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HCI III > Modules 4-5 > Flashcards

Modules 4-5 Flashcards

1
Q

What is the number one thing that makes change hard?

A

barriers

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2
Q

List common barriers

A

individuals, resources, systems, education, other

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3
Q

What is Six Sigma

A

It is a quality improvement philosophy that strives to eliminate defects through reduction of variation in a process

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4
Q

What does Six Sigma focus on?

A

Stakeholder engagement, data analysis, eliminating waste, improving outcomes

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5
Q

What factors influence which leadership style to use?

A

personal background, staff, the organization

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6
Q

BARRIERS: Individuals

A
  • attitude (i.e., fear of change, lack of self-control)
  • practice skills (i.e., limited communication skills)
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7
Q

BARRIERS: Resources

A
  • lack of management, incentives, protocols, guidelines
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8
Q

BARRIERS: Systems

A
  • Limited acceptance by other health care professionals
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9
Q

BARRIERS: Education

A

Knowledge and training

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10
Q

BARRIERS: Other

A

Lack of mentors and models, lack of vision

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11
Q

Autocratic Leadership Style

A
  • classical approach
  • manager retains power and decision-making authority
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12
Q

Bureaucratic Leadership Style

A
  • manages “by the book”
  • Everything done according to procedure or policy
    – business focused. it’s not about the employees
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13
Q

Democratic Leadership Style

A
  • aka participative style
  • allows staff to establish goals
  • encourage growth and promotions
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14
Q

Laissez-Faire Leadership Style

A
  • aka the “hands-off style”
  • minimum intervention from leader
  • Full autonomy for workers
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15
Q

What is Negotiation?

A

A voluntary attempt, through direct dialogue, to resolve conflicts that arise from competing needs, interests, and goals.

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16
Q

How do you prepare for a negotiation?

A

-recognize you’re preferred negotiation style
-frame, plan, and strategize

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17
Q

What are the different styles of negotiation?

A

Distributive (win/lose)
Integrative (win/win)
mixed-motive

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18
Q

What factors could affect negotiations?

A
  • negotiating in teams
  • multi-party negotiations
  • power imbalances (who has the resources)
  • history
  • personalities
  • time
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19
Q

Essentials for Negotiating:
Effective negotiators…

A
  • recognize the choices that they need to make
  • recognize and adapt to others’ behaviors
  • Are both empathetic and assertive
  • Carry the burden of moving negotiations ahead
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20
Q

What are the roles in a Lean Six Sigma Project?

A
  • master black belt
  • black belt
  • green belt
  • yellow belt
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21
Q

Master Black Belt

A
  • Teach, coach, and mentor black and green belts to ensure the methodology and tools are being applied properly
  • advisor
  • Master
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22
Q

Black Belt

A
  • lead, execute, and complete the project
  • Can lead complex, business critical projects
  • Expert
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23
Q

Green Belt

A
  • Support Lean Six Sigma projects through executing a subset of tools and phases
  • Able to do the work in a capable manner
  • Practitioner
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24
Q

Yellow Belt

A
  • Plays a small role in the process of developing knowledge
  • Understand the process and what they have to do
  • Introductory
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25
Q

White Belt

A
  • Plays a small role in the process of developing knowledge
  • All those who have to interact with the process
  • Awareness
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26
Q

Six Sigma

A
  • More focused on reducing defects (variation) and increasing productivity
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27
Q

Lean

A
  • Adopt many ideologies from just-in-time manufacturing
  • Strive for perfection
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28
Q

What is Lean Six Sigma?

A
  • Standard of excellence equates to 3.4 defects per million opportunities (DPMO)
  • Centered on the concept that any process variation can be reduced using data collection, statistical tools, and sustained process monitoring
  • Sigma measures the variability of a process concerning specification limits (set by customer)
  • Sigma level is a metric that represents how well a process is performing, how much variation there is, and how likely a defect will occur
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29
Q

Who created the 5 principles of LEAN thinking?

A

Jim Womack and Daniel Jones

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30
Q

What are the 5 principles of LEAN thinking?

A
  • value
  • create value stream
  • flow and pull
  • empowerment
  • perfection
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31
Q

5 principles of LEAN thinking:
Value

A

customers will pay a certain price for a good/service based on the associated value they place on it

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32
Q

5 principles of LEAN thinking:
Create Value Stream

A

visualize and map out high-level actions of the entire process to identify value-added activities that can be eliminated, time delays, and waste (non-value-added activities)

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33
Q

5 principles of LEAN thinking:
Flow and Pull

A

increase flow of products/services through the value stream based on pull of customer demand (just-in-time)

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34
Q

5 principles of LEAN thinking:
Empowerment

A

empowering employees provides greatest customer value and works to eliminate waste

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35
Q

5 principles of LEAN thinking:
Perfection

A

working towards zero defects and zero waste

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36
Q

What does DMAIC stand for?

