes these 10 factors as critical for successful TQM implementation based on their prevalence across the frameworks analyzed.
PART B Please response to these two original posts below. Wh.docxsmile790243
PART B
Please response to these two original posts below. When
responding to these posts, please either expand the
thought, add additional insights, or respectfully disagree
and explain why. Remember that we are after reasons
and arguments, and not simply the statement of
opinions.
Original Post 1
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
To begin, I would like to remind us that being intrinsically valuable
means having values for just being us and nothing else. I believe
that human lives are intrinsically valuable in virtue of our
uniqueness. As a bio nerd, I would like to state the fact that there
are a lot of crossover events during meiosis, which create trillions
of different DNA combinations. Hence, from a biological
standpoint, without considering other aspects, being you is
already valuable because you are that one sperm that won the
race and got fertilized. On a larger scale, there are hardly two
people whose look and behaviors are the same in the same
family, unless they are identical twins. However, identical twins
still act differently and have differences (such as fingerprints).
Since we are raised in different families, we are taught different
things and have different cultures. In general, we all have
different genetic information, appearances, personalities, senses
of humor, ambitions, talents, interests and life experiences. These
characteristics make up our “unique individual value” and make
us so unique and irreplaceable.
I would also love to discuss how our diversities enrich and
contribute to society, but that would be a talk about our extrinsic
values.
Original Post 2
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
I believe that human lives are intrinsically valuable due to a
number of reasons. Firstly, human lives aren’t replaceable. You
can’t replace a human being with another just like you can
replace a broken laptop with brand new one. Part of the reason
why we tend to think this way is that we were nurtured with the
notion that there is, indeed, a special value to human life. This
could be in virtue of our uniqueness-- the fact that we are
sentient and capable of complex thoughts and emotions
separates us from any other species on this planet. From a
scientific standpoint, this is also one of the reasons as to why
humans became the dominant species in today’s age.
Moreover, human lives aren’t disposable. I think this is largely due
to us humans having the ability to empathize with others. We
understand that it’s morally inappropriate to take the life of
another individual even if they’re complete strangers because
they’re another human being like us who has their own thoughts,
values, memories, and stories. In a way, we have a strong
emotional connection to our own species. As .
Part C Developing Your Design SolutionThe Production Cycle.docxsmile790243
Part C Developing Your Design
Solution
The Production Cycle
Within the four stages of the design workflow there are two distinct parts.
The first three stages, as presented in Part B of this book, were described
as ‘The Hidden Thinking’ stages, as they are concerned with undertaking
the crucial behind-the-scenes preparatory work. You may have completed
them in terms of working through the book’s contents, but in visualisation
projects they will continue to command your attention, even if that is
reduced to a background concern.
You have now reached the second distinct part of the workflow which
involves developing your design solution. This stage follows a production
cycle, commencing with rationalising design ideas and moving through to
the development of a final solution.
The term cycle is appropriate to describe this stage as there are many loops
of iteration as you evolve rapidly between conceptual, practical and
technical thinking. The inevitability of this iterative cycle is, in large part,
again due to the nature of this pursuit being more about optimisation rather
than an expectation of achieving that elusive notion of perfection. Trade-
offs, compromises, and restrictions are omnipresent as you juggle ambition
and necessary pragmatism.
How you undertake this stage will differ considerably depending on the
nature of your task. The creation of a relatively simple, single chart to be
slotted into a report probably will not require the same rigour of a formal
production cycle that the development of a vast interactive visualisation to
be used by the public would demand. This is merely an outline of the most
you will need to do – you should edit, adapt and participate the steps to fit
with your context.
There are several discrete steps involved in this production cycle:
Conceiving ideas across the five layers of visualisation design.
Wireframing and storyboarding designs.
Developing prototypes or mock-up versions.
219
Testing.
Refining and completing.
Launching the solution.
Naturally, the specific approach for developing your design solution (from
prototyping through to launching) will vary hugely, depending particularly
on your skills and resources: it might be an Excel chart, or a Tableau
dashboard, an infographic created using Adobe Illustrator, or a web-based
interactive built with the D3.js library. As I have explained in the book’s
introduction, I’m not going to attempt to cover the myriad ways of
implementing a solution; that would be impossible to achieve as each task
and tool would require different instructions.
For the scope of this book, I am focusing on taking you through the first
two steps of this cycle – conceiving ideas and wireframing/storyboarding.
There are parallels here with the distinctions between architecture (design)
and engineering (execution) – I’m effectively chaperoning you through to
the conclusion of your design thinking.
To fulfil this, Part C presents a detailed breakdown of the many design
.
More Related Content
Similar to Leading for Quality in HealthcareDevelopment and Validation.docx
Best Practices of Total Quality ManagementImplementation in .docxikirkton
Best Practices of Total Quality Management
Implementation in Health Care Settings
FAISAL TALIB
Mechanical Engineering Section, University Polytechnic, Faculty of Engineering and
Technology, Aligarh Muslim University, Aligarh, India
ZILLUR RAHMAN and MOHAMMED AZAM
Department of Management Studies, Indian Institute of Technology Roorkee,
Roorkee, India
Due to the growing prominence of total quality management
(TQM) in health care, the present study was conducted to identify
the set of TQM practices for its successful implementation in
healthcare institutions through a systematic review of literature.
A research strategy was performed on the selected papers published
between 1995 and 2009. An appropriate database was chosen and
15 peer-reviewed research papers were identified through a
screening process and were finally reviewed for this study. Eight
supporting TQM practices, such as top-management commitment,
teamwork and participation, process management, customer focus
and satisfaction, resource management, organization behavior
and culture, continuous improvement, and training and educa-
tion were identified as best practices for TQM implementation in
any health care setting. The article concludes with a set of recom-
mendations for the future researchers to discuss, develop, and work
upon in order to achieve better precision and generalizations.
KEYWORDS health care institutions, total quality management,
TQM implementation, TQM practices
Address correspondence to Faisal Talib, Assistant Professor, Mechanical Engineering
Section, University Polytechnic, Faculty of Engineering and Technology, Aligarh Muslim
University, Aligarh-202002, Uttar Pradesh, India. E-mail: [email protected]
Health Marketing Quarterly, 28:232–252, 2011
Copyright # Taylor & Francis Group, LLC
ISSN: 0735-9683 print=1545-0864 online
DOI: 10.1080/07359683.2011.595643
232
INTRODUCTION
The health care and medical services are growing immensely due to a high
influx of the private sector, changing disease patterns, medical tourism,
and demographic variations. Development of new and advanced techniques,
increased awareness on patient’s safety, intensity of competition in health
care market, and new generation of purchasers and providers have forced
the health care institutions to improve the efficiency and introduce a
consumer culture in their institutions for effective cost and quality of care
(Mosadegh Rad, 2005; Lee, Ng, & Zhang, 2002; Short, 1995). Quality of care
is the vital issue for every health care institution and there is an immediate
need for health care reforms in order to address and resolve the problems
associated with quality of care, as well as patient preferences, safety, and
choice (Koeck, 1997). Another critical issue is the consistently increasing
operating costs of health care institutions. Rising health care expenditures
have created serious financial burdens for the ex-chequer (government
department in charge of national revenue or national ...
The mission statement sets the direction and priority for developing and implementing the quality plan. It clearly states the nature of the organization’s commitment to quality and should then be tied to the organizational operations through programs, projects, actions and rewards/recognition.
