Giddens 50- Health Care Quality

Health Care Quality
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Terms in this set (24)
Health Care Quality
the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
Quality
Providing excellent service via competent care, comprehensive communication, professional teamwork, and culture sensitivity
Safe
All patients should expect care delivery that is correct and error free, professional practice within their scope of licensure, and with avoidance of injury in their care delivery
Effective
Integration of curative and preventative services and NOT providing services that are of no benefit
Timely
Reducing wait times. When delivery is timely, unnecessary complications are avoided
Patient-Center Care
Care that is responsive to individual preferences, needs, and values and these considerations are integrated into clinical decision making
Efficient
Efficient use of resources to minimize waste; encourage best practices
Equitable
Care provided without consideration to gender, ethnicity, geography, or socioeconomic status- all are afforded the same access
Avedis Donabedian defined health care quality as values and goals present in the. medical system and defined outcomes as validators of quality and effectiveness of medical care
1.) Structure: the attributes of settings in which care is delivered; where care is given impacts processes and outcomes
2.) Process: include the services offered: the technical quality of the service
3.) Outcome: the impact of structure and process on the patient's satisfaction; perceptions of quality, knowledge, attitudes, and behavior; and health outcomes
Errors
Errors of execution
Errors in health plan (wrong dx, wrong tx)
Represent a failure in the system or failure by staff
Near-miss, adverse event, sentinel event
RCA
FMEA (failure mode effective analysis)
Regulatory AgenciesThese agencies license health care facilities for operation and can fine organization or restrict services and suspend operation if there is a failure to meet expected standards CMS TJC OSHA USDA US DOJ DEAAdvisory BodiesMost influential: The Institute of Medicine The National Quality Forum The National Database for Nursing Quality Indicators The National Center for Nursing Quality Nursing-specific advisory bodiesQuality Management ProgramsShould be comprehensive, incorporating all areas of the organization, including clinical areas, administrative and management practices and facility operations PDSA Culture of Safety Leapfrog Total Quality Improvement Six SigmaCulture of Safetya blame free environment in which staff can practice & openly discuss potential errors or near-misses as well as actual errors---just culture: No shame No Blame7 subcultures of patient safety culture1. leadership 2. teamwork 3. evidence-based 4. communication 5. learning 6. just 7. patient-centeredCharacteristics of culture of safety1.) acknowledgement of the high risk, error prone nature of an organizations activities 2.) a blame free environment where individuals are able to report errors or close calls without fear or reprimand or punishment. 3.) an expectation of collaboration across ranks to seek solutions to vulnerabilities 4.) a willingness on the part of the organizations to direct resources for addressing safety concernsHealth Information TechnologyUse of data to track performance and benchmarks Coordinates care and multidisciplinary teams Translates new evidence into practiceThe Joint CommissionA not-for-profit organization that evaluates and accredits different types of healthcare facilities Highest standard for QUALITY and SAFETYNational Quality ForumA private, not-for-profit membership organization created to develop and implement a nationwide strategy to improve the measurement and reporting of healthcare quality. GOLD STANDARDNational Center for Nursing Qualitynursing-specific advisory body that addresses patient safety and quality in nursing care and nurses' work lives.Root Cause AnalysisError management used when a patient is seriously injured or killed as a result of medical errorFailure Mode and Effects Analysis (FMEA)a systematic process for identifying potential design and process failures before they occur, with the intent to eliminate them or minimize the risk associated with themLeapfrog GroupAn employer-based coalition, works with medical experts throughout the US to identify and propose solutions designed to reduce medical errors through the adaption of specific best practices "Never Event Policy"Computer Physician Order Entry (CPOE)A computerized program into which physicians directly enter patient orders; replaces handwritten orders on an order sheet or prescription pad