This document discusses key concepts of quality improvement and risk management in healthcare. It outlines tools used in continuous quality improvement including the PDSA cycle, SWOT analysis, statistical analysis, and seven common CQI tools. Data collection from electronic medical records and patient health information is analyzed to identify areas for improvement and adhere to regulations. Incident reports are also used to investigate the root cause of issues and identify problems in patient care. The overall goal is to effectively manage risks and continually enhance the delivery of quality healthcare.
To lower health costs, physician networks and medical homes must employ a closed loop population management program that focus on patient SOH stratification, chronic disease management, care coordination and incentive management. This approach will enable them to consistently reduce ER and inpatient admissions, which are the greatest expenditures in health care today.
To lower health costs, physician networks and medical homes must employ a closed loop population management program that focus on patient SOH stratification, chronic disease management, care coordination and incentive management. This approach will enable them to consistently reduce ER and inpatient admissions, which are the greatest expenditures in health care today.
Presentation for UP MSHI HI201 Health Informatics class under Dr. Iris Tan and Dr. Mike Muin. Check out my blog - http://jdonsoriano.wordpress.com/2014/10/09/fitting-the-pi…making-it-work/
Essay on Clinician Accountability & Clinical GovernanceDavid Thompson
Clinical governance and clinician accountability are integral concepts in today’s modern healthcare sector. The purpose of this paper is to critically evaluate the statement that comprehensive clinician accountability and clinical governance reduces the likelihood of errors being committed in the delivery of health care. After key definitions are initially identified, the concepts of comprehensive clinician accountability, clinical governance and the link between the two are then explored in the context of their effects on the potential for, and incidence of, clinical error with reference to current literature.
With the upcoming move to ICD-10 Procedure Codes across the world, information flow will reach many new recipients to improve the world's health conditions!
Running head QUALITY IMPROVEMENT .docxtoltonkendal
Running head: QUALITY IMPROVEMENT 1
QUALITY IMPROVEMENT 7
Quality improvement
Diana Velez
Phoenix University
March 7, 2016
Quality improvement involves continuous and systematic actions carried out by measuring improvements in healthcare services and health status of targeted groups of patients (McLaughlin & Kaluzny, 2006). This paper aims at evaluating quality improvements concerning patient safety at Davis Health Care. Patient safety can be described as the freedom from accidental injury. In quality improvement(QI), the management of data is a significant part of improving the performance of a healthcare organization. It involves the collection, tracking, analysis, interpretation and taking appropriate actions on organizational data for specific measures such as patient safety.
Measuring the inputs, processes and outcomes of a health system is a proactive and systematic approach to practice-level decisions for delivery systems and patient care. data management involves a continuous measuring and monitoring, and it enables an organization's quality improvement team to identify and implement available opportunities for improving its existing care delivery systems such as patient safety and monitor progress. Data needed for monitoring improvement in patient safety include information on evidence-based care provided, systems that affect patient access to quality care, the safety of the patients, support for patient engagement, cultural competence and coordination of medical care with other components of the healthcare organization. Tools that can be used for collecting performance information in relation to patient safety include benchmarking, brainstorming and surveys.
Benchmarking in Healthcare can be defined as a collaborative and continuous discipline used in measuring and comparing results of key work processes such as patient safety initiatives with those of best performers in measuring the organizational performance (Joint Commission Resources, Inc.; Joint Commission International, 2012). There are two different types of benchmarking that can be applied in measuring patient safety and quality performance. Internal benchmarking is used in identifying best practices inside an organization for comparing best practices within the organization and the current practice over time. The information gathered can be plotted on a control chart using statistically derived lower and upper limits. However, the use of internal benchmarking alone cannot yield information or results that are fully representative of the best practices. External or competitive benchmarking involves the use of comparative data between healthcare organizations to evaluate performance and identify patient safety improvements that have been successful in other organizations.
B ...
Presentation for UP MSHI HI201 Health Informatics class under Dr. Iris Tan and Dr. Mike Muin. Check out my blog - http://jdonsoriano.wordpress.com/2014/10/09/fitting-the-pi…making-it-work/
Essay on Clinician Accountability & Clinical GovernanceDavid Thompson
Clinical governance and clinician accountability are integral concepts in today’s modern healthcare sector. The purpose of this paper is to critically evaluate the statement that comprehensive clinician accountability and clinical governance reduces the likelihood of errors being committed in the delivery of health care. After key definitions are initially identified, the concepts of comprehensive clinician accountability, clinical governance and the link between the two are then explored in the context of their effects on the potential for, and incidence of, clinical error with reference to current literature.