This document summarizes the updated Health Leadership Competency Model 3.0 from the National Center for Healthcare Leadership. The model was revised based on input from hundreds of healthcare leaders through interviews, focus groups, and surveys. The updated model contains 4 "action" domains related to direct leadership work (Execution, Relations, Boundary Spanning, and Transformation) and 3 "enabling" domains related to professional development (Values, Health System Awareness & Business Literacy, and Self-Awareness & Self-Development). In total it includes 28 competencies organized to guide leadership development and assessment.
The document summarizes the National Center for Healthcare Leadership's (NCHL) updated Health Leadership Competency Model 3.0. The model is organized into 4 action domains (Execution, Relations, Transformation, Boundary Spanning) and 3 enabling domains (Health System Awareness & Business Literacy, Self-Awareness & Self-Development, Values). It includes 28 competencies across the domains. The revision involved interviews, focus groups, and surveys with healthcare leaders to validate changes from the prior version. The goal is to provide a framework to guide leadership development and performance.
Methods Of Program Evaluation. Evaluation Research Is OfferedJennifer Wood
This document discusses different approaches to evaluation research and program evaluation. It provides examples of different types of evaluation research, such as problem analysis, evidence-based policy, and evidence generation. It also discusses publication bias in medical informatics evaluation research and evaluates the training evaluation process for a dinner event. Key aspects of performance evaluations and the challenges associated with the performance evaluation process are outlined as well. Different participant-oriented approaches to evaluation like participatory evaluation, developmental evaluation, and empowerment evaluation are also presented.
Assessing Quality Outcome And Performance ManagementKelly Taylor
This document discusses the evolution of performance management from its origins to its current conceptualization and practice. It begins by defining performance management and outlining how the concept has changed over time from focusing on individual outputs and rewards to emphasizing a flexible, developmental process oriented around both individual and organizational goals. The document then examines different performance management approaches and how they have been applied in healthcare organizations to improve quality and outcomes through human resource interventions and performance indicators.
The Quality of Care Committee (QCC) at Arrowhead District Hospital implemented several strategies to improve healthcare quality, including:
1) Educating leadership and staff on quality initiatives, metrics, and processes.
2) Adopting best practices from other high-performing facilities through site visits and conferences.
3) Implementing crew resource management, rounding, and a just culture approach to reduce errors and improve safety.
As a result, Arrowhead saw a 25% reduction in mortality, improved scores, and shared their successes in publications.
Total quality management (TQM) is a methodology that aims to continually improve processes and quality by drawing on principles from various fields like behavioral sciences, data analysis, economics, and process analysis. TQM focuses on meeting and exceeding customer expectations through quality planning, assurance, and control throughout the project lifecycle. It considers factors like customer satisfaction, teamwork, and continuous improvement. The implementation of TQM principles can help organizations improve quality, productivity, and competitiveness.
DHA7002 Walden University Improving Healthcare Quality Discussion.pdfsdfghj21
The Quality of Care Committee (QCC) at Arrowhead District Hospital implemented several strategies to improve quality of care, including crew resource management, rounding, and a just culture approach to errors. As a result of these efforts, the hospital demonstrated significant improvements such as a 25% reduction in mortality and improved core measure scores. Key strategies that helped drive quality included engaging physicians in quality goals, overseeing credentialing, and adding a family member to the QCC.
QI PLAN PART 22QI PLAN PART 25Running head QI.docxamrit47
QI PLAN PART 2 2
QI PLAN PART 2 5
Running head: QI PLAN PART 2 1
QI Plan Part 2
This methodology is chosen because in performance improvement it entails satisfactory of the patients, the process of delivery and improvement of the processes. The quality improvement (QI) is identified to focus on bringing out the gap in between the current levels of quality and the expected quality levels. The Quality Improvement uses the tools for managing quality together with the principles towards understanding and address systems deficiencies hence improving or re-designing efficiently the effective healthcare processes (Scales, 2014). Moreover, setting up a Quality Improvement process is termed to be an easy task but in order to integrate these processes in day to day activities, there have to be effective implementation via the leadership dedication, empowering of the employees, the healthy culture of business and the effectiveness of strategic planning that management has been embraced along with the desired performances.
The information technology applications include the Hospital Admission Risk Prediction (HARP) and the Episheet. In terms of improving the performance area, the HARP aims in predicting the future events, creating the intervention mechanism to the health care providers and generating the information regarding patient risk within future framework (Scales, 2014). The other application tool named Episheet is a qualitative tool which is applied in epidemiologic data analysis. It will help improve the performance area through gathering of the information and ensuring the priority of the healthcare organization.
In order to meet the performance improvement plan, innovation technology has to be considered in all applications. The IT applications are applied in an object oriented technology as well as in a computerized patient records systems and might also be used in the specific components of IT. Certainly, the object oriented technology would ensure that all different systems within the organization are connected and proper management (Hermann, 2005). The information technology entails the management of the patient’s records through computerization in order to prevent loss or from being accessed by the illegitimate persons. Furthermore, this aspect explores that for the use of the specific IT components, it is quite easy to monitor an organizational quality performance because the organization does not need change from the component directly to the other when delivering its services.
The quality indicators are identified as the guide to evaluation of the appropriate performance of an organization. The reason is that the performance is always evaluated continuously and at last at the end of the projects in a way that the organization carries out the process. Therefore, the benchmarks are termed as the programs as well as the operations which are set in order to make assessment of organizational performances. It is ideally ach ...
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
HS410 Unit 6 Quality Management - DiscussionDiscussionThi.docxAlysonDuongtw
HS410 Unit 6: Quality Management - Discussion
Discussion
This is a graded Discussion
. Please refer to the Discussion Board Grading Rubric in Course Home / Grading Rubrics.
Respond to all of the following questions and be sure to respond to two of your other classmates’ postings:
1.
What are the steps in the quality improvement model and how is benchmarking involved?
2. What are the stages in which data quality errors found in a health record most commonly occur?
3. What is the definition of risk management?
4. What are the parts of an effective risk management program?
5. What is utilization review and why is it important in healthcare?
6. What is the process of utilization review?
Please paper should be 400-500 words and in an essay format, strictly on topic, original with real scholar references to support your answers.
NO PHARGIARISM PLEASE!
This is the Chapter reading for this assignment:
Read Chapter 7 in
Today’s Health Information Management
.
INTRODUCTION
Quality health care “means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results.”1 The term quality, by definition, can mean excellence, status, or grade; thus, it can be measured and quantified. The patient, and perhaps the patient's family, may interpret quality health care differently from the way that health care providers interpret it. Therefore, it is important to determine—if possible—what is “right” and what is “wrong” with regard to quality health care. The study and analysis of health care are important to maintain a level of quality that is satisfactory to all parties involved. As a result of the current focus on patient safety, and in an attempt to reduce deaths and complications, providing the best quality health care while maintaining cost controls has become a challenge to all involved. Current quality initiatives are multifaceted and include government-directed, private sectorsupported, and consumer-driven projects.
This chapter explores the historical development of health care quality including a review of the important pioneers and the tools they developed. Their work has been studied, refined, and widely used in a variety of applications related to performance-improvement activities. Risk management is discussed, with emphasis on the importance of coordination with quality activities. The evolution of utilization management is also reviewed, with a focus on its relationship to quality management.
In addition, this chapter explores current trends in data collection and storage, and their application to improvements in quality care and patient safety. Current events are identified that influence and provide direction to legislative support and funding. This chapter also provides multiple tips and tools for both personal and institutional use.
