Breathing Life into Quality Improvement Flashcards
What is quality assurance?
The systematic monitoring and evaluation of the various aspects of a project, service, or facility to maximize the probability that minimum standards of quality are being attained by the production process
Reactive
What is quality improvement?
Building and executing a quality program
Proactive
Why is continuous quality improvement important?
To Err Is Human: Building a Safer Health System (1999) focused on patient safety and brought to the public’s attention the fact that 44,000 to 98,000 deaths occur each year due to medical errors
What is the focus of CQI?
The process part of donabedians quality conception
CQI promotes the view that addressing (controlling) factors that create variation aid in improving quality
Is process related to variation?
Yes
CQI promotes the view that understanding and addressing the factors create variation will produce superior quality
If quality “varies” – you are not in-control of the process
Do all quality improvement efforts require numerical data?
Yes
Because you cannot manage what you cannot measure
Measurement is translating what is observed into metrics
Metrics are the means used to record what is observed
*used for identifying and modifying system operations
What does more variation mean?
More waste
Inability to consistently produce the outcomes desired
What is process variation?
This is range of values that the metric can take as a result of different causes in the process
You can actually measure the variation in a system (they are all converted into numbers)
What is common variation?
Numerous, small causes of variability that are inherent to any system, operate randomly, or by chance
Normal or natural variations in process outputs that are due purely to chance
What is special cause variation?
Assignable, have relatively large effects on process
Occurs in occasion or sporadic
Variation in process outputs that are due to special factors (tools wearing out)
What are the two things that variation in quality of the production output is due to?
Common causes
Specific causes
What is donabedians best practice concept?
Technical management of health and illness
Management of interpersonal elements
Amenities of care
Ethical conduct
*looking at everything overall
What are the two approaches for CQI?
Preventative approach
Reactive approach
Does CQI require measurement and analysis?
Yes, which still remaining focused on the customer
What aspects of the operation does QI include?
All
What staff members are included in QI?
All
What are the steps for QI?
Create the Basic Structures
Evaluate & Determine Priorities
Select Performance Measures
Collect Data/Determine a Baseline
Analyze Data/Evaluate Performance
Plan & Implement Changes for Improvement
Monitor Performance Over Time
What is the ideal situation in terms of quality?
Quality as an integral part of the organization’s “culture”
Buy-in at all levels—Board, management, staff and patients.
Resources—staff time, meetings, information systems
Provide education
What three questions start the model for improvement (MFI)?
What are we trying to accomplish?
How will we know that a change is an improvement?
What changes can we make that will result in improvement?
What is six stigma?
A measure of quality that strives for near perfection
A disciplined, data drive approach and methodology for elimination defects in any process
What is the acronym for six sigma?
Define
Measure
Analysis
Improve
Control
What does PDSA mean?
Plan
Do
Study
Act
*MFI uses rapid cycles of these to test the effects of small changes
What is a systems approach?
A collection of parts which interact with each other to function as a whole
All the components must have a common aim
There experience with the system overall also has an effect (did they have difficulty finding the place, was the staff nice)
Will factor into their overall experience
What is a heap?
A term in-between a cow and beef
Group is not acting as a whole