With the upcoming move to ICD-10 Procedure Codes across the world, information flow will reach many new recipients to improve the world's health conditions!
Running head QUALITY IMPROVEMENT .docxtoltonkendal
Running head: QUALITY IMPROVEMENT 1
QUALITY IMPROVEMENT 7
Quality improvement
Diana Velez
Phoenix University
March 7, 2016
Quality improvement involves continuous and systematic actions carried out by measuring improvements in healthcare services and health status of targeted groups of patients (McLaughlin & Kaluzny, 2006). This paper aims at evaluating quality improvements concerning patient safety at Davis Health Care. Patient safety can be described as the freedom from accidental injury. In quality improvement(QI), the management of data is a significant part of improving the performance of a healthcare organization. It involves the collection, tracking, analysis, interpretation and taking appropriate actions on organizational data for specific measures such as patient safety.
Measuring the inputs, processes and outcomes of a health system is a proactive and systematic approach to practice-level decisions for delivery systems and patient care. data management involves a continuous measuring and monitoring, and it enables an organization's quality improvement team to identify and implement available opportunities for improving its existing care delivery systems such as patient safety and monitor progress. Data needed for monitoring improvement in patient safety include information on evidence-based care provided, systems that affect patient access to quality care, the safety of the patients, support for patient engagement, cultural competence and coordination of medical care with other components of the healthcare organization. Tools that can be used for collecting performance information in relation to patient safety include benchmarking, brainstorming and surveys.
Benchmarking in Healthcare can be defined as a collaborative and continuous discipline used in measuring and comparing results of key work processes such as patient safety initiatives with those of best performers in measuring the organizational performance (Joint Commission Resources, Inc.; Joint Commission International, 2012). There are two different types of benchmarking that can be applied in measuring patient safety and quality performance. Internal benchmarking is used in identifying best practices inside an organization for comparing best practices within the organization and the current practice over time. The information gathered can be plotted on a control chart using statistically derived lower and upper limits. However, the use of internal benchmarking alone cannot yield information or results that are fully representative of the best practices. External or competitive benchmarking involves the use of comparative data between healthcare organizations to evaluate performance and identify patient safety improvements that have been successful in other organizations.
B ...
PREPARATIONConsider the hospital-acquired conditions that ar.docxkeilenettie
PREPARATION
Consider the hospital-acquired conditions that are not reimbursed for under Medicare/Medicaid. Among these conditions are specific safety issues such as infections, falls, medication errors, and other safety concerns that could have been prevented or alleviated with the use of evidence-based guidelines. Hospital Safety Score, an independent nonprofit organization, uses national performance measures to determine the safety score for hospitals in the United States. The Hospital Safety Score Web site and other online resources provide hospital safety scores to the public.
Read the scenario below:
Scenario
As the manager of a unit, you have been advised by the patient safety office of an alarming increase in the hospital safety score for your unit. This is a very serious public relations matter because patient safety data is public information. It is also a financial crisis because the organization stands to lose a significant amount of reimbursement money from Medicare and Medicaid unless the source of the problem can be identified and corrected. You are required to submit a safety score improvement plan to the organization's leadership and the patient safety office.
Select a specific patient safety goal that has been identified by an organization, or one that is widely regarded in the nursing profession as relevant to quality patient care delivery, such as patient falls, infection rates, catheter-induced urinary infections, IV infections, et cetera.
DELIVERABLE: SAFETY SCORE IMPROVEMENT PLAN
Develop a 3–5 page safety score improvement plan.
Identify the health care setting and nursing unit of your choice
in the title of the mitigation plan. For example, "Safety Score Improvement Plan for XYZ Rehabilitation Center."
You may choose to use information on a patient safety issue for the organization in which you currently work, or search for information from a setting you are familiar with, perhaps from your clinical work.
Demonstrate systems theory and systems thinking as you develop your recommendations.
Organize your report with these headings:
Study of Factors
Identify a patient safety issue.
Describe the influence of nursing leadership in driving the needed changes.
Apply systems thinking to explain how current policies and procedures may affect a safety issue.
Recommendations
Recommend an evidence-based strategy to improve the safety issue.
Explain a strategy to collect information about the safety concern.
How would you determine the sources of the problem?
