Nurses play a pivotal role in hospital quality improvement initiatives. As the staff that spends the most time at the patient bedside, nurses are well-positioned to identify issues and make improvements. However, nurses face challenges in becoming more involved due to limited resources, competing demands on their time, and the need for cultural changes. Hospitals must support nurse leadership in quality improvement through dedicated programs, accountability measures, and by valuing nurse feedback to continuously enhance care quality and safety.
Audit of clinical practice
1. What is clinical audit?
2. What is history of clinical audit?
3. Why clinical audit?
4. Audit cycle
5. Stages of clinical audit
Quality Improvement In Healthcare: Where Is The Best Place To Start?Health Catalyst
One of the biggest challenges providers face in their quality improvement efforts is knowing where to get started. In my experience, one of the best ways to overcome that “where do we begin?” factor is by using data from an enterprise data warehouse to look for high-cost areas where there are large variations in how health care is delivered. Variation found through the KPA is an indicator of opportunity. The more avoidable variation that is reflected in a particular care process, the more opportunity there is to reduce that variation and standardize the process. Suppose after performing a KPA you discover three areas of opportunity. How do you determine which one to pursue, especially if it’s your first journey into process improvement? The most obvious answer would seem to be the one with the largest potential ROI. That may not always be the best course to pursue, however. You will also want to take into consideration the readiness/openness to change in each of those areas.
Strategic priorities in Patient Safety. Philip Hassen. IV International Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Audit of clinical practice
1. What is clinical audit?
2. What is history of clinical audit?
3. Why clinical audit?
4. Audit cycle
5. Stages of clinical audit
Quality Improvement In Healthcare: Where Is The Best Place To Start?Health Catalyst
One of the biggest challenges providers face in their quality improvement efforts is knowing where to get started. In my experience, one of the best ways to overcome that “where do we begin?” factor is by using data from an enterprise data warehouse to look for high-cost areas where there are large variations in how health care is delivered. Variation found through the KPA is an indicator of opportunity. The more avoidable variation that is reflected in a particular care process, the more opportunity there is to reduce that variation and standardize the process. Suppose after performing a KPA you discover three areas of opportunity. How do you determine which one to pursue, especially if it’s your first journey into process improvement? The most obvious answer would seem to be the one with the largest potential ROI. That may not always be the best course to pursue, however. You will also want to take into consideration the readiness/openness to change in each of those areas.
Strategic priorities in Patient Safety. Philip Hassen. IV International Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Quality and safety, Vision 2025, Specific challenges of Nursing on quality, Quality improvement division, Fish bone technique,QI model, PDCA, Role of Nurse, Empowerment, Nursing positioning and policies,
A Guide to Applying Quality improvement to Healthcare Five PrinciplesHealth Catalyst
Healthcare is an art and a science. What many in the industry don’t understand is that systems and processes can coexist with personalized care. Quality improvement methods can be as effective in healthcare as they have been in other industries (e.g., agriculture, manufacturing, etc.).
Quality improvement in healthcare is not just achievable, it’s an absolute necessity given the amount of wasteful spending in the U.S. on healthcare. Organizations can reduce this wasteful spending while improving their processes by applying these five guiding principles:
Facilitate adoption through hands-on improvement projects.
Define quality and get agreement.
Measure for improvement, not accountability.
Use a quality improvement framework and PDSA cycles.
Learn from variation in data.
By using these principles and starting small, organizations can quicken the pace of quality improvement in healthcare.
The challenges faced by nursing administrators are many and varies. An overview of such challenges will be helpful in working towards the managerial solutions.
Quality and safety, Vision 2025, Specific challenges of Nursing on quality, Quality improvement division, Fish bone technique,QI model, PDCA, Role of Nurse, Empowerment, Nursing positioning and policies,
A Guide to Applying Quality improvement to Healthcare Five PrinciplesHealth Catalyst
Healthcare is an art and a science. What many in the industry don’t understand is that systems and processes can coexist with personalized care. Quality improvement methods can be as effective in healthcare as they have been in other industries (e.g., agriculture, manufacturing, etc.).
Quality improvement in healthcare is not just achievable, it’s an absolute necessity given the amount of wasteful spending in the U.S. on healthcare. Organizations can reduce this wasteful spending while improving their processes by applying these five guiding principles:
Facilitate adoption through hands-on improvement projects.
Define quality and get agreement.
Measure for improvement, not accountability.