DATA QUALITY
Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of.
Mh0059 – quality management in healthcare servicessmumbahelp
DRIVE WINTER 2013
PROGRAM MBA/MBAHCSN3 - Sem 4 / PGDHSMN - Sem 2
SUBJECT CODE & NAME MH0059 – Quality Management in Healthcare Services
BK ID B1323
Credit and Max. Marks 4 credits; 60 marks
Common Competencies for AllHealthcare ManagersThe Healthc.docxpickersgillkayne
Common Competencies for All
Healthcare Managers:
The Healthcare Leadership
Alliance Model
MaryE. Stefl, PhD, professor and chair. Department of Health Care Administration,
Trinity University, San Antonio, Texas - - • .
E X E C U T I V E S U M M A R Y
Today's healthcare executives and leaders must have management talent sophisti-
cated enough to match the increased complexity of the healthcare environment.
Executives are expected to demonstrate measurable outcomes and effectiveness and
to practice evidence-hased management. At the same time, academic and profession-
al programs are emphasizing the attainment of competencies related to workplace
effeaiveness. The shift to evidence-based management has led to numerous efforts to
define the competencies most appropriate for healthcare.
The Healthcare Leadership Alliance (HLA), a consortium of six major profession-
al membership organizations, used the research from and experience with their indi-
vidual credentialing processes to posit five competency domains common among all
practicing healthcare managers: (1) communication and relationship management,
(2) professionalism, (3) leadership, (4) knowledge of the healthcare system, and
(5) business skills and knowledge. The HLA engaged in a formal process to delin-
eate the knowledge, skills, and abilities within each domain and to determine which
of these competencies were core or common among the membership of all HLA
associations and which were specialty or specific to the members of one or more HLA
organizations. This process produced 300 competency statements, which were then
organized into the Competency Directory, a unique and interactive database that can
be used for assessing individual and organizational competencies. Overall this work
helps to unify the field of healthcare management and provides a lexicon and a basis
for collaboration among different types of healthcare executives.
This article discusses the steps that the HLA followed. It also presents the HLA
Competency Directory; its application and relevance to the practitioner and academ-
ic communities; and its strengths, limitations, and potential.
For more information on the concepts in this article, please contact Dr. Stefi at
[email protected]
360
COMMON COMPETENCIES FOR ALL HEALTHCARE MANAGERS
P eter Drucker (2002) has said thatlarge healthcare institutions may be
the most complex in human history and
that even small healthcare organiza-
tions are barely manageable. Some time
has passed since Drucker's observation,
but the complexity of healthcare orga-
nizations, along with the demands on
managers and leaders, has not dimin-
ished in any way. Today, executives in
all healthcare settings must navigate a
landscape influenced by complex social
and political forces, including shrinking
reimbursements, persistent shortages of
health professionals, endless require-
ments to use performance and safety
indicators, and prevailing calls for trans-
parency. Further, managers and.
The document discusses various approaches to quality improvement in healthcare, including Six Sigma, Total Quality Management (TQM), and the FADE model. Six Sigma uses statistical methods and aims for near-zero defect rates. TQM takes a customer-focused approach to continuous process improvement through methods like scientific problem-solving and participation at all levels. The FADE model outlines five steps for quality improvement projects: focus, analyze, develop, execute, and evaluate. Microsystems thinking views individual care units as the building blocks for organizational outcomes.
Measuring What Counts in HIS - Balanced ScorecardsSudhendu Bali
This study aimed to develop a balanced scorecard (BSC) for a tertiary care private university hospital in Pakistan using a modified Delphi technique. An expert panel of clinicians and hospital managers identified and rated potential performance indicators according to importance, scientific soundness, relevance to strategy, feasibility, and modifiability. Of an initial 50 indicators, the panel selected 20 indicators across the four BSC domains of financial, customer, internal processes, and learning/growth. The resulting scorecard will be implemented to monitor performance, address measurement issues, and enable benchmarking with other settings. This represents one of the first attempts to implement BSC in a low-income country hospital setting.
Exploratory factor analysis identified six key challenge dimensions of implementing hospital accreditation in Iran:
1) Implementation challenges, 2) Evaluation challenges, 3) Challenges related to accreditation content, 4) Structural challenges, 5) Psychological challenges, and 6) Managerial challenges. These six dimensions accounted for over 63.2% of the total variance among challenges. The scale used to assess challenges showed strong validity and reliability. Addressing these implementation challenges will be important for the successful deployment of hospital accreditation in Iran.
SAFE 1 - Introducing Quality Improvement - a presentation.pptxJABEED P
This document provides an introduction to quality improvement methods. It discusses key quality domains, defines quality improvement, and outlines some common QI tools like the Model for Improvement, PDSA cycles, driver diagrams, and stakeholder maps. Deming's profound knowledge theory emphasizes systems thinking, variation, psychology, and knowledge theory in quality improvement work. The document advocates applying these methods to assess and enhance microsystems of care delivery.
This document discusses critical success factors for implementing total quality management. It analyzes 14 TQM frameworks and identifies common critical success factors across the frameworks. Through frequency analysis of the frameworks, it determines that the top critical success factors are: top management commitment, quality culture, strategic quality management, design quality management, process management, supplier quality management, education and training, empowerment and involvement, information and analysis, and customer satisfaction. The document establishes these 10 factors as critical for successful TQM implementation based on their prevalence across the frameworks analyzed.
Similar to Leading for Quality in HealthcareDevelopment and Validation.docx (20)
PART B Please response to these two original posts below. Wh.docxsmile790243
PART B
Please response to these two original posts below. When
responding to these posts, please either expand the
thought, add additional insights, or respectfully disagree
and explain why. Remember that we are after reasons
and arguments, and not simply the statement of
opinions.
Original Post 1
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
To begin, I would like to remind us that being intrinsically valuable
means having values for just being us and nothing else. I believe
that human lives are intrinsically valuable in virtue of our
uniqueness. As a bio nerd, I would like to state the fact that there
are a lot of crossover events during meiosis, which create trillions
of different DNA combinations. Hence, from a biological
standpoint, without considering other aspects, being you is
already valuable because you are that one sperm that won the
race and got fertilized. On a larger scale, there are hardly two
people whose look and behaviors are the same in the same
family, unless they are identical twins. However, identical twins
still act differently and have differences (such as fingerprints).
Since we are raised in different families, we are taught different
things and have different cultures. In general, we all have
different genetic information, appearances, personalities, senses
of humor, ambitions, talents, interests and life experiences. These
characteristics make up our “unique individual value” and make
us so unique and irreplaceable.
I would also love to discuss how our diversities enrich and
contribute to society, but that would be a talk about our extrinsic
values.
Original Post 2
Are human lives intrinsically valuable? If so, in virtue of what? (Is
it our uniqueness, perhaps, or our autonomy, or something else?)
I believe that human lives are intrinsically valuable due to a
number of reasons. Firstly, human lives aren’t replaceable. You
can’t replace a human being with another just like you can
replace a broken laptop with brand new one. Part of the reason
why we tend to think this way is that we were nurtured with the
notion that there is, indeed, a special value to human life. This
could be in virtue of our uniqueness-- the fact that we are
sentient and capable of complex thoughts and emotions
separates us from any other species on this planet. From a
scientific standpoint, this is also one of the reasons as to why
humans became the dominant species in today’s age.