Explain a plan to implement a recommendation and monitor outcomes.
What quality indicators will you use?
How will you monitor outcomes?
Will policies or procedures need to be changed?
Will nursing staff need training?
What tools will you need to do this?
Additional Requirements
Written communication: Written communication should be free of errors that detract from the overall message.
APA formatting: Resources and in-te ...
Quality Improvement and Professional Nursing Practice Chapte.docxmakdul
Quality Improvement
and Professional Nursing Practice
Chapter 9
1
Healthcare Quality (1 of 2)
Quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
Healthcare Quality (2 of 2)
Quality improvement refers to the use of data to monitor the outcomes of care processes, and uses improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems
Crossing the Quality Chasm (IOM, 2001)
Safe, timely, effective, efficient, equitable, and patient-centered (STEEEP)
10 rules for redesign to move the healthcare system toward the identified performance expectations
10 Rules for Redesign (1 of 3)
Care is based on continuous healing relationships with patients receiving care whenever and wherever it is needed
Care can be customized according to the patient’s needs and preferences even though the system is designed to meet the most common types of needs
The patient is the source of control and as such, should be given enough information and opportunity to exercise the degree of control he or she chooses regarding decisions that affect him or her
10 Rules for Redesign (2 of 3)
Knowledge is shared and information flows freely so that patients have access to their own medical information
Decision making is evidence based; that is, it is based on the best available scientific knowledge and should not vary illogically between clinicians or locations
Safety is a system property and patients should be safe from harm caused by the healthcare system
10 Rules for Redesign (3 of 3)
Transparency is necessary where systems make information available to patients and families that enable them to make informed decisions when selecting a health plan, hospital, or clinic, or when choosing alternative treatments.
Patient needs are anticipated rather reacted to
Waste of resources and patient time is continuously decreased
Cooperation among clinicians is a priority to ensure appropriate exchange of information and coordination of care
Healthcare Transparency (1 of 2)
Medicare’s Hospital Compare at: www.hospitalcompare.hhs.gov
Medicare’s Home Health Compare at: https://www.medicare.gov/homehealthcompare/
Quality Check’s Find a Health Care Organization at: http://www.qualitycheck.org/
consumer/searchQCR.aspx
The Leapfrog Group’s Hospital Safety Score at: http://www.hospitalsafetyscore.org
Healthcare Transparency (2 of 2)
America’s Health Rankings by the United Health Foundation at: http://www.americashealthrankings.org
Improving Healthcare for the Common Good (IPRO) at: http://ipro.org/for-consumers
IPRO’s Why Not the Best? at: http://www.whynotthebest.org
The Commonwealth Fund at: http://www.commonwealthfund.org
Measures of Quality
Benchmarking
Core measures
Accountability
Composite measures
Measures of Nursing Care
Consumer Assessment of Healthcare Providers and Systems (CAHP ...
Top seven healthcare outcome measures of healthJosephMtonga1
The seven healthcare outcome measures are meant to understand the quality of health systems and how they could be measured and how quality care could be provided to clients.
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
3. CQI and Risk Management
Core Concepts
• PHI: Data and
information
• Electronic
Medical Record
• Risk
Management
• CQI
Plan Do
ActStudy
4. Six Quality Dimensions
(Sollecito& Johnson, 2013).
Purpose
Quality management (CQI)
Timely, Effective, Patient centered; Efficient, Equitable, Safety. The six quality dimensions
are a model for quality control measures for patient care.
5. PDSACycle
(Sollecito& Johnson,2013).
Purpose
Quality management (CQI)
Plan - Do – Study –Act. The PDSAcycle helps Quality Control Managers to plan and implement
changes that are short term or long term; effectively deliver quality care to patients.
6. S.W.O.T.Analysis
(Sollecito& Johnson, 2013).
Purpose
Strengths Weakness Opportunities and Threats. S.W.O.TAnalysis:
Atool utilized by QM to assess internal and external organizational factors that affect patient care
negatively or positively. Risks are effectively managed based on this risk assessment tool. Risk
Management
7. StatisticalAnalysis, Benchmarking, Customer Satisfaction
Measures
(Sollecito& Johnson, 2013).
Tools utilized by QM to assess quality in the delivery of care and further manage risks in health
care.
Surveys are utilized for the purpose of assessing patient’s perception about quality and safety.
Surveys assist with planning and Risk Management.