Use a quality improvement framework and PDSA cycles.
Learn from variation in data.
By using these principles and starting small, organizations can quicken the pace of quality improvement in healthcare.
The challenges faced by nursing administrators are many and varies. An overview of such challenges will be helpful in working towards the managerial solutions.
North highland himss_hardwiringclinicalfinancialperformance_041315North Highland
North Highland's Ricardo Martinez and Donna Houlne's presentation on "Hardwiring Clinical and Financial Performance Through Patient-Centered, Physician-Directed Transformation"
Quality assurance is a way of preventing mistakes and defects in manufactured products and avoiding problems when delivering products or services to customers; which ISO 9000 defines as "part of quality management focused on providing confidence that quality requirements will be fulfilled".
Quality management in nursing professionSANJAY SIR
Quality improvement requires in any field to provide best services to the community in the health care system. it is uploaded to aware the the paramedics & nursing personnel to improve the quality care & helps educators to teach their students.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
1. NURSING LEADER DRIVING QUALITY CARE
Manjunathan C,
RN RPN., M.Sc.(N)., M.Sc.,(CP)
Deputy Nursing Superintendent,
Apollo CBCC Cancer Care,
Apollo Hospitals International Ltd.
2. Introduction to Quality
Quality of care plays an important role in describing the intricate relationships
between quality, cost, and accessibility of health care within a community.
Carrying out interventions correctly according to pre-established standards and
procedures, with an aim of satisfying the customers of the health system and
maximizing results without generating health risks or unnecessary costs.
“A process for making strategic choices in health systems”
3. Define: Quality
National Association of Quality Assurance Professionals described quality as “the
level of excellence produced and documented in the process of patient care, based on
the best knowledge available and achievable at a particular facility.”
The Community Health Accreditation Program defined quality as “the degree to
which consumers progress toward a desired outcome”
4. Leadership in Quality
Leadership- the process of influencing others
Leaders inspire thru personal trustworthiness & self-confidence
Leaders communicate a vision of quality that turns self-interest into commitment
to the job
5. Difference: Boss / Leader Drive Quality
• A boss manages their employees, while a leader inspires them to innovate, think
creatively, and strive for perfection. Every team has a boss, but what people need is
a leader who will help them achieve greatness of quality in health care.
6. Nurse Drive Change in Patient safety
• Nurse Relates to providing care processes and
achieving outcomes as supported by scientific evidence.
Effectiveness
• Nurse Relates to maximizing the quality of a
comparable unit of health care delivered or unit of
health benefit achieved for a given unit of health care
resources used
Efficiency
• Nurse Relates to providing health care of equal quality
to those who may differ in personal characteristics
other than their clinical condition or preferences for
care.
Equity
• Relates to meeting patients' needs and preferences and
providing education and support.
Patient centered
• Relates to actual or potential bodily harm.
Safety
• Relates to obtaining needed care while minimizing
delays.
Timeliness
7. Cont…
Unit Based Clinical Leadership Model
The Healthcare Leadership Model is made up of nine behavioural dimensions:
• Inspiring shared purpose
• Leading with care
• Evaluating information
• Connecting our service
• Sharing the vision
• Engaging the team
• Holding to account
• Developing capability
• Influencing for results
8. Role of Nurse in Hospital Quality
Improvement
Nurses Pivotal to Hospital Quality Initiatives:
Hospitals face increasing demands to participates in a wide range of quality improvement
activities.
The nurses are reliant on nurses to help address these demands. Nurses faces challenges
and can provide important insight about how hospitals can optimize resources to
improve patient care quality.
1.Key quality improvement areas are,
a. Maintaining ALOS
Prevention and controlling of Infection
Prevention of fall
Effective Assessment, Plan of Care, Documentation and Hands Off (SBAR) as well Pain
assessment.
b. Specific area quality improvement
Extravasations
TAT for Immunosuppressant's
TAT for Critical test
TAT for Critical values
Accidental removal of tubing's
MET Criteria-Code Orange (Rapid Response team)
Code Blue
Data collection on quality indicator(Nursing, Infection Control and Specific) Gap
analysis and sustaining on basis of PDCA etc.
9. Quality Improvement Program /
Demands Increasing
Hospital have had quality improvement department. It It is not new for the hospital,
What is new however the demands increasing due to,
• Uplifting of policies SOPs, Manuals and Protocols ,
1. EXTERNAL PROGRAMES
• Accreditation (JCI, NABH, Bureau VERITAS and ISO 500001), regulatory bodies,
quality improvement, Medical speciality societies, State hospital associations and
health plans. In addition to these external programmes.