Moreover, human lives aren’t disposable. I think this is largely due
to us humans having the ability to empathize with others. We
understand that it’s morally inappropriate to take the life of
another individual even if they’re complete strangers because
they’re another human being like us who has their own thoughts,
values, memories, and stories. In a way, we have a strong
emotional connection to our own species. As .
Part C Developing Your Design SolutionThe Production Cycle.docxsmile790243
Part C Developing Your Design
Solution
The Production Cycle
Within the four stages of the design workflow there are two distinct parts.
The first three stages, as presented in Part B of this book, were described
as ‘The Hidden Thinking’ stages, as they are concerned with undertaking
the crucial behind-the-scenes preparatory work. You may have completed
them in terms of working through the book’s contents, but in visualisation
projects they will continue to command your attention, even if that is
reduced to a background concern.
You have now reached the second distinct part of the workflow which
involves developing your design solution. This stage follows a production
cycle, commencing with rationalising design ideas and moving through to
the development of a final solution.
The term cycle is appropriate to describe this stage as there are many loops
of iteration as you evolve rapidly between conceptual, practical and
technical thinking. The inevitability of this iterative cycle is, in large part,
again due to the nature of this pursuit being more about optimisation rather
than an expectation of achieving that elusive notion of perfection. Trade-
offs, compromises, and restrictions are omnipresent as you juggle ambition
and necessary pragmatism.
How you undertake this stage will differ considerably depending on the
nature of your task. The creation of a relatively simple, single chart to be
slotted into a report probably will not require the same rigour of a formal
production cycle that the development of a vast interactive visualisation to
be used by the public would demand. This is merely an outline of the most
you will need to do – you should edit, adapt and participate the steps to fit
with your context.
There are several discrete steps involved in this production cycle:
Conceiving ideas across the five layers of visualisation design.
Wireframing and storyboarding designs.
Developing prototypes or mock-up versions.
219
Testing.
Refining and completing.
Launching the solution.
Naturally, the specific approach for developing your design solution (from
prototyping through to launching) will vary hugely, depending particularly
on your skills and resources: it might be an Excel chart, or a Tableau
dashboard, an infographic created using Adobe Illustrator, or a web-based
interactive built with the D3.js library. As I have explained in the book’s
introduction, I’m not going to attempt to cover the myriad ways of
implementing a solution; that would be impossible to achieve as each task
and tool would require different instructions.
For the scope of this book, I am focusing on taking you through the first
two steps of this cycle – conceiving ideas and wireframing/storyboarding.
There are parallels here with the distinctions between architecture (design)
and engineering (execution) – I’m effectively chaperoning you through to
the conclusion of your design thinking.
To fulfil this, Part C presents a detailed breakdown of the many design
.
PART A You will create a media piece based around the theme of a.docxsmile790243
PART A:
You will create a media piece based around the theme of “alternative facts.
Fake News:
Create a
series of 3
short, “fake news” articles or news videos. They should follow a specific theme. Make sure to have a clear understanding of WHY your fake news is being created (fake news is used by people, groups, companies, etc to convince an unsuspecting audience of something. It’s supposed to seem real, but the motivation behind it is to deceive. As part of this option, consider what your motivations are for your deception).
Part A: should be around 750 words for written tasks (or 250 for each 3 part task)
PART B:
The focus for this assignment is to demonstrate a
clear understanding of media conventions
, as well as
purpose
and
audience
. Therefore, along with your media product, you’ll also be required to submit a short
reflection
detailing why you created your product and for whom it was intended. You must discuss and analyze the elements within your media product (including why & how you used the persuasive techniques of ethos, logos and pathos) as well as the other elements of media you used and why.
.
Part 4. Implications to Nursing Practice & Implication to Patien.docxsmile790243
Part 4. Implications to Nursing Practice & Implication to Patient Outcomes
Provide a paragraph summary addressing the topics implications to nursing practice and patient outcomes. This section is NOT another review of the literature or introduction of new topics related to the PICOT question.
You may find if helpful to begin each topic with -
Nurses need to know …
Important patient outcomes include …
Example
– please note this is an older previous students work and so some references are older than 5 years.
Be sure to provide the PICOT question to begin this post.
PICOT Question:
P=Patient Population
I=Intervention
C=Comparison
O=Outcome
T=Time (duration):
In patients in the hospital, (P)
how does frequently provided patient hand washing (I)
compared with patient initiated hand washing (C)
affect hospital acquired infection (O)
within the hospital stay (T)
Implications to Nursing Practice & Patient Outcomes
Nurses need to know that they play a significant role in the reduction of hospital acquired infection by ensuring by health care workers and patients wash hands since nurses have the most interactions with patients. Implementing hand hygiene protocol with patients can enhance awareness and decrease healthcare associated infection (HAI). Both nurses and patients need to know that HAI is associated with increased morbidity and mortality as well cost of treatment and length of hospital stay. Nurses and patients also need to know that most HAI is preventable. Gujral (2015) notes that proper hand hygiene is the single most important, simplest, and least expensive means of reducing prevalence of HAI and the spread of antimicrobial resistance. Nurse and patient hand washing plays a vital role in decreasing healthcare costs and infections in all settings.
References
Gujral, H. (2015.) Survey shows importance of hand washing for infection prevention. American Nurse Today, 10 (10), 20. Retrieved from hEp://www.nursingworld.org/AmericanNurseToday
.
PART AHepatitis C is a chronic liver infection that can be e.docxsmile790243
PART A
Hepatitis C is a chronic liver infection that can be either silent (with no noticeable symptoms) or debilitating. Either way, 80% of infected persons experience continuing liver destruction. Chronic hepatitis C infection is the leading cause of liver transplants in the United States. The virus that causes it is blood borne, and therefore patients who undergo frequent procedures involving transfer of blood are particularly susceptible to infection. Kidney dialysis patients belong to this group. In 2008, a for-profit hemodialysis facility in New York was shut down after nine of its patients were confirmed as having become infected with hepatitis C while undergoing hemodialysis treatments there between 2001 and 2008.
When the investigation was conducted in 2008, investigators found that 20 of the facility’s 162 patients had been documented with hepatitis C infection at the time they began their association with the clinic. All the current patients were then offered hepatitis C testing, to determine how many had acquired hepatitis C during the time they were receiving treatment at the clinic. They were considered positive if enzyme-linked immunosorbent assay (ELISA) tests showed the presence of antibodies to the hepatitis C virus.
Health officials did not test the workers at the hemodialysis facility for hepatitis C because they did not view them as likely sources of the nine new infections. Why not?
Why do you think patients were tested for antibody to the virus instead of for the presence of the virus itself?
Ref.: Cowan, M. K. (2014) (4th Ed.). Microbiology: A Systems Approach, McGraw Hill
PART B
Summary:
Directions for the students: There are 4 essay questions. Please be sure to complete all of them with thorough substantive responses. Current APA Citations are required for all responses.
1. Precisely what is microbial death?
2. Why does a population of microbes not die instantaneously when exposed to an antimicrobial agent?
3. Explain what is wrong with this statement: “Prior to vaccination, the patient’s skin was sterilized with alcohol.” What would be a more correct wording?
4. Conduct additional research on the use of triclosan and other chemical agents in antimicrobial products today. Develop an opinion on whether this process should continue, providing evidence and citations to support your stance.
.
Part A post your answer to the following question1. How m.docxsmile790243
Potential negative reactions from others to an adolescent questioning their sexual identity or gender role could negatively impact their social environment, behavior, and self-esteem. As social workers, we can play a role in creating a supportive environment for these adolescents by educating families and communities, advocating for inclusive policies, and providing counseling and resources to help adolescents accept themselves and develop coping strategies.
