Midterm Flashcards
How does the Institute Of Medicine (IOM) define healthcare 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
How does the Institute Of Medicine (IOM) define outcomes?
the anticipated benefits or results from a planned implementation of a process
Define each of the 4 concepts in the Plan-Do-Check (Study)-Act Model
Plan: Members of the team agree on a project and an intervention for change
Do: Tests of change are carried out, and outcomes are documented.
Check (Study): Data are analyzed to assess whether the change was successful and what actions may be necessary for the next improvement cycle.
Act: Changes are made to the intervention; when a desired outcome is reached, the actions are disseminated
Define Six Sigma
Six Sigma is a statistically driven improvement process. Sigma refers to the number of standard deviations a process is from average performance. If a process is within six standard deviations of the average performance, then it is said to be in Six Sigma. At this point, the process results in approximately 3.4 errors per million opportunities, or it is 99.99996% error-free.
The framework of Six Sigma includes DMAIC. What do each of these letters stand for?
Define: Define the project, goals, and other parameters
Measure: Use tools to determine quality, identify variation, validate measuring process, and collect data
Analyze: Identify underlying causes for an issue, testing statistical significance from the population sampled
Improve: Solutions are implemented to improve a process so it will be efficient, economical, and safe
Control: Systems are in place to ensure improvements are sustained
What does a regulatory agency do?
establishes mandates with authorization from Congress to write regulations that explain the technical, operational, and legal details necessary to implement laws.
What do the letters in NRC stand for?
Nuclear Regulatory Commission
What is the NRC’s mission?
Its mission is to ensure the safe use of radioactive materials for beneficial civilian purposes while protecting people and the environment.
What do the EPA’s radiation protection programs involve?
The EPA’s radiation protection programs involve regulation of the emergency response and storage, handling, and disposal of radioactive materials.
Which agency monitors and regulates the transportation of hazardous materials?
The transportation of hazardous materials is monitored and regulated through the Department of Transportation (DOT).
List the devices regulated by the Center for Devices of Radiological Health?
- Diagnostic x-ray imaging devices
- Microwave ovens
- Industrial x-ray systems
- X-ray or electron generators
- Television receivers and monitors
- Cellular phones
- Sunlamps
- Entertainment lasers
- Ultrasound imaging devices
What does the FDA regulate?
This agency regulates the manufacture and use of devices that generate isotopes.
Who monitors the operation of equipment or devices regulated by the FDA?
The operation of the actual equipment or device is monitored by the State.
What do the letters in SMDA stand for? What does the SMDA require?
Safe Medical Devices Act
It requires medical facilities to report to the FDA any medical device that has caused death or injury of a patient or employee.
What do the letters in OSHA stand for? Why was OSHA created?
Occupational Safety and Health Administration
OSHA was created to ensure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, and education.
Describe the policy that OSHA mandated in the mid 1980s.
a policy on bloodborne pathogens that stated that an exposure control plan must be in place for all industries in which workers may come in contact with blood and other infectious materials.
In what way is OSHA connected to radiation therapists’ mold (i.e. block making) rooms?
OSHA standards apply to mold rooms.
What does it mean to be an agreement state? (Hint: Atomic Energy Act of 1954)
In “agreement states,” the NRC has relinquished portions of its regulatory authority specific to licensing and regulating byproduct materials (radioisotopes), source materials (uranium and thorium), and certain quantities of special nuclear materials.
What do the letters TJC stand for? What is TJC?
The Joint Commission TJC is a nonprofit organization that accredits and certifies more than 20,000 healthcare organizations in the United States.
Without TJC accreditation, an institute may not receive what 3 things?
Without TJC accreditation, an institution may not receive reimbursement from CMS, have a physician residency program, or receive malpractice insurance.
What was designed to accredit independent oncology centers?
the American College of Radiation Oncology-Practice Accreditation Program (ACRO-PAP) program
What do the letters ACR stand for? What does the ACR devote its resources to?
The American College of Radiology devotes its resources to making imaging accessible to those who need it in a safe and effective manner. They also collaborate with the CMS and the Physician Quality Reporting System by encouraging physicians to submit outcome information.
What do the letters AAPM stand for? Who is the AAPM for?
The American Association of Physicists in Medicine is for medical physicists.
Which organization developed practice standards for radiation therapists in 1995?
American Society of Radiologic Technologists (ASRT)
Define the following terms according to the definitions developed by the ISO
a. Quality: the totality of features and characteristics of a radiation therapy process that bear on its ability to satisfy stated or implied needs of the patient.
b. Quality Assurance: all those planned or systematic actions necessary to provide adequate confidence that a product or service will satisfy given requirements for quality
c. Quality Control: the operational techniques and activities used to fulfill requirements for quality
d. Quality Assessment: the systematic collection of data and quality improvement (QI) that encompasses the activities directed to improve the quality of a system by reducing error or variation in that system
e. Continuous Quality Improvement: CQI’s principle is that room for improvement exists in every process, every time. CQI emphasizes the view of healthcare as a process, with focus on the system as a whole and not the actions of an individual. It is synonymous with TQM and Quality Assessment.
f. Total Quality Management: TQM is a customer-centered approach that is driven by data and long-term strategies for improvement. It is synonymous with CQI and Quality Assessment.
All aspects of a QA program can be checked with use of a
quality audit
For accreditation, measurement of patient outcomes is now required by which organization?
The Joint Commission
TJC’s Agenda for Change includes a set of 6 standardized core measurements. List them
measurements of morbidity, mortality, recurrence of disease, survival rates, patient satisfaction, and quality of life
What do the letters in SEER stand for? What does SEER do?
Surveillance, Epidemiology and End Results provides clinicians with population data stratified by age, gender, race, year of diagnosis, and geographic areas.
Who is part of the radiation oncology quality improvement team?
radiation oncologists, medial physicists, radiation therapists, medical dosimetrists, nurses, engineers, and other support staff
Who is commonly responsible for the establishment and continuation of a quality improvement program?
the medical director of the radiation oncology center
What is a quality improvement plan?
A quality improvement plan is an official statement that declares specific quality practices and resources used to conduct the activities that provide patient care.
What is the indicator measurement system?
This system provides a continuous evaluation of performance to help healthcare organizations measure and improve their quality of care through the use of common quality indicators.
What are quality indicators?
Quality indicators are tools used to measure a department’s performance of functions, processes, and outcomes over time.
According to the Inter-Society Council for Radiation Oncology Blue Book, what does structure include?
Structure includes the staff, equipment, and facility.
According to the Inter-Society Council for Radiation Oncology Blue Book, what does process cover?
Process covers the pre- and post-treatment evaluations and the actual treatment application.
According to the Inter-Society Council for Radiation Oncology Blue Book, how is outcome documented?
Outcome is documented by the frequency of accomplishing stated objectives, usually tumor control, and by the frequency and seriousness of treatment-induced sequelae.