Leadership, QI, policy Flashcards
Team Leadership Model: Decision 1
Should the leader monitor the team or take action?
Seek out information to understand the team
Analyze information
Interpret the information and decide how to act
Team Leadership Model: Decision 2
Should the leader intervene to meet the task or relational need?
Performance functions
Task functions
Team Leadership Model: Decision 3
Should the leader intervene internally or externally?
Assess for conflicts between group members.
Assess for unclear goals
Assess for proper support
Reflective Practice
Reflection is used to make sense of experience
Enhances critical thinking and clinical reasoning
Links theory to practice
Conflict
Occurs when a person believes he wants something that’s incompatible with what other people want
Conflict resolution
Directed by a neutral party who tries to get a win-win
Negotiation
Discussion between people, trying to reach a goal
Mediation
It’s like a negotiation but there’s a 3rd party who is facilitating a DISCUSSION
Arbitration
There’s a 3rd party who reviews the evidence and, unlike with mediation, they don’t just get a discussion going, they actually make a decision to settle the case
Professional Civility
Behavior that shows respect toward another person
Critical thinking
The acquisition of knowledge with an attitude of deliberate inquiry
Making clinical decisions based on evidence-based practice
Decreases the difficulty of choosing from conflicting or multiple recommendations when diagnosing and treating clients
Develops self-awareness, gain new insights about self, and in relation to others
Research Utilization
It’s a specific part of evidence based, where you examine knowledge from research to make changes in practice
The process of Research Utilization
Critique research
Synthesize the findings
Apply the findings
Measure the outcomes
Develop a clinical question using the PICO method
Patient/population/problem
Intervention
Comparison
Outcome
evidence hierarchy
RCT, meta analysis, systematic review
Evidence based guidelines based on systematic review
RCT without randomization
Evidence from systematic review of descriptive and qualitative studies
Internal validity
The intervention (independent variable) actually caused the change in the outcome (dependent variable)
External validity
The sample is representative of the population and the results can be generalized (aka applied to external people)
Descriptive statistics
Used to describe the basic features of the data in the study.
These statistics can be used in qual and quan studies
Examples of descriptive statistics are mean, standard deviation, and variance
Mean
average of scores
Standard deviation and variance
Pretty much the same thing.
How much deviation is there from the average. Low standard deviation means all the scores are around the mean. High deviation means the scores are all over the place, far from the mean.
Inferential statistics
Values that let you make conclusions that go beyond just the data themselves; it’s about taking the data and saying, this is what the data means for the larger population
Example of inferential statistics
t test
Analysis of variance
Pearson’s correlation
Probability
P value
t test
Assesses whether the means of two groups are statistically different from each other
Analysis of variance
tests the differences among three of more groups
Pearson’s r correlation
Tests the relationship between two variables
Probability
how likely is something. 0 = definitely will not happen. 1 = definitely will happen
P value
Also known as level of significance.
It describes the probability of a particular result occurring by chance alone.
For example, if P = .01, there’s a 1% chance that the outcome was just from chance and not from your intervention
Institutional Review Boards ensure that
Risks to participants are minimized
Participant selection is equitable
Adverse events are reported and risks and benefits are reevaluated
Informed consent is obtained
Everyone involved has to pass an exam about human rights
Quality Improvement
Projects that improve systems, decrease cost, and improve productivity
It lets you have a standardized way of evaluating things
Institute of Medicine’s quality aims
Safe Effective Client-centered Timely Efficient Equitable
Donabedian Model of quality improvement
Structure
Process
Outcome
Process of quality improvement can be P.D.S.A. cycle:
Plan
Do (carry out the plan)
Study (examine the results)
Act (decide what actions will improve the process)
Just Culture of Safety
Hold people accountable and investigates errors
Goal of creating open and fair learning environment to design safe systems and manage choices
It’s a mindset that makes people proactively look for ways to improve the system
Complexity Science
Provides a framework to understand, design, and structure change
It’s a nonlinear process
It focuses on the interaction of the parts and relationships
National Committee for Quality Assurance (NCQA)
The NCQA has developed Health Effectiveness Data Information Sets (HEDIS) to measure health outcomes. Currently, 11 HEDIS measures exist:
- Antidepressant medication management
- Follow-up care for children prescribed ADHD meds
- Follow up after hospitalizations
- Diabetes screening for people with schizophrenia and BP who use antipsychotics
- Diabetes monitoring for people with diabetes and schizophrenia
- Cardiovascular monitoring for people with cardiovascular disease and schizophrenia
- Adherence to antipsychotic medications for individuals with schizophrenia
- Use of multiple concurrent antipsychotics for child/adolescents
- Metabolic monitoring for children and adolescents on antipsychotic medication
- Use of first line psychosocial care for children and adolescents on antipsychotic medication
- Mental health utilization
Patient-Centered Care Model
Welcoming environment
Activation (which means client empowerment)
Coordination and integration (assess the client’s needs for services)
Access and navigation skills (Provide the patient with a “medical home,” keep wait times to a minimum)
Community outreach
Conflict of Interest
Conflicts of interests should be disclosed at least annually, or whenever new financial interests are received.
Examples of COIs include relationships with companies, money, referrals, and fee splitting.
The 4 components of health policy
Process: creating, implementing, and evaluating
Policy reform:
Policy environment: where it takes place
Policy makers