PART BPlease response to these two original posts below..docxsmile790243
PART B
Please response to these two original posts below. When responding to
these posts, please either expand the thought, add additional insights, or
respectfully disagree and explain why. Remember that we are after reasons
and arguments, and not simply the statement of opinions.
Original Post 1
"What is moral relativism? Why might people be attracted to it? Is
it plausible?"
First of all, moral relativism is the view that moral truths are
subjective and depend on each individual's standpoints. Based
on this, everyone's moral view is legitimate. This can be attracted
because it sounds liberating and there is no need to argue for a
particular position. Moral relativism seems convincing in some
cases. For example, some people are okay with giving money to
homeless people, thinking that it's good to provide for the people
in need. Some people, on the other hand, claim that they can
work to satisfy their own needs. Moral relativism works well in
these cases because they all seem legitimate. However, there are
cases that moral relativism does not seem reasonable. For
example, child sacrifice in some cultures seems cruel and
uncivilized to most people. Hence, moral relativism is not
absolutely true.
Original Post 2
“Is your death bad for you, specifically, or only (at most) for others? Why
might someone claim that it isn’t bad for you?”
I'd start off by acknowledging what the two ancient philosophers,
Lucretius and Epicurus, outlined about death. They made the
point that death isn't necessarily bad for you since no suffering
takes place and that you yourself don't realize your own death. In
this way, one could make the claim that death isn't intrinsically
bad for you.
Another perspective I wanted to add was the influence of death
(both on you and others around you). Specifically, the event of
death itself may not be bad for you, but the idea of impending
death could impact one's life. Some may live freely, totally care-
free, accepting of death and enjoy life in the moment. Others may
be frightened by the idea of death that they live in constant fear
and hence death causing their mental health to take its toll. In
this way, I'd argue that death could, in fact, be bad for you. One
common reason for being afraid of death is the fear of being
forgotten. Not to mention the death of an individual certainly
affects others; death doesn't affect one's life but also all that is
connected to it. Focusing back to the point, it's clear that the
very idea of death directly affects the concerned individual. The
fact that those who live in fear of death are looking for legacies
and footprints to leave after they leave this world is telling of how
death could be arguably bad for you before it even happens.
PART A
Pick one or more questions below and write a substantive post
with >100 words. Please try to provide evidence(s) to support
your idea(s).
Questions:
• Do we have a duty to work out whe.
Part A (50 Points)Various men and women throughout history .docxsmile790243
Part A (50 Points):
Various men and women throughout history have made important contributions to the development of statistical science. Select any one (1) individual from the list below and write a 2 page summary of their influence on statistics. Be specific in detail to explain the concepts they developed and how this advanced our understanding and application of statistics.
Florence Nightingale
Francis Galton
Thomas Bayes
Part B (50 Points):
Select any one statistical concept you learned in this course and explain how it can be applied to our understanding of the Covid-19 pandemic (2 pages). You should use a specific example and include at least one diagram to illustrate your answer.
Please note: Your work must be original and not copied directly from other sources. No citations are needed. Be sure to submit this assignment in Blackboard on the due date specified.
.
This document discusses urinary tract infections (UTIs). It begins with a matching exercise identifying structures of the urinary system. The second part addresses UTIs in more detail. It defines a UTI, discusses the microorganisms that cause UTIs and where they enter the body. It also explains common signs and symptoms of UTIs, as well as diagnostic tests and treatments. The document concludes by noting that UTIs are more common in women and describes some ways women can reduce their risk.
Part A Develop an original age-appropriate activity for your .docxsmile790243
The document describes developing two original age-appropriate activities for preschoolers. The first activity uses either Froebel's cube gift, parquetry gift, or Lincoln Logs and identifies two skills it develops. The second activity promotes the same skills but is based on the Montessori method. The summary describes each activity and notes two key differences between them.
Part 3 Social Situations2. Identify multicultural challenges th.docxsmile790243
Part 3: Social Situations
2. Identify multicultural challenges that your chosen individual may face as a recent
refugee.
• What are some of the issues that can arise for someone who has recently
immigrated to a new country?
• Explain how these multicultural challenges could impact your chosen individual’s
four areas of development?
3. Suggest plans of action or resources that you feel should be provided to this family to
assist them in proper develop
Part 3: Social Situations
• Proposal paper which identifies multicultural challenges that your chosen individual may face as a recent refugee.
• Suggested plan of action and/or resources which should be implemented to address the multicultural challenges.
• 2-3 Pages in length
• APA Formatting
• Submission will be checked for plagiaris
.
Part A (1000 words) Annotated Bibliography - Create an annota.docxsmile790243
Part A
(1000 words): Annotated Bibliography - Create an annotated bibliography that focuses on ONE particular aspect of current Software Engineering that face a world with different cultural standards. At least seven (7) peer-reviewed articles must be used for this exercise.
Part B
(3000 words):
Research Report
- Write a report of the analysis and synthesis using the
(Part A
) foundational
Annotated Bibliography
.
Part C (500 words): Why is it important to try to minimize complexity in a software system.
Part D (500 words): What are the advantages and disadvantages to companies that are developing software products that use cloud servers to support their development process?
Part E (500 words): Explain why each microservice should maintain its own data. Explain how data in service replicas can be kept consistent?
.
Part 6 Disseminating Results Create a 5-minute, 5- to 6-sli.docxsmile790243
Part 6: Disseminating Results
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project:
· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Points Range: 81 (81%) - 90 (90%)
The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project.
The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples.
The narrated presentation accurately and clearly provides a justification that details the selection of this dissemination strategy that is fully supported by specific and relevant examples.
The narrated presentation provides a complete, detailed, and specific synthesis of two outside resources related to the dissemination strategy explained. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
Points Range: 5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Evidenced Based Change
Leslie Hill
Walden University
Introduction/PurposeChange is inevitable.Health care organizations need change to improve.There are challenges that need to be addressed(Baraka-Johnson et al. 2019).Challenges should be addressed using evidence-based research.These changes enhance professionalism therefore improving quality of care and quality of life.The purpose of this paper is to identify an existing problem in health care and suggest a change idea that would be effective in addressing the problem. The paper also articulates risks associated with the change process, how to distribute the change information and how to implement change successfully.
Organizational CultureThe Organization is a hospice facilityOffers end of life care for pain and symptom managementThe health care providers cu.
Part 3 Social Situations • Proposal paper which identifies multicul.docxsmile790243
Part 3: Social Situations • Proposal paper which identifies multicultural challenges that your chosen individual may face as a recent refugee. • Suggested plan of action and/or resources which should be implemented to address the multicultural challenges. • 2-3 Pages in length • APA Formatting • Submission will be checked for plagiarism
Part 3: Social Situations 2. Identify multicultural challenges that your chosen individual may face as a recent refugee. • What are some of the issues that can arise for someone who has recently immigrated to a new country? • Explain how these multicultural challenges could impact your chosen individual’s four areas of development? 3. Suggest plans of action or resources that you feel should be provided to this family to assist them in proper development.
.
Part 3 Social Situations 2. Identify multicultural challenges that .docxsmile790243
Part 3: Social Situations 2. Identify multicultural challenges that your chosen individual may face as a recent refugee. • What are some of the issues that can arise for someone who has recently immigrated to a new country? • Explain how these multicultural challenges could impact your chosen individual’s four areas of development? 3. Suggest plans of action or resources that you feel should be provided to this family to assist them in proper development.
