ch 23 managing quality and risk Flashcards
key organizations that seek to improve quality (5)
-Agency for Healthcare Research and Quality (AHRQ)
-National Quality Forum (NQF)
-Institute for Healthcare Improvement (IHI)
-The Joint Commission (TJC)
-Quality and Safety Education for Nurses (QSEN)
QM
quality management
QI
quality improvement
PI
performance improvement
TQM
total quality management
CQI
continuous quality improvement
4 things included in structure of total quality mangement
-facilities
-equipment
-staff
-finances
when is quality management most effective
most effective in a flat, democratic organization
goal of quality management
improve systems and processes, not to assign blame
6 steps in quality improvement process
-identify important needs to consumer
-assemble interprofessional teams to review identified needs/services
-collect data to measure
-establish measurable indicators
-select and implement plan to meet outcomes
-collect data to evaluate achievement of outcomes
benefits of comprehensive systematic approach (5)
-prevents errors before they occur
-identifies and corrects errors (adverse events decreased, safety and quality outcomes maximized)
-optimizes pt outcomes
-prevents pt care problems
-mitigates adverse events
overarching philosophy that defines a healthcare culture emphasizing customer satisfaction, innovation, and employee involvement
quality management
ongoing process of innovative improvements, prevention of error, and development of staff
quality improvement
data on performance for core quality indicators
accountability measures
what data is included in accountability measures (7)
-inpatient psych services
-VTE care
-stroke core
-perinatal care
-immunization
-tobacco Tx
-substance use
bar chart that identifies the major causes or components of a particular quality control problem
pareto chart
indicators that depend on the quantity or quality of nursing care and reflect the structure, process, and outcomes of nursing care
nursing-sensitive indicator
patient outcomes that improve if there is a greater quantity or quality of nursing care
(pressure ulcers, falls, IV infiltrations)
nursing sensitive outcomes
programs which ensure conformity to a standard
(documentation, adherence to practice standards)
quality assurance programs
focus of quality assurance programs vs quality improvement programs
QA: discovery and correction of errors
QI: prevention of errors
errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients and that indicate a real problem in the safety and credibility of a healthcare facility.
never events
events that should occur 100% of the time and include healthcare actions such as hand hygiene and accurate patient identification
always events
serious, unexpected occurrence involving death or severe physical or psychological harm, such as inpatient suicide, infant abduction, or wrong-site surgery
sentinel event
unplanned event that did not result in injury, illness, or damage but had the potential to do so
near miss
most common healthcare sentinel events
-wrong pt, site, procedure
-unintended retention of foreign body
-delay in Tx
-suicide
-operative/postop complications
-fall
-med error
-criminal event
-perinatal death/injury
-med equipment related
