Ch. 2 Defining a Performance Improvement Model

Question 1

What are the basic system elements?

Answer 1

input(s) –> conversion process –> output(s)

Question 2

What is the significance of the IOM’s Crossing the Quality Chasm report?

Answer 2

It offered a new framework for a redesign of US HC system (STEEEP)

Question 3

Systems Iceberg metaphor (tip vs hidden)

Answer 3

Events
Patterns
———-
System structures - influence behavior, not readily visible

Question 4

What is systems thinking?

Answer 4

Orgs can be viewed as system of interdependencies and connectedness rather than a collection of individual parts/people

(NOTE: more emphasis on process/procedures and less on the indv)

Question 5

_____ is the idea that cause and effect are SUBTLE and long-term effects are NOT obvious.

Answer 5

Dynamic complexity

Question 6

Performance Improvement Frameworks: Lean Six Sigma

Answer 6

A combination of lean and Six Sigma to eliminate waste (lean) and improve accuracy (six sigma)

Question 7

What 3 things guide measurement?

Answer 7

1. logical and common sense
2. reg and accreditation requirements
3. High risk, high volume

Question 8

What is performance measure?

Answer 8

Quantitative tool that provides indication of org’s performance to a specified process/ outcome

Question 9

What is benchmarking?

Answer 9

Comparing your organization’s performance to that of similar organizations

Question 10

It is a JC requirement to appoint a ____ to oversee organization-wide PI activities

Answer 10

leadership group

Question 11

Performance Improvement Frameworks: Six Sigma

Answer 11

measuring variation in a process with the intent of producing error-free results

• Uses standard deviation

Question 12

Who should identify an improvement opportunity?

Answer 12

Management, leadership groups, staff, HC employees

Question 13

Steps to establish a PI program (5)

Answer 13

1. define and implement PI model
2. Staff edu to train employees
3. Define PI measures
4. Appoint PI teams for when exceeding established benchmarks
5. Record sig findings

Question 14

What does Deming’s cyclical model assumes?

Answer 14

There is always room for improvement in services, processes, and outcomes

Question 15

Why were the national patient safety goals established? By who? Significance of these?

Answer 15

In response to the Err is Human report by the JC. Required as part of accreditation process institutions must promote/train staffs in.

Question 16

What are the steps for Deming’s Plan? (4)

Answer 16

Plan, Do, Check, Act

Question 17

The science of good performance measures (4)

Answer 17

• numerator statement (# of times something occurred)
• denominator statement (# of times it could have occurred)
• Description of the population
• measurement period w baseline goal

Numerator; denominator; population; measurement period

Question 18

Performance Improvement Frameworks: Lean

Answer 18

Streamlines processes in overproduction, wasting time, waste, and attention to root causes

Question 19

Systems Iceberg metaphor: why does successful change require going below the waterline?

Answer 19

Need to better understand the results we are getting by understanding history, strategies managers may use and being aware of mental models

Question 20

Performance Improvement Frameworks: High reliability organizations

Answer 20

Learning to manage the unexpected from mistakes/errors caused by employees’ mindlessness from being hurried or overloaded