Part 3: Social Situations • Proposal paper which identifies multicultural challenges that your chosen individual may face as a recent refugee. • Suggested plan of action and/or resources which should be implemented to address the multicultural challenges. • 2-3 Pages in length • APA Formatting • Submission will be checked for plagiarism
.
Part 2The client is a 32-year-old Hispanic American male who c.docxsmile790243
Part 2
The client is a 32-year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to the PMHNPs office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues except for some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse. the “Montgomery- Asberg Depression Rating Scale (MADRS)” and obtained a score of 51 (indicating severe depression). reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.
· Decision #1: start Zoloft 25mg orally daily
· Which decision did you select?
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
· Decision #2: Client returns to clinic in four weeks, reports a 25% decrease in symptoms but concerned over the new onset of erectile dysfunction
*add Augmentin Wellbutrin IR 150mg in the morning
· Why did you select this decision? Support y our response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
· Decision #3: Client returns to clinic in four weeks, Client stated that depressive symptoms have decreased even more and his erectile dysfunction has abated
· Client reports that he has been feeling “jittery” and sometimes “nervous”
*change to Wellbutrin XL 150mg daily
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Explain how ethical considerations might impact your treatment plan and communication with clients.
Conclusion.
Part 2For this section of the template, focus on gathering deta.docxsmile790243
Part 2:
For this section of the template, focus on gathering details about common, specific learning disabilities. These disabilities fall under the IDEA disability categories you researched for the chart above. Review the textbook and the topic study materials and use them to complete the chart.
Learning Disability Definition Characteristics Common Assessments for Diagnosis Potential Effect on Learning and Other Areas of Life Basic Strategies for Addressing the Disability
Attention Deficit Hyperactivity Disorder (ADHD)
Auditory Processing Disorder (APD)
Dyscalculia
Dysgraphia
Dyslexia
Dysphasia/Aphasia
Dyspraxia
Language Processing Disorder (LPD)
Non-Verbal Learning Disabilities
Visual Perceptual/Visual Motor Deficit
.
Part 2 Observation Summary and Analysis • Summary paper of observat.docxsmile790243
Part 2: Observation Summary and Analysis • Summary paper of observation findings for each area of development and connection to the observed participant. • Comprehensive description of the observed participant. • Analyzed observation experience with course material to determine whetherthe participant is developmentally on track for each area of development. • 4 Pages in length • APA Formatting • Submission will be checked for plagiarism
Part 2: Observation Summary and Analysis 1. Review and implement any comments from your instructor for Part 1: Observation. 2. Describe the participant that you observed. • Share your participant’s first name (can be fictional name if participant wants to remain anonymous), age, physical attributes, and you initial impressions. 3. Analyze your observation findings for each area of development (physical, cognitive, social/emotional, and spiritual/moral). • Explain how your observations support the 3-5 bullets for each area of development that you identified in your Development Observation Guidefrom Part 1: Observation. • Explain whether or not your participant is developmentally on track for each area of development. 4. What stood out the most to you about the observation? 5. Include at least 2 credible sources
.
Part 2 Observation Summary and Analysis 1. Review and implement any.docxsmile790243
Part 2: Observation Summary and Analysis 1. Review and implement any comments from your instructor for Part 1: Observation. 2. Describe the participant that you observed. • Share your participant’s first name (can be fictional name if participant wants to remain anonymous), age, physical attributes, and you initial impressions. 3. Analyze your observation findings for each area of development (physical, cognitive, social/emotional, and spiritual/moral). • Explain how your observations support the 3-5 bullets for each area of development that you identified in your Development Observation Guidefrom Part 1: Observation. • Explain whether or not your participant is developmentally on track for each area of development. 4. What stood out the most to you about the observation? 5. Include at least 2 credible sources
Part 2: Observation Summary and Analysis • Summary paper of observation findings for each area of development and connection to the observed participant. • Comprehensive description of the observed participant. • Analyzed observation experience with course material to determine whetherthe participant is developmentally on track for each area of development. • 4-6 Pages in length • APA Formatting • Submission will be checked for plagiarism
.
Part 2Data collectionfrom your change study initiative,.docxsmile790243
Part 2:
Data collection
from your change study initiative, sample, method, display of the results of the data itself, process, and method of analysis (graphs, charts, frequency counts, descriptive statistics of the data, narrative)
Part 3: Interpretation of the results of the Data
Collection and
Analysis, address likely resistance, and provide recommendations for continuing
the study
or evaluating your change study/initiative.
.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Leading for Quality in HealthcareDevelopment and Validation.docx
1. Leading for Quality in Healthcare:
Development and Validation of a
Competenqr Model
Andrew Garman, PsyD, MS, CEO, National Center for
Healthcare Leadership,
and professor, health systems management. Rush University;
and Linda Scribner,
BA, CPHQ, director of quality and clinical outcomes
management, Methodist
Dallas Medical Center
E X E C U T I V E S U M M A R Y
Increased attention to healthcare quality and impending changes
due to health
reform are calling for healthcare leaders at all levels to
strengthen their skills in
leading quality improvement initiatives. To address this need,
the National Asso-
ciation for Healthcare Quality spearheaded the development and
validation of a
competency model to support healthcare leaders in assessing
their strengths and
planning appropriate steps for development. Initial development
took place over
the course of several days of meetings by an advisory panel of
quality profession-
als. The draft model was then validated via electronic survey of
a national sample
of 883 quality professionals. Follow-up analyses indicated that
the model was
content valid for each of the target samples and also
distinguished differing levels
2. of job scope and experience. The resulting model contains six
domains spanning
three organizational levels.
For more information on the concepts in this article, please
contact Dr. Carman
at [email protected] or [email protected]
373
JOURNAL OF HEALTHCARE MANAGEMENT 5 6 : 6 N O V
E M B E R / D E G E M B E R 2 0 1 1
I N T R O D U C T I O N
As delivery of high-quality healthcare
continues to grow more complex, so
do the roles of the professionals lead-
ing these efforts. Recent years have seen
increased focus on the leadership ele-
ments ofthe quality professionals' roles;
initiatives such as the Comprehensive
Unit-Based Safety Program (CUSP; Pro-
novost et al. 2005), crew resource man-
agement. Lean Six Sigma, and Malcolm
Baldrige emphasize the key elements
of leadership and management needed
for success (see Carman et al. 2011).
Civen the impending changes associated
with the Affordable Care Act, leaders are
likely to be charged with implementing
these quality improvement initiatives
within a context of increasing emphasis
on resource efficiency. While the oppor-
tunities to improve may be tremendous,
threading the value needle will likely
3. test the mettle of all leaders of quality
efforts in the years to come.
In preparation for this new era for
the quality professional, the National
Association of Healthcare Quality
(NAHQ) began an initiative to investi-
gate the leadership development needs
ofthe profession. Their efforts yielded
a competency model that is specific to
leadership in quality and holds implica-
tions for professionals across the career
path. Development and validation of
this model are described in the follow-
ing section.
METHOD
Development of the competency model
began in lune 2008. Members ofthe
NAHQ board agreed to serve as the
advisory panel for developing a leader-
ship model and convened a two-day
series of meetings to develop the draft.
The meetings proceeded through three
phases: clarification of goals, definition
of scope, and competency identifica-
tion. In the competency identification
phase, subcommittees were formed to
represent the perspectives of present-
state, future-state, and senior leadership.
