CPXP April 2019 MW Flashcards
Health Literacy 4 Strategies
- Plain Language
- Clear and Simple
- Cultural Respect
- Offer and Confirm Understanding
An individual have the capacity to obtain, communicate, process, and understand
Total Performance Score (TPS) -VBP
Clinical Care
Safety
Person & Community Engagement
Efficiency & Cost Reduction
Ties Medicare payment to performance measures
LEAN
Integrated principles and tool developed by Toyota. Eliminates Waste
Focus on effectively delivering value
Continuous incremental improvement and respect for people.
Focus on customer/stockholders
PDSA
Plan, Do, Study, Act
LEAN
Testing a change in the real work setting- action orientated learning
Designing the plan for a change, implementing that plan, reviewing the outcomes and other associated days to see how closely the plan achieved the desired result, Just think the plan based on what was learned, beginning the plan do study act process again by designing and updated plan
Total Quality MGT (TQM)
MGT Approach. All organization members participating in improving processes, products, services and; culture in which they work. Long term success through customer satisfaction
Six Sigma
Views all work as a process that can be measured, analyzed, improved & controlled. Eliminates defects improves quality.
A defined and disciplined business methodology to increase customer satisfaction and profitability by streamlining operations, improving quality and eliminating defects in every organization-wide process. reduce operational costs. Take next level
DMAIC Six Sigma
Define, measure, analyze, improve, control - Qualitative & Quantitative approach
Outcome Measure
Reflects the impact of the healthcare service or intervention on health status of patients.
Ex: Mortality rates & rates of infection
How does the system impact the values of patients, their health and wellbeing? What are impacts on other stakeholders such as payers, employees, or the community?
For diabetes: Average hemoglobin A1c level for population of patients with diabetes
For access: Number of days to 3rd next available appointment
Process Measure
Are the parts/steps in the system performing as planned? Are we on track in our efforts to improve the system?
Indicates what a provider does to maintain or improve health
The % of people receiving preventive services such as, mammograms or immunizations.
VBP
Clinical Care Safety Person & community Engagement Efficiency & cost reduction 25% each
Shift
6 or more consecutive points above or below the median
Trend
5 or more increasing or decreasing points
How do you communicate data analysis outcomes & plans?
Communication
Key driver & vendor resources
Why data points are important
Stakeholders understand their important role in improvement
positive trends generate ideas on solutions to improve
PFAC Sponsor
Leader in the organization who supports & promotes the PFAC. Ensures greater buy-in from staff.
Triple AIM
Improve PE, Improve Health Populations, reducing per capital cost of health care
PFAC
When healthcare works together across the continuum. Patient Family Advisory Council 80/20 Planning, delivery, evaluation of HC that is mutually beneficial among providers, patients, and family Ex: Patient and family experience How care is delivered to patients Materials give to patients and families Facility design
How does effective communication impact the patients experience
Patients and family feel they are listened to, supported, understood, and validated.
Promotes trust
Improves quality of care
Improves outcome
RIPC
Patient family centered care
Respect
Information sharing
Participation w/ patients & families
Collaboration
Sympathy
Verbal & nonverbal - expression of feeling sad or dismay
Attached connected
Empathy
Understanding & connection with one another, while remaining somewhat detached
Shared Decision Making (SDM)
patients & provider make decision together.
take into account best clinical outcomes available
Culture
Collective programing or wiring of the human mind that distinguishes the member of one human group from another through behavior Self-worth esteem thoughts communication action beliefs values Guides decision making
REGARDS (diversity)
Race Ethnicity Gender Age Religion Disability Sexual orientation
Health Literacy
Individual can obtain, communicate, process, and understand basic health info and services to make appropriate health decision 12%
Impact of Health Literacy
Skip preventive care measure (PAP, flu shot, mammograms)
enter sicker
less knowledge of illness
increased hospital visits
Ordinal Data
Non numeric satisfaction
similar yet categories can be ranked
Very poor, poor, good, very good, excellent
Think order
Order of value is most important , difference between each is not known
Nominal
Qualitative
Categorized according to descriptive information labeling variables.
Gender, hair, black, white
Think NAME
Ethnography
Qualitative research that allows a trained observer to observe and document.
Studies the patients experience
Part of experience based co-design
Frequency of distribution
Distribution of scores w/in class of intervals Displays the number of observations within a given interval Used in a Histogram-show normal distribution (falls in the middle)
Variance
The square of standard deviation plus another measure of a distribution spread or dispersion
Validity
Quality of a test
Measures what is say it does
Interoperability
Computer systems or software to exchange & make use of information
Exp based design (EBD)
Methods focused on understanding the experience and emotions those involved in receiving and delivering health care services
design better exp for all pt. and staff.
Capture, understand, improve and measure
Exp. based co-design
Gathering experience from pt. & staff through in-depth interviewing, observations, group discussions, identifying KEY TOUCH POINTS.(EMOTIONALLY SIGNIFICANT POINTS). Assigning positive and negative feeling
Descriptive Statistics
Values that describe the characteristics of a sample or population
Affinity Diagram
Organized large number of ideas into their natural relationships.
Ex: sort comments into topics
Post-it into themes
Run Chart
Graph of data over time. Most important tool when accessing change.
Grievance
written or verbal regarding patient care, abuse or neglect, or issue related to the hospital that takes more than 24 hours to investigate, address, and communicate back to patient.
Must respond in 7 days and close grievance in 30 days
It is resolved when the patient is satisfied .
IHI
IHI- Institute for Healthcare Improvement established
1991
Promotes a methodology that uses PDSA to make small tests of change that, once measure, and updated can lead to wide spread change.
