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IDEALS > patient safety and improvement > Flashcards

patient safety and improvement Flashcards

1
Q

what is quality improvement?

A

it is committing to act upon mistakes and learning and reflecting on them - it is a commitment to continuously improving the quality of healthcare, focusing on the preferences and needs of people who use the services

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2
Q

what does QI incorporate?

A

it addresses the gap between the service being delivered and what should be delivered - it involves changing at least one of the quality characteristics - service, environment, product and making a sustainable difference

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3
Q

what does QI encompass?

A

a set of values and a set of methods

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4
Q

what is the set of values in QI?

A

commitment to self reflection, shared learning, use of theory, partnership working, leadership and an understanding of context

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5
Q

what is the set of methods in QI?

A

measurement, understanding variation, cyclical change, benchmarking and a set of tool and techniques

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6
Q

what are the basic principles of QI?

A

eliminate inappropriate variation and document any change

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7
Q

what does all improvement require?

A

change

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8
Q

what does the triangle model of suggested improvement skills show?

A

that there are experts on the outskirts for analysis and prioritisation, and then frontline staff to set goals and measure, clinical leaders for implementation and spread, operational leaders for managing spread, executives for setting direction and bug goals

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9
Q

how can QI protect patients and improve care?

A

place patients needs at centre, deal effectively with uncertainty, understanding the framework of system you work in, promote and monitor health, understand improvement, respond appropriately, demonstrate awareness and understand importance

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10
Q

what should every aim be?

A 
SMART
specific 
measurable 
achievable 
realistic/relevant 
time limited
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11
Q

what are the key improvement themes?

A

involving staff, users carers and public, process and systems thinking, personal and organisational development and making it a habit - initiating, sustaining and spreading

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12
Q

what is incorporated in process and systems thinking?

A

understanding the work processes and systems and how they link and looking for ways to increase capacity and reduce demand and waste

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13
Q

what is the aim, method, bias and sample size of improvement?

A

aim - improvement of care
method - observable
sample size - just large enough - small sequential samples
bias - accepting consistent bias

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14
Q

what is the flexibility of hypothesis, testing strategy, determining if the change is improvement and confidentiality of data in improvement?

A

flexibility - hypothesis is flexible and changes as learning occurs
testing strategy - sequential test
determining improvement - run charts or shewart control charts
confidentiality - data only used by those involved

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15
Q

what is the aim, method, bias and sample size of accountability?

A

aim - comparison, choice, reassurance, spur for change
method - not test just evaluating current performance
sample size - 100% of current data
bias - measure and adjust to reduce

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16
Q

what is the flexibility of hypothesis, testing strategy, determining if the change is improvement and confidentiality of data in accountability?

A

no hypothesis
no tests
no change focus
publicly available for review

17
Q

what is the aim, method, bias and sample size of research?

A

new knowledge
test blinded or controlled
designed to eliminate bias
just in case data

18
Q

what is the flexibility of hypothesis, testing strategy, determining if the change is improvement and confidentiality of data in research?

A

fixed hypothesis
one large tests
p values, hypothesis and statistical tests
research subjects identities’ are protected

19
Q

why do we need to test changes before we implement?

A

do not always determine the difference between change and improvement - need objective ways of measuring change impact

20
Q

what are the QI methods?

A

clinical audit - measuring against a predefined standard where the biggest challenge is completing the cycle of audit
PDSA - clinical audit a stage further - focusing on development testing and implementation and repeated rapid small scale tests of change

21
Q

what is the QI methodology beneficial for in clinical audit?

A

happens in a real time dynamic way with little or often measurement - focuses on change and making a visible, timely difference to patient care but making the process more robust

22
Q

what is PDSA?

A

plan do study act - test ideas before implementing changes, change ideas, measurements and aims incorporated

23
Q

what is beneficial about PDSA?

A

overall saves time as can see what is working effectively

24
Q

how would you measure improvement?

A

collect baseline data, define clearly define what you are collecting, clear and open transparent measurement and continuous measurement

25
Q

what are outcome measures?

A

they are measurements of achieving an endpoint

26
Q

what are balance and process measures?

A

balance - checking change hasnt caused another problem

process - measures of the throughput

27
Q

what is the aim of statistical process control?

A

display data to make the performance visible, show if has resulted in improvement compared to baseline data, determine if there are gains

28
Q

what is the clinical audit cycle?

A

identifying the problem or the topic, setting the criteria and agree standards, collect data, analysing the data, identifying why it did not work, implementing changes and monitoring progress

29
Q

how is QI achieved?

A

through changing provider behaviour and organisation through using a systematic change method and strategies

30
Q

QI day to day: what is the process?

A

aim, change, measure, predicted improvement and anticipated problems

31
Q

what is the most effective way to start QI?

A

small changes focuses on the team’s needs - rapid cycles of change measure review

32
Q

what are effective changes?

A

they are quick and immediately evident

33
Q

what is beneficial about ideas that don’t work?

A

they direct learning and can encourage enthusiasm - can later support a larger scale change

IDEALS (15 decks)

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