Purpose
8. SevenCQITools
Seven Continuous Quality Improvement Tools
I. Flowcharts
II. Cause-and-effect diagrams,
III. Histograms,
IV. Pareto charts,
V. Run charts,
VI. Control charts
VII. Regression analysis (Haas, Swan & Haynes, 2014).
9. SevenToolsof CQI
(Sollecito& Johnson, 2013).
Purpose
The seven tools gives CQI management effective strategies to measure, assess, and analyze data. For
example: the charts and diagrams reflect data extracted from PHI within the E.H.R and E.M.R. the
information is used to make changes that are necessary to achieve improvement goals; and adhere to state and
federal laws and regulations that govern patient care.
Quality management (CQI)
10. Reporting Incidents
In health care, incident reports are tools that are used as a part of research and root cause analysis. Reports identify
what the problem and nature of an incident, accident or complaint is.An incident/accident report is one of the first
attempts of communicating any occurrence of system failure that are due to technical, equipment related; or
involves issues with patient care.
Root CauseAnalysis will also include an in depth investigation of independent or dependent variables,
along with the incident report. (Sollecito & Johnson, 2013).
11. Summary
Data Collection
Continuous Quality Improvement
Risk Management
Data assessment
Patient Health Information
Health Information Systems
Electronic Medical Record
Electronic Health Record
12. References
Agency for Health Care Research and Quality.AHRQ (2016).The Six Domains of Health Care Quality. Retrieved from
website onApril 29, 2016 from: https://cahps.ahrq.gov/consumer reporting/talkingquality/create/sixdomains.html
Haas, S., Swan, B., Haynes, T. (2014). Care Coordination andTransition Management (CCTM) Core Curriculum text (1).
(2014). Pitman, NJ, US:AmericanAcademy ofAmbulatory Care Nursing. Retrieved from http://www.ebrary.com
Sollecito, W.A., & Johnson, J.K. (2013). McLaughlin and Kalunzy’s continuous quality improvement in health care (4th
ed.). Burlington, MA: Jones & Bartlett Learning.
Langley G.J., Moen R.D., & Nolan K.M. (2009).The improvement guide:Apractical approach to enhancing
organizational performance (2nd ed.). Hoboken, NJ: Jossey-Bass.
Editor's Notes
An online learning tool (e-manual) for Continuous Quality Improvement and Risk Management.
Core concepts overview
CQI and Risk Management: Core concepts
Six quality dimensions
PDSA Cycle
SWOT Analysis
Statistical Analysis, Benchmarking, Customer Satisfaction Measures
Seven CQI Tools
Seven CQI Tools (cont’d)
Reporting Incidents
Summary
References
Core concepts in Quality Improvement and Risk management are adding value to customer service while controlling costs, adding value to an improved experience; improving the health status of patients. Another core concept is reducing per capita costs. (Sollecito & Johnson, 2013). Elements of effective quality control and risk management are structural, philosophical, and health specific. Core concepts are based on the Six Domains of Health Care Quality and Patient Rights, which will be further touched upon later in this on-line learning manual.
“Safe: Avoiding harm to patients from the care that is intended to help them. Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively). Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care. Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy. Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.“ (cahps.ahrq.gov, 2016).
Organizations utilize CQI and Risk Management in health care not only for customer satisfaction. Accreditation requirements are assessed, cost containment. competition; added pressure from shareholders and employers are various reasons facilities use quality control teams and risk managers. (Sollecito & Johnson, 2013). Continuous quality improvement focuses on customer satisfaction with a philosophical baseline as well as methodological processes such as risk management protocol / procedures. Risk management is paired with CQI, in the process of maintaining best practices in the delivery of health care to the patient population. Tools are necessary to identify, assess, and measure system failures or risks; in order to achieve the best outcomes for patient - centered care - while also meeting regulatory requirements and organizational objectives. The PDSA (plan-do-study-act )cycle, Statistics, and the Seven Tools of CQI are examples of structural elements. Teamwork, organizational learning and customer strategic focus (patient – centered care), are philosophical elements. Risk adjustment outcome measures; epidemiological studies; and medical records/data are examples of health specific elements in CQI. Health information systems (E.M.R/E.H.R.) and data extracted from patient health information are the main tools necessary in Risk Management strategies.
The six dimensions are used as a guide, and direction for quality control standards. The six dimensions assist with directing the CQI team and health care workers with quality and risk management initiatives for health care that is satisfactory from the customer point of view.