10. Cont…
2. INTERNAL PROGRAMES
The hospitals engaging in variety of internal quality improvement activities based on
patient and employees feedback.
• Lean six Sigma Project
• Internal Clinical Audit
• AIDET
• SHHh
• Ward as a Unit Programmes
• Weekly process
• Apollo Way
• Apollo Clinical Excellence
• Uniflow system
• SUD tracking
• IPSG & HIRA
• 360 degree audits
• Cross functional audits
• Open and Closed audits
• Case and data presentation audits
• Competencies, Annual Appraisal and trainings like Mandate, Induction and
preceptors etc.
• Others Like MOM, HICP,ESP,PFE.
11. How can QI Division Support You for quality
improvement programe
13. QI MODEL FOR IMPROVEMENT
• Model consists of:
– three questions (aim, measure,
change) to form context for
improvement
– Plan-Do-Study-Act (PDSA) Cycle to
structure tests
14. Various Pressure Drive Hospital
Participation Decision
The hospital itself require a quality accreditation certification to tie up with corporate
patients, TPA (Med sav, Apollo Munich, Max health), ONGC, CGHS, Maa Yojana, ECHS
(Cashless and Reimbursement).
To stand as a competitors in market, It is bound to show the important on quality
progress.
The pressure from Local Bodies, National Bodies and International Bodies.
More than above all,
Liabilities, Consumer act, rights and Responsibilities of patients, Patient rights and
education, These are the highly pressured area to have accreditation
The pressure drives for reimbursement, This created strong financial incentives for
hospitals.
15. Demands Increase, So Does the role of
Nurses
Respondents described how vital nurses are to hospitals, that nursing care is a major
reason why people need to come to a hospital,
‘The nurses are heart and Soul’ of the hospitals. Nurses spend most of the time at the
patient bedside.
‘Nurses are the safety net’, They are right there, Real time, catching medication errors,
catching patient falls etc.,,
16. Cultures sets for Quality Improvement
• The supportive hospital culture is the key to make important advances in quality
improvement. The several strategies are
• Supportive hospital leadership
• Setting expectations for all staff
• Holding staff accountable for individual roles
• Inspiring and using physician and nurses championship efforts
• Providing ongoing, Visible and useful feedback to engage effectively.
• IMPORTANT is no blaming and fault finding culture has to made.
• Self reporting Culture
17. Challenges specific to Nurses
Involvement in Quality Improvement
The challenges are,
Budget
New divisions-focus vs integration
Fire fighting(Comfortable) vs Process, Practice and care improvement
Limited measurement of quality
Having adequate Nursing Staff
Facing growing demands to participate in more, Often duplicative, quality
improvement activities.
Dealing with high administrative burden associated with these activities.
Confronting traditional nursing education that does not always adequately
prepare nurses for evolving role in today’s contemporary setting.
18. Engaging All Nurses Not Just Nursing
Leadership
Involving Nurses in Quality Improvement activities , Preparing policies, SOP’s and
other legal documents such as MRD records, Statutory documents etc,
More over making them as a speciality nurses such as Stem Cell Transplant nurse,
Infusion Nurse, Tissue viability Nurse, Medication Management Nurse, Critical
Care Nurse, Chemotherapy Nurse, Radiation Nurse, Operation Theatre and
Dialysis Nurse,
19. Quality led by Staff
Staff experience – seek and value feedback and ideas for improvement
Quality and safety Walk-rounds
Enable people to do a better job
‘Walk in my shoes’
Do reinvent the wheel
20. Nursing Role in New Health Care
Arena
• Focusing on wellness
• Patient and Family cantered care
• Care coordination
• Data analysis focus on outcomes and improvement.
21. Implications
• Improving health care quality and patient safety is epic in health care system.
• Hospital will have to become more adept and sophisticated in discerning and
pursuing activities that substantively contribute to the achievement of their quality,
patient safety other performance goals.
• Quality improvement is not solely the domain of nurses, They are integral to these
activities because of their day to day patient care responsibilities.
• Hospitals will need to guard against diminishing the involvement of nurses in quality
improvement activities where they are likely to have the greatest influence and
impact.
22.
23. “We have two jobs: Our job and
the job of improving our job”.
THANK YOU