A

Define
Measure
Analyze
Improve
Control

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37
Q

DMAIC: Define

A

involves selecting a project based on business, operational, or customer needs and aligning with organizational strategy

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38
Q

DMAIC: Measure

A

involves data collection, validation of the measurement system, and initial documentation or variation

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39
Q

DMAIC: Analyze

A

Uses date to establish the main inputs (causes) that affect the outputs (problem)

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40
Q

DMAIC: Improve

A

identifies the improvements/solutions to optimize the outputs and reduce defects

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41
Q

DMAIC: Control

A

uses documentation, monitoring, and accountability assignment to maintain the gains made by process improvements

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42
Q

Project Identification - Pareto Priority Index

A

PPI = [(Savings $) x (Probability of Success)]/(Cost x Completion Time)

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43
Q

What Is the Pareto Priority Index equation used for?

A

To help identify/prioritize which tasks/projects to focus first

44
Q

SIPOC

A

Supplier
Input
Process
Output
Customers

45
Q

What is SIPOC?

A
  • A process that is a series of steps or actions that transform inputs (x) into outputs (y)
  • A tool used by a Six Sigma project team to further define a project not fully scoped
46
Q

provides general direction and is considered ‘voluntary’

A

guideline

47
Q

Method(s) that has/have consistently shown results superior to those achieved with other means

A

best practice

48
Q

intermediary measures between an intervention and an outcome

A

process/performance indicator

49
Q

What we measure

A

metric

50
Q

measurement norm when compared to similar entities

A

benchmark

51
Q

Formal statement of a principle, course, or plan of action that should be followed; thou must

A

policy

52
Q

Provides detailed steps someone needs to follow to achieve a recurring task; thou shall

A

procedure

53
Q

Specifies uniform uses of specific technologies or configurations

A

standard

54
Q

Detailed plan of a scientific or medical experiment, treatment, or procedure; requires written order by provider before it can be initiated

A

protocol

55
Q

The result of a performance; an observable or measurable terminal event

A

outcomes

56
Q

ensuring that policies, procedures, and activities are consistent with rules, regulations, and standards

A

compliance

57
Q

how well a certain activity is accomplished (e.g., meeting vs. not meeting expectations

A

performance

58
Q

ECHO model is an integrated approach that is a theoretical basis for consideration of potential trade-offs among variables in optimizing allocation of health care resources. The VARIABLES in the ECHO model are:

A

clinical
humanistic
economic

59
Q

T/F
Traditionally, outcomes in pharmaceutical products or services were measured based on economic efficiency and quality whereas today the focus is more on clinical-based

A

False

60
Q

OUTCOME, PROCESS, STRUCTURAL?
% of pts with T2DM who have an A1C at goal of < 7%

A

outcome

61
Q

OUTCOME, PROCESS, STRUCTURAL?
% of pts with HTN who had elevated BP values upon presentation to clinic had a repeat BP value recorded

A

process

62
Q

OUTCOME, PROCESS, STRUCTURAL?
% of pts with T2DM diagnosis who are being seen daily by a PharmD

A

structural

63
Q

T/F
Historically, quality measures focused on structural and process whereas today the focus has shifted to outcomes

A

True

64
Q

T/F
KPIs and KSIs as metrics have an external application and can be used when comparing similar entities within the same sector

A

False

65
Q

When choosing healthcare quality measure, the monitoring system must support ongoing awareness of performance trends and emerging issues and essential elements include

A
  • periodically assess sustainability
  • develop report formats to provide clear communication
  • establish a schedule for regular reporting
66
Q

T/F
Effective dashboards can be beneficial in their ability to visualize single data points and provide greater accessibility and accountability in the use of data information

A

false

67
Q

T/F
An effective dashboard is created with a top-down approach in terms of organizational hierarch (e.g., executive dashboards should feed into departmental dashboards)

A

false

68
Q

An effective dashboard should:
(4 options)

A
  • have clearly defined roles in place for ownership or metrics
  • tell a story
  • be intuitive
  • have experts on the data at the department level
69
Q

When designing metrics, they should be what?
(5 options)

A
  • time bound
  • measurable
  • attainable
  • relevant
  • specific
70
Q

Results from the SURMOUNT studies for the newest GLP-1 RA to hit the market, tirzepatide (Mounjaro) demonstrated a weight loss exceeding that reported from other GLP-1 DAs in use. As an Amb care pharmacist working in an internal med clinic you have a large population of pts w/ T2DM being treated with a GLP-1 RA many of whom have converted over to tirzepatide. You are interested in determining how many of those pts who have converted to trizepatide have experienced improvement In weight loss. You develop a surgery to send to those pts to assess the impact. The survey is an example of which type of outcome?

A

Humanistic

71
Q

Compliance

A

Ensures that policies, procedures, and activities are consistent with laws, rules, regulations, and standards

72
Q

Performance

A

Tells us how well a certain activity is doing whether you are accomplishing what was intended

73
Q

Outcomes

A

The result of a performance and is a terminal event
(An observable or measurable terminal event)

74
Q

ECHO model assists in…

A

planning, conducting, and evaluating pharmaceutical products and services from a multi-dimensional perspective

75
Q

benchmarks

A

Measurement ‘norms’ that are used when comparing to similar entities

76
Q

Lean focuses on…

A

waste reduction

77
Q

Six Sigma focuses on…

A

emphasizes variation reduction

78
Q

RCA

A

retrospective review of system processes to determine the root cause of an adverse event to outcome
-what went wrong

79
Q

FMEA

A

prospective review of system processes to determine areas of high risk or vulnerability before they lead to an adverse event or outcome
-what could go wrong

80
Q

Dashboards

A

Method by which you can track, trend and communicate process improvement and outcome measures

81
Q

What is the ECHO Model?

A

A combination of traditional clinical-based outcomes with more contemporary measures of economic efficiency and quality

82
Q

Economic evaluations focus on:

A

cost-of–illness
cost-minimization analysis
cost-benefit analysis
cost-effectiveness analysis
cost-utility analysis

83
Q

Humanistic evaluation focus on:

A

Quality of life
Patient preferences
Patient Satisfaction
Willingness-to-pay`

84
Q

Quality

A

increase probability of positive outcomes and decrease probability of negative outcomes

85
Q

Historical Focus

A

structure and process

86
Q

Current Focus

A

outcomes

87
Q

T/F
With VBC, healthcare organizations and providers do not assume more risk.

A

False
W/ VBC healthcare organizations and providers, they DO assume more risk

88
Q

Donabedian Model

A

Quality measure classified as structural, process, or outcome

89
Q

Pharmacy Standard of Care

A

What a reasonable and prudent pharmacist would do under the same circumstances

90
Q

Guideline

A

Provides general direction. additional advice, and support for policies, standards or procedures
-voluntary

91
Q

Best Practice

A

method(s) that has/have consistently shown results superior to those achieved with other means

92
Q

Policy

A

relates to a decision of the governing body of an organization and is typically an internal organizational decision that aids how it functions
-thou must

93
Q

Procedure

A

Provides detailed mandatory steps someone needs to follow to achieve a recurring task or comply with a policy
-thou shall

94
Q

standard

A

specifies uniform uses of specific technologies or configurations

95
Q

protocol

A

Detailed plan of a scientific or medical experiment, treatment, or procedure

96
Q

Six Sigma

A

eliminate/avoid defects

97
Q

Lean

A

eliminate/remove/minimize waste

98
Q

Event Flow Diagram

A

Trace chronology of events that led to the adverse event or near miss

99
Q

5 Why’s Analysis

A

When looking at one major cause and need to drill-down to arrive at one root cause

100
Q

Fishbone Diagram

A

When looking at numerous major causes and need down probing to arrive a numerous root causes based on ‘cause and effect’ relationships

101
Q

Hazard Score =

A

severity x probability of occurrence x probability of detection
HR = severity x POO x POD

102
Q

Pharmacy Quality Assurance

A
  • performance measures
  • monitoring measures
  • quality improvement indicators
103
Q

Performance measure

A

intended to evaluate the quality …
- e.g., proportion of days covered: statins and statin use in DM pts

104
Q

monitoring measures

A

intended to promote standardized documentation and reporting …
- e.g.,med therapy problem resolution

105
Q

quality improvement indicators

A

intended to asses improvement …
- e.g., provisions of MTM svc’s post hospital discharge and readmission of pts provided MTm sec’s post hospital discharge

106
Q

Essential elements of choosing health care quality

A
  • choose a limited set of effective measures
  • establish a schedule for regular reporting
  • develop a report formats to provide clear communication
  • establish procedures for acting on identified problems
  • assess sustainability periodically
107
Q

Good health data visualization helps healthcare teams and organizations to:

A
  • simplify data information
  • increase collaboration
  • avoid data misinterpretation

HCI III (3 decks)

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