IHI questions:
What are we trying to accomplish? (AIM)
How will we know that a change is an improvement? (measure)
What change can we make that will result in improvement? (idea)
Static
Inform me - hospital website
Transactional
Engage me -EHR patient portal
Interactional
Empower Me - Social media & enterprise portals
Self-Management
Partner with me- digitals scales, telehealth
Interoperability
Support my e-community - health information and exchange
Coaching
Employee and coach must agree on the action item and timeline
Create an emotional bond.
Successful coaches consistently display a genuine desire to assist the employee to achieve the goal
What is the 4 step process?
Prepare-observations and validation
Discuss-skills and performance using open ended questions and active listening
Coach- to set expectations
Follow-up to validate progress is occurring and provide feedback and engagement
What are the elements of successful coaching?
The coach he must believe that the coach wants them to succeed the coach must create a safe and professional environment.
Create an emotional bond
-Technical help, individual challenge, personal support
Characteristics of a servant leader (HEAL)
- Listening
- Empathy understanding others feelings in perspective
- Healing emotional and spiritual health
- Awareness and persecution – do you understand my own values feelings, strength and weakness
Emotional attunement
An over arching principle of action and extraordinary patient experience. We must have the capacity to read a situation and grasp the emotional tone. nonverbal communication
Linear communication
Information/communication is transmitted from center to receiver. Relayed through the five senses sight smell and taste hearing touching. Risk equals false assumptions about needs and concerns/no validation
Circular transactional
Takes into account the context of communication and it’s circular involving mutual giving and receiving
Psychological contacts
Cultural Contacts personality
Relational contact volume touch, eye contact
Environmental context cold room versus comfortable room
Situational contacts location home office
Four step process of developing a patient experienced strategic communication plan
One: assess its current state. Where are we now? How are we doing
Two: reviews critical documents. Where are they and what do they say
Three: identify gaps in policy. Make note to add info and identify documents and process owners
Four: create communication plan
Who approves the grievance process
Governing Body
Responsible for effective operation of the grievance process
When did CMS begin collecting HCAHPS Data?
2006
Patient Family Centered Care PFCC
Planning, delivery and evaluation that is grounded in a mutually beneficial partnership Among healthcare providers, patients, families.
Re-defined the relationship and healthcare by placing an emphasis on collaborating with people of all ages, at a level of care, and in all healthcare settings
Goal is to her about the health and well-being of individuals and families and to maintain their control
Patient and family advisor
Patient and family of advisors are individuals who have received care at your hospital and who offer insight and input to help hospitals provide care and services that are based on patient and family identified needs rather than assumption of clinicians are other hospital staff
Cultural sensitivity
Recognition that there a difference between cultures. Reflected in the ways that different groups communicate, relate to one another and interact with healthcare professionals
Cultural sensitivity begins with the recognition that there are differences between cultures
Proving information to stakeholder what does it need to be?
Evidence based and data driven
Analyzing the data we collect in identifying those opportunities for improvement that will give us the most bang for our buck, then going back and re-running the data to verify the fatness arbor effort is being data driven
Central tendency
Mean median and mode
A measure of central tendency is a single value that a tamps to describe a set of data up identify the central position with in that set of data
Interval ratios
Mean
Average this is particularly useful in looking at trending over time. It helps to minimize the peaks and valleys, or sawtooth effect of performance improvement efforts or what’s called normal variation. The downside of the mean is that it can be pulled up or down by extreme values In a smaller sample
A type of average were scores are some in divided by the number of observations
Quantitative data discrete and continuous
Discrete is something you can count
Continuous data is something that you measure
Direct correlation
The values of both variables change in the same direction
Indirect correlation
The values of both variables change in the opposite direction
Histogram
A graphical representation of a frequency distribution. Frequency of distribution how often each value occurs
Apply the key elements for successful in sustained change
Establish a sense of urgency Create a guiding coalition Develop a vision and strategy Communicate the change vision And power broad-based action Generate short term wins Consolidate Gains and producing more change Anchor new approaches in the culture
Gemba
The place where value is created
Gemba Kaizen is a Japanese concept of continuous improvement designed for enhancing processes and reducing waste
Look at The process and the flow and not Soley focused on the end result
Health literacy age level
5th grade or below
Autonomy-Ethical respect
Respect the uniqueness and dignity of each person
Ethics-non maleficence
Prevent harm and removal of harmful conditions
Ethics- beneficence
Act to remove harm and prompt benefit
Justice-ethics
Treat individuals equally
Communication model
Engage, empathize, educate, enlist
Coaching create an emotional bond
Technical help
Dividual challenge
Personal support
Organizational change
first, there must be awareness of the need for change.
Culture plays a significant role
Change catalyst
Burning platform or threat Passion to be better External restructuring New facilities or technologies Visionary leadership
Strategic planning
The strategic plan is the —— that guides the hospital operation to its —-
Map and vision
Links with the organization does (the mission), where the organization is going (vision) and how the organization will get there (the values)
Median
The point at which 50% of the cases in a distribution fall below and 50% above
Mode
Most frequently occurring score in a distribution
Impact of PE
Patients and families feel listen to, supported understood and validated
Promotes trust
Proves quality of care
Improve health outcomes
Why do we use empathy and sympathy
Relieved suffering and distrust for patience, communicating affectively throughout the stages of illness, Dennis Sherrill respect for the desire of the patient and family during the healthcare decision making process, relating to and acknowledging the patient as a whole person not just a condition or disease
QAPI
Quality Assurance
Performance Improvement
Data driven approach to maintaining and improving safety and quality in nursing homes while involving nursing home caregivers in problem solving