Training staff in each area of the six dimensions is ongoing and continuous. If there are barriers in the process it can be challenging. Every area needs to be stressed as being important to deliver quality care with a focus on “patient – centeredness.” (Sollecito & Johnson, 2013).
The PDSA cycle is used by health care organizations as a starting point when planning the implementation of a system for quality control measures.
Planning can be the most difficult phase. Everyone must cooperate for a plan to be effectively carried out. All of the initial efforts for planning have a domino effect on whether or not a goal will be accomplished – the best interest of the patient has to be kept first and foremost in mind throughout all of the phases.
Plan- Do –Study- Act (PDSA)
• Consider what you want to accomplish
• Implement measures to assess when changes become an improvement
• Predict what changes will bring improvement
• Testing improvements
• Learning from testing the improvements
• Learn from data collected
• Sustainable Risk Management
• Negative results – what to do
• Review processes for quality and risk management. What can you do better? (Sollecito & Johnson, 2013).
The SWOT analysis can be used to plan strategies to achieve goals. Identify strengths that support any weaknesses within an organization. Eliminate any weakness by making necessary adjustments or changes. Determine threats and utilize opportunities to engage and collaborate with shareholders, and affiliates any common goals or interests.
Data can become obsolete and outdated. Data and information is gathered from a subjective point of view. The information will often times reflect the bias of individuals involved in the decision making process. (Sollecito & Johnson, 2013).
Statistics are a number #1 tool in CQI and Risk Management. By analyzing statistical data, information is obtained to make important decisions and improvements on the delivery of care to patients. Statistics, surveys, benchmarking; are all effective research tools that help Risk Managers to identify negative trends, or pinpoint a problem.
Each individual customer has a different opinion on what their perception of quality is. That needs to be kept in mind with the use of surveys for measuring customer satisfaction. Quality can be difficult to define, and gauge because of differences of opinions.
There is a great advantage to using the seven CQI Tools. These tools give a visual map of measurements for critical analysis during specific times – that can be compared against each other to assess, and discover needs. The measurements can determine if goals are actually being met efficiently.
The information has to be collected accurately to capture the best picture; also, analyzed from a professional in depth perspective. The flowcharts and other tools can give a shorter look (hours, days, weeks) at benchmarks, and scores or a longer outlook in (months to annually). Accurate predictions are needed to map out a goal, or institute a plan.
Incident reports give a clear and accurate picture of the problem. A date, time, detailed documentation enable Risk Managers to group together similar incidents for the implementation of quality control measures to rectify a small problem and prevent it from becoming a major problem. For example: a ‘skin assessment’ sheet is a form of incident reporting for wound care nurses. New skin tears, and bruises are documented in detail with measurements for follow up by a treatment/wound care nurse or team. The skin assessment sheets are also reviewed by a Risk Manager, or QI team for the purpose of 1) identifying the cause and 2) preventing future incidents or risks of the patient acquiring any skin tears.
Incident and accident reports have to be consistent with information that is not conflicting if more than one report is filled out for the same incident or occurrence. Investigations involving patient neglect and abuse incidents can be lengthy – over an extended period of time. The domino effects of adverse and negative findings of incident reports – depending on the situation - may be prolonged over an extended period of time whenever there is an immediate need to replace staff. Measurements for a new skin tear or open area must be consistently measured using the same method and treated.
Learning opportunities, in-services that are required; and continued education for employees include the use of online manuals communicated in the form of published manuals, and power point presentations. Individual on - line education that is self paced is another way health care organizations use health information systems to promote best practices. Data collection continues to be the main tool for effective risk management strategies in health care today. Core concepts in continuous quality improvements include team work; and overcoming barriers that present challenges for a health care team such as:
cultural differences
conflicting interests
poor communication – or lack of communication
Tools that are utilized in CQI teams for the purpose of managing risks are
Data and patient information
Plan –Do-Study-Act
Statistics, benchmarking, measurements
SWOT Analysis
Seven CQI Tools
Incident Reporting, Root Cause Analysis, and Research
The purpose of continuous quality improvement / risk management are to implement measures that give assurance to patients and their families that they are receiving the safest care possible; while remaining compliant with regulatory requirements that are issued to providers of health care services by local, state, and federal agencies. CQI and Risk Managers instill values in health care employees that reflect the use of best practices as it applies to the delivery of patient care at all times in the workplace.