Quality Flashcards
1
Q
customer satisfaction
meet standards & criteria
cionsistent use of products
cost effective
continuous process
A
quality
2
Q
pre-determined level of excellence against which quality can be measures
A
Standards/Criteria
3
Q
intergrated review of evidence
A
Systematic Review
4
Q
SR of quantitative studies
A
Meta-Analysis
5
Q
SR of qualitative studies
A
Meta-Synthesis
6
Q
what are the 3 standards or criteria for quality
A
Structure
Process
Outcome
7
Q
antecedent variables, 7M’s
A
Structrue
8
Q
independent, interdependent nursing role
A
Process
9
Q
Satisfaction
A
Outcome
10
Q
If the target satisfaction is not met
A
OFI (opportunities for improvement)
11
Q
type of controlling that evaluates, monitor, and regulate services rendered to consumer
A
Quality Control
12
Q
Quality control 3 areas of concern
A
activities to evaluate
monitoring tools
regulation of services
13
Q
activities to evaluate
A
job satisfaction
14
Q
regulating of services
A
accreditation
15
Q
3 control process
A
- the criteria/standard is determined
- (implementation) information are collected to determine whether the standard has been met
- educational and corrective action is taken if the standard has not been met
16
Q
if the standard has not been met
A
Non-compliance
17
Q
if there is non-compliance what corrective action
A
OFI
18
Q
pre-determined level of excellence
A
standard
19
Q
3 standards
A
Standard for practice
organizational standards
standardized clinical guidelines
20
Q
quality of nursing care the patient receives
A
standard for practice
21
Q
PPNPS mean
A
philippine professional for nursing practice standards
22
Q
example of standards for practice/PPNPS
A
BON Res. 112 (2005)
Intrtavenous Nursing standards by ANSAP
23
Q
level of acceptable practice within an organization
A
Organizational Standards
24
Q
diagnosis-based, step-by-step interventions for providers to follow
A
Standardized clinical guidