Health Care Quality Flashcards
Scope of quality: a continuum of quality consistency
Patient centered; Patient care outcomes; Patient satisfaction; Safety; Evidence-based; Resource efficient
Safe health care
Knowledge based, sound decision making, avoidance of injuries, scope of practice honored, practice within standards of care
Effective health care
Offers services that are most important;
Addresses needs of populations served, including the vulnerable;
Curative and preventive services;
Attains high population coverage
Efficient health care
Transitions are respectful, coordinated, and efficient;
Routinely uses information for decision making;
Monitors costs;
Minimizes length of stay;
Work done well with fewer resources
Errors of execution
Failure of a planned intervention;
Failure to complete an action as intended;
Variations form the standard of care
Errors in planning
Wrong diagnosis;
Wrong treatment plan;
Wrong delivery of care
Human error
Caused by people
System error
Failure in the system identifying a mistake that could potentially cause a harmful or unintended outcome
Near miss event
Mild variation in care; Caused by system or human; Does not reach the pt; Does not cause harm; Use FMEA to analyze
Sentinel event
Severe variation in care; Caused by system or human; Reaches the pt; Death or major harm occurs; Use RCA to analyze
Adverse event
Moderate variation in care; Caused by system or human; Reaches the pt; Minimal or no harm; Use FEMA to analyze
Health care quality
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
Complex adaptive systems
Humans are fallible;
Systems are flawed;
Negligence or criminality are rarely the cause of error
Root cause analysis (RCA)
Formal process: Define the problem, Identify the risks and protective factors, Develop and test prevention strategies, Implement and adopt strategies
Failure mode effective analysis
Process to prevent the occurrence of errors or system failures: Define the critical problem, Analyze causes, Identify solutions, Evaluate the results
Quality and safety education for nurses (QSEN)
Patient centered care; Teamwork/collaboration; Evidence-based practice; Quality improvement; Safety; Informatics
Process of quality
Services offered;
Technical quality of the services;
Quality of the interpersonal relations;
Adequacy of pt education, access, safety, and promotion of continuity of care
Outcomes of quality
The impact of structure and process on the pts satisfaction: Perceptions of quality, Knowledge, Attitudes, Behavior, Health outcomes
Culture of safety
Acknowledgment of high risk, error prone nature;
Blame free environment;
Expectation of collaboration;
Willingness to direct resources toward safety
Health information technology
Enables the use of data to track performance against benchmarks;
Coordinates the care and multi-disciplinary teams;
Translates new evidence into practice
Structure of quality
Adequacy of facilities, equipment,supplies, staff training, provider knowledge and attitudes, and supervision
Centers for Medicare and Medicaid services (CMS)
Regulates organizations;
Has quality oversight for Medicare/Medicaid reimbursement;
Includes focus on measuring nursing quality
The joint commission (TJC)
Only accrediting organization with the capability and experience to evaluate health care organizations across the continuum of care;
National pt safety goals established to address specific areas of concern in regards to pt safety
Institute of medicine (IOM)
Conducts studies and provides unbiased and authoritative advice to improve the nations health
The national quality forum (NQF)
Multi stakeholder organization that advances efforts to improve quality through performance measurement and public reporting
The national database for nursing quality indicators (NDNQI)
Aids the RN in pt safety and quality improvement by providing research-based national comparative data on nursing care and its relationship to pt outcomes
Health care quality interrelated concepts
Health policy; Health care economics; Health care organizations; Safety; Technology and informatics
PDSA
Develop a plan to test the change;
Try out the plan;
Analyze what happened from the change;
Determine what was learned, refine the plan, repeat the cycle
Leap frog group
Works with medical experts throughout the U.S. To identify and propose solutions designed to reduce medical errors
Regulatory agencies
Oversight bodies in place to ensure health care quality and public safety:
Centers for Medicare and Medicaid services;
The joint commission;
OSHA;
FDA;
DEA
Advisory bodies
The institute of medicine (IOM);
Quality and safety education for nurses (QSEN);
National quality forum (NQF);
National database for nursing quality indicators (NDNQI)
