Quality Improvement
    - An overview
QI overview


  Theories &
 Frameworks



               Relevance to
                Healthcare




Application in Nursing
Analysing the problem



  A need to
                                 Are there
determine the                                Where are the        What is
                                 multiple
  significant    What is the                  problems of       ‘quality’ in
                                problems?
 source of a     problem?                    quality coming   regards to the
                               Importance?
    quality                                      from?          outcome?
                                 Urgency?
  problem..
Why do we use Quality Improvement?
  When an outcome of a process or system
  does not meet the necessary or desired
                 quality.

  To identify areas/processes that are causing deficit to a
                       final outcome.



            To test and implement positive change.



                   To monitor progress of outcomes.
Testing ideas for improvement



Industry- QI focuses on issues like product failures or
work-related injuries to increase quota and/or profit.

Healthcare- the ethical onus is to reduce medical
errors , morbidity and mortality.

Administration- increasing efficiency and reducing re-
work is addressed.
Testing ideas
The process to facilitate
                                    Framework
learning & improvement

Need for ongoing            Tools

development, where
active participation is                    What’s being
                                             done?
resourced, supported, re
cognised and rewarded.
                               How is it
                                done
Measures
                   3 TYPES

     Structure      Process      Outcome




These can be analysed in aid of identifying the
         issue behind a quality deficit
Structure
              Physical aspect
The manufacturing capacity of a factory plant
 or, the number of bays that a hospital has
 available in the emergency department..
Process
             How it’s working

 How many units are being produced at the
factory or, what percentage of people coming
    into the hospital after-hours are being
        attended to in the emergency..
Outcome
              Is it making a
               difference?

How many units are being discarded at the
end of the line or, how many people being
treated in emergency represent for the same
complaint
Gathering data
 Creating a
                  Collecting     Data collection
measurement
                 baseline data        tools
    plan



                      Measuring
                     the cause of
                     poor quality
Defining the outcome
                      What is quality?
                       How do you
What is quality? How determine a good
do you determine a      outcome?
  good outcome?


                           Reducing/eliminating the gap
         Goal              between the current outcome
                             and the desired outcome




                   Monitoring progress

Quality improvement overwiew presentation

  • 1.
    Quality Improvement - An overview
  • 2.
    QI overview Theories & Frameworks Relevance to Healthcare Application in Nursing
  • 3.
    Analysing the problem A need to Are there determine the Where are the What is multiple significant What is the problems of ‘quality’ in problems? source of a problem? quality coming regards to the Importance? quality from? outcome? Urgency? problem..
  • 5.
    Why do weuse Quality Improvement? When an outcome of a process or system does not meet the necessary or desired quality. To identify areas/processes that are causing deficit to a final outcome. To test and implement positive change. To monitor progress of outcomes.
  • 6.
    Testing ideas forimprovement Industry- QI focuses on issues like product failures or work-related injuries to increase quota and/or profit. Healthcare- the ethical onus is to reduce medical errors , morbidity and mortality. Administration- increasing efficiency and reducing re- work is addressed.
  • 7.
    Testing ideas The processto facilitate Framework learning & improvement Need for ongoing Tools development, where active participation is What’s being done? resourced, supported, re cognised and rewarded. How is it done
  • 8.
    Measures 3 TYPES Structure Process Outcome These can be analysed in aid of identifying the issue behind a quality deficit
  • 9.
    Structure Physical aspect The manufacturing capacity of a factory plant or, the number of bays that a hospital has available in the emergency department..
  • 10.
    Process How it’s working How many units are being produced at the factory or, what percentage of people coming into the hospital after-hours are being attended to in the emergency..
  • 11.
    Outcome Is it making a difference? How many units are being discarded at the end of the line or, how many people being treated in emergency represent for the same complaint
  • 12.
    Gathering data Creatinga Collecting Data collection measurement baseline data tools plan Measuring the cause of poor quality
  • 13.
    Defining the outcome What is quality? How do you What is quality? How determine a good do you determine a outcome? good outcome? Reducing/eliminating the gap Goal between the current outcome and the desired outcome Monitoring progress

Editor's Notes

  • #4 Adapted from: Health Quality Ontario. (2011). Analysing your system. Retrieved December 12, 2011, from Health Quality Ontario: http://www.ohqc.ca/en/analysing_system_7.html
  • #5 These are some of the methods used to make an inventory of the problemImages sourced from:- http://www.anticlue.net/images/AntiFishbone.jpg (Fishbone) http://www.cps.gov.uk/assets/images/publications_images/pm_06_T.jpg (process map)- http://t1.gstatic.com/images?q=tbn:ANd9GcR_X-d5YsOshDOtsWgwRrwSa_BxLwMF1yHotGHDN-dxpgVNMX5s (Pareto chart)
  • #6 Adapted from:U.S. Department of Health & Human. (2011). Report to congress: National strategy for quality improvement in health care. Ontario: Queen's Printer.
  • #7 Image sourced from: consult-cobblestone.comAdapted from: Department of Community & Family Medicine. (2005). What is quality improvement. Retrieved Decemeber 12, 2011, from Patient safety - Quality imporvement: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html
  • #8 Use of tools and frameworks, that can address issues such as ‘What is being done?’ and ‘How is it done?’ simultaneously to achieve an effective outcome - measurementAdapted from: Health Quality Ontario. (2011). Analysing your system. Retrieved December 12, 2011, from Health Quality Ontario: http://www.ohqc.ca/en/analysing_system_7.html
  • #9 Adapted from: Department of Community & Family Medicine. (2005). What is quality improvement. Retrieved Decemeber 12, 2011, from Patient safety - Quality imporvement: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html
  • #10 Adapted from: Department of Community & Family Medicine. (2005). What is quality improvement. Retrieved Decemeber 12, 2011, from Patient safety - Quality imporvement: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.htmlImage sourced from: http://t0.gstatic.com/images?q=tbn:ANd9GcS5wxiDuH_qa9Eb3_AJ2FZV7EAy6RsvykysPb-4OhjkzSfpyoMc7w
  • #11 Adapted from: Department of Community & Family Medicine. (2005). What is quality improvement. Retrieved Decemeber 12, 2011, from Patient safety - Quality imporvement: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.htmlImage sourced from: http://t1.gstatic.com/images?q=tbn:ANd9GcTkU_PcqQJGUTuB-65zizMEpygjpX97ZO2Cb86xa1BS7CGmUxkNLQ
  • #12 Pictured sourced from: accountabilityimpact.co.ukAdapted from: Department of Community & Family Medicine. (2005). What is quality improvement. Retrieved Decemeber 12, 2011, from Patient safety - Quality imporvement: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html
  • #13 Image sourced from: http://t2.gstatic.com/images?q=tbn:ANd9GcRxwpmAvvDGS9EfXPgKKzHdjEQuB32hEcP9Wz2RrdaUKW7d520H
  • #14 Adapted from: Health Quality Ontario. (2011). Analysing your system. Retrieved December 12, 2011, from Health Quality Ontario: http://www.ohqc.ca/en/analysing_system_7.html