13.2 Quality Improvement Perspectives and Models

Question 1

Types of Models

Answer 1

Total Quality Management (TQM)
Continuous Quality Improvement (CQI)
Six Sigma
Lean
Clinical Microsystems

Question 2

Steps of QI

Answer 2

1. Assessment
   - Assessment to understand more about performance patterns.
2. Analysis
   - Display data in graphics and analyze the performance data.

Fishbone Diagram - Shows cause and effect to help find root causes and identify design failures that cause errors

Flowcharting - Used to detail steps in a process to identify and understand unnecessary ones

3. Plan for Improvement
   - Developing a plan for improvement.
   - Plan includes aim, measures, and proposed change.
4. Testing and Implementation of the Improvement Plan
   - Plan-Do-Study-Act (PDSA) - Focus is experimentation using small and rapid tests of change
   - Evaluate the success of intervention in bringing out improvement. Important to track the stability and sustainability of the new work process by monitoring system performance over time.

Question 3

Nurses In QI

Answer 3

• Bedside nurses have a unique perspective on root causes and interventions that may work reliably for dysfunctional care because we are at the frontline of care.
• It requires both professional knowledge (nursing knowledge) and knowledge of improvement that helps to promote continuous improvements in healthcare.

Question 4

PDSA

Answer 4

Plan - What is your plan
Do - What are you going to do and who are the people doing what
Study - Collect data and see how the process performed
Act - Modifying the plan for the next cycle