Using the Health Administrators Leader-
ship model (HAL) (Carman, Tyler, and
Darnall 2003) as their seed model, the
subcommittees reviewed this and other
published models against the goals
4. and scope criteria developed during the
phase one and two meetings. These sep-
arate reviews were then compiled during
a large group meeting to form the first
draft. These results were summarized
overnight and disseminated the follow-
ing morning for further discussion. The
revised model contained 21 competen-
cies organized into six domains. This
model was circulated to the commit-
tee a third time several weeks after the
original meeting, and feedback was col-
lected via teleconference. At that point
the board agreed by consensus that
the model reñected the elements they
believed would be essential to quality
leadership moving forward.
With the draft of the model final-
ized, the next step was to conduct a con-
struct validation study. To accomplish
this, an electronic survey was developed
for distribution to quality professionals,
using methods adapted from Williams
and Crafts (1997). The survey asked
respondents to review each of the com-
petency descriptions and rate it accord-
ing to level of perceived importance
to their quality leadership role using a
five-point scale of relative importance
( 1 = No importance, 5 = Extremely
374
5. LEADING FOR QUALITY: DEVELOPMENT AND
VALIDATION OF A COMPETENCY MODEL
important). An open-ended question
followed each competency, to allow
respondents to comment on clarity,
word choice, or other concerns with
the way the competency was defined.
Respondents were also asked to answer
a set of demographic questions concern-
ing the nature of their positions and
their institutional settings.
Invitations to complete the survey
were sent to all members of NAHQ
(n = 4,445), using a list maintained
by this organization and a list of non-
NAHQ members holding the Certified
Professional in Healthcare Quality
(CPHQ) credential (n = 2,704), which
was provided by the Healthcare Quality
Certification Board.
RESULTS
A total of 883 quality professionals
responded to the survey, for a response
rate of 12 percent. Respondent demo-
graphics are provided in Exhibit 1. For
respondent role, four categories were
created to collapse roles to a manage-
able number: senior executive leader-
ship (CEO, president, chief of staff, chief
or VP of medical affairs, chief nursing
executive, chief operating or operations
officer, chief financial officer); senior
quality leadership (president or vice
6. president for quality services, quality
improvement, patient safety divisions/
departments, physician quality leader
(department or service line); mid-level
quality leadership (director or manager
of quality, patient safety, and/or risk
management); and direct contributor
(quality coordinator, quality specialist,
data analyst, data abstractor).
To determine the validity of the
model and its component competencies.
a series of content validity ratios (CVR)
(Lawshe 1975) were calculated. CVRs
indicate the proportion of respondents
who agree that a particular competency
is very or extremely important. This
analysis indicated that all competencies
were above the recommended threshold
value of 0.49 (range: 0.66 for "Finan-
cial Acumen" to 0.97 for "Professional
Ethics").
Model Structure
The association between competen-
cies and domains was examined using
principal components factor analysis, a
statistical technique that tests the extent
to which items on a survey tend to be
rated similarly by respondents (higher
levels of association suggest that the
items hang together more closely, form-
ing associations). To test whether the
domains originally defined would map
to the competencies we originally speci-
7. fied, the analysis was set up to fit the
data to a six-domain solution. Results
of this analysis, shown in Exhibit 2,
supported the original structure for 17
of the 21 competencies and identified
four areas in need of reconciliation.
First, the systems thinking competency,
which was originally in the organiza-
tional awareness domain, loaded more
heavily onto the fosters positive change
domain. Second, the lifelong learning
competency, originally in the profes-
sionalism domain, loaded relatively
equally onto the self-management and
professionalism domains and slightly
higher onto self-management. Third,
the professional ethics competency,
which was originally under the pro-
fessionalism domain, loaded more
strongly onto the self-management
375
JOURNAL OF HEALTHCARE MANAGEMENT 5 6 : 6 N O V
E M B E R / D E C E M B E R 2 0 1 1
E X H I B I T 1
Respondent Demographics
Professional
NAHQ member
Certified professional in Health Quality (CPHQ)
8. Both
Years working in quality
Less than 1 year
1-2 years
3-5 years
6-10 years
11-15 years
More than 15 years
Hospital bed size (hospital-based professionals)
Less than 50
50-99
100-199
200-299
300-399
400-499
500 or more
Job level (by categorizable role, respondents in hospital
settings)
11. (68)
(10)
(9)
(18)
(17)
(14)
(8)
(25)
(59)
(3)
(8)
(48)
(41)
domain. Fourth, drive for results,
originally under the passion for positive
change domain, loaded equally strongly
onto two other domains: performance
improvement and self-management.
These four findings were vetted with the
original advisory panel, who by consen-
sus agreed that the survey results made
conceptual sense and should be used to
guide revision ofthe model. These final
12. revisions yielded the model shown in
Exhibit 3.
Subgroup Analyses
Our next step was to develop a more
refined understanding of how the
competencies may differ in their rela-
tive importance as a function of orga-
nization setting, organization size,
experience level, and position level.
376
LEADING FOR QUALITY: DEVELOPMENT AND
VALIDATION OF A COMPETENCY MODEL
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JOURNAL OF HEALTHCARE MANAGEMENT 5 6 : 6 N O V
E M B E R / D E C E M B E R 2 0 1 1
E X H I B I T 3
Leadership in Quality: Final Model Structure and Associations
with Respondent Demographics
Significant Associations
Domains/ Drganization Interaction
Competencies Experience Joh Level Size Terms
I. Fosters positive change * * * * * *
Advocates and adapts to change
Partners for change * * * *
Cultivates a quality-supportive climate * *
20. Drives for results * * * * * *
JJ. Communicating
Verbal communication skills
Written communication skills
Listening and receiving feedback * *
Educating
JJJ. Qrganizational awareness * * * * * *
Strategic planning * * * *
Strategic thinking and alignment ** ** ** **
Financial acumen * *
Systems thinking * * * * * *
IV. Self-management * *
Professional ethics
Manages personal limits
Resilience & self-restraint
V. Professionalism / Professional values
Consumer advocacy
Future focus * * * *
21. Lifelong learning
VJ. Performance improvement
Managing data
Analytic thinking / knowledge-based * * * * * *
decision-making
Develops a knowledge-rich environment
Note: Complete and current descriptions of each ofthe
competencies are available online: www.nahq.org/membership/
leadership/devmodel.html
* * Group differences statistically significant at p < 0.05
378
LEADING FOR QUALITY: DEVELOPMENT AND
VALIDATION OF A COMPETENCY MODEL
For organization setting, although the
survey contained a question about
primary practice setting, within-category
response counts were too small for
meaningful separate analysis of these
results. For this reason, we focused
only on respondents who provided a
bed count for their organizations in
the demographics section of the sur-
vey. A total of 267 (31%) respondents
22. indicated "not applicable" and were
categorized as nonhospital settings.
The remaining 69 percent were cat-
egorized as hospital settings. A series
of statistical analyses (ANOVAs) was
conducted to determine whether there
were differences between hospital and
nonhospital groups on the importance
ofthe competencies and competency
domains. These analyses yielded no sta-
tistically significant differences between
these groups, providing some evidence
for generalizability across organiza-
tional settings.
To examine the influence of orga-
nization size and experience level, we
followed a similar approach. For organi-
zation size, we focused only on hospi-
tal settings and only considered those
respondents who reported bed counts
associated with their organizations.
These analyses suggested significant
differences as a function of organization
size for four competencies within the
organizational awareness and fosters
positive change domains (strategic
planning, strategic thinking and align-
ment, partners for change, and drives for
results), as shown in Exhibit 3. Level of
experience was also significantly asso-
ciated with five competencies (strate-
gic thinking and alignment, financial
acumen, systems thinking, analytic
thinking/knowledge-based decision
23. making, and listening and receiving
feedback). For all significant effects,
the direction of the effect was for larger
organizations and higher experience lev-
els to be associated with higher levels of
importance for the competency/domain.
To analyze competencies accord-
ing to position level, subgroups were
formed according to responses to the
demographic question "The primary
functional role (not necessarily the title)
of my current position related to qual-
ity or patient safety is: ." Responses
were categorized into the four role levels
described previously (senior execu-
tive leadership, senior quality leader-
ship, mid-level quality leadership, and
direct contributor). For the competency
analysis, respondents were selected
only if they reported a bed count in
the demographic section (indicating
they worked in a hospital setting). This
analysis yielded statistically significant
associations for 5 ofthe 21 competen-
cies: one from the revised organizational
awareness domain, two from the revised
fosters positive change domain, and one
each from the performance improve-
ment and professionalism/professional
values domains. Those five competen-
cies were strategic thinking and align-
ment, drive for results, systems thinking,
analytic thinking/knowledge-based
decision making, and future focus. In
all cases, higher organizational level was
24. associated with greater perceived impor-
tance of the competency, suggesting
that these five competencies would be
particularly appropriate foci for leader-
ship development programs that center
on career progression to higher organi-
zational levels.
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D I S C U S S I O N A N D
C O N C L U S I O N
Several important limitations of this
work are important to keep in mind
when interpreting the results. First,
although the sample size obtained for
the content validity study was large, the
small response rate means the responses
could differ in important ways from
the population from which they were
drawn. Second, because the focus of this
projert was on leadership in quality, the
model should not be considered a com-
plete description of all critical elements
of a quality professional's job. Effective-
ness in a quality leadership role will
typically also require mastery of a con-
siderable knowledge base and technical
competencies that are beyond the scope
ofthe present effort. Third, competency
models are only as useful as the leader-
25. ship-development efforts they support.
When they are incorporated into devel-
opment programs based on sound adult
learning principles, competency models
can be powerful facilitators of indi-
vidual change, but by themselves these
models do little to help people develop.
Last, the effectiveness of even the most
skilled quality professionals ultimately
will be bounded by the level of collabo-
ration they experience from the other
leaders and clinicians they work with.
Attention to leadership as a team sport
and the need for a continuous learning
focus will continue to be essential in
supporting quality improvement gains
in healthcare organizations.
These limitations notwithstanding,
results of this study suggest that the
Quality Leadership model and its com-
ponent competencies can be considered
content-valid descriptions ofthe areas
quality leaders need to master to be
effective in their roles and thus represent
a useful model for leadership develop-
ment within the quality profession. This
appears to hold true regardless of setting
(hospital or other) or of other profes-
sional chararteristics such as experience,
job level, or organization size. Addition-
ally, the relative importance of a num-
ber ofthe competencies and domains
increased as a flinrtion of higher posi-
tion level and larger, more complex
26. organizational settings, suggesting spe-
cific areas that may be particularly useful
foci for leadership-development efforts.
Based on the pattems of results
described previously, we constructed
the graphic model depicted in Exhibit 4.
The pyramid shape captures the hier-
archy of the competencies according
to the analyses described in the prior
sections. In particular, professional-
ism/professional values appears as the
base to indicate the critical role that
this domain (and professional ethics in
particular) plays across all quality posi-
tions. The next level contains founda-
tional skills that, while still relevant to
all positions, start to look different at
different organizational levels. The top
level, which contains organizational
awareness and fostering positive change,
is the most closely associated with
higher organizational levels.
Taken together, these competen-
cies illustrate several important ways in
which successful leadership of quality
efforts may differ from a more general
definition of leadership effectiveness.
In comparison to other widely recog-
nized healthcare leadership competency
models (for a review, see Carman and
Johnson 2006), there appears to be a
380
27. LEADING FOR QUALITY: DEVELOPMENT AND
VALIDATION OF A COMPETENCY MODEL
E X H I B I T 4
Graphic Representation of the Quality Leadership
Developmental Competency Modei
Professionalism / Professional Values
Senior-level
roles
Roles at
all levels
greater relative emphasis on developing
and maintaining a culture of continuous
process improvement (partnering for
change, cultivating a quality-supportive
climate) and the competencies necessary
for the analytic work associated with
data-driven decision making (manag-
ing data, analytic thinking, developing
a knowledge-rich environment). It is
perhaps not surprising that both empha-
ses map closely to areas focused on by
the Malcolm Baldrige award criteria
(National Institute of Standards and
Technology 2010).
Conversely, competencies with
an external focus (e.g., community
relations, board relations) or longer-
term focus (e.g., flindraising, talent
28. development), or a focus on day-to-
day operations (e.g., human resource
management, information technology
management) are absent or deempha-
sized. So the model does appear to trade
a narrower focus for greater depth of
focus on quality leadership specifically.
In terms of developing current and
future quality leaders, competency mod-
els can support these efforts in a variety
of ways. Competency models are par-
ticularly helpful for identifying areas in
which further development may provide
the greatest relative payoff. For example,
the competency definitions can be used
as a template for creating developmen-
tal 360-degree feedback programs in
preparation for on-the-job develop-
ment. Similarly, the model can be used
as a framework for a development
planning discussion between leaders
and their direct reports, using templates
such as those provided by Carman and
Dye (2009). Models that are adopted
by a hospital or health system's senior
leaders can be particularly useful for
aligning the developmental agenda of
the entire organization. For example.
381
J O U R N A L O F H E A L T H C A R E M A N A G E M E N
29. T 5 6 : 6 N O V E M B E R / D E C E M B E R 2 0 1 1
an employee and organizational devel-
opment department can cross-walk an
organization-endorsed competency
model against internally provided train-
ing and development programs to better
communicate these opportunities to
employees and to identify potential gaps
in their offerings. Additionally, assess-
ments such as 360-degree feedback can
be aggregated to the organization levei
to identify and begin to address broader
skill gaps.
In conclusion, this model appears
relevant and usefijl for leaders and edu-
cators interested in developing capacity
in the area of quality leadership. In sup-
port of open dissemination, and in the
spirit of viewing quality as everyone's
responsibility, all competency descrip-
tions and supplementary material have
been made available on the NAHQ
website. Our hope is that the availability
of this model will help organizations
attend to the leadership development
needs of their quality professionals.
R E F E R E N C E S
Garman, A. N., and C. F. Dye. 2009. The
Healthcare C-Suite; Leadership Development
at the Top. Chicago: Health Administration
Press.
30. Garman, A. N., and M. P. Johnson. 2006.
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P R A C T I T I O N E R A P P L I C A T I O
Janet Holdych, PharmD, CPHQ, director of quality. Catholic
Healthcare West,
San Francisco, California
T en years ago the Institute of Medicine's landmark report
Crossing the QualityChasm called out the US healthcare
delivery system for not consistently pro-
viding high quality care to all people. The report concluded that
fundamental
changes were needed in order to provide safe, effective, patient-
centered, timely,
efficient, and equitable care (IOM 2001). Operationalizing this
vision has led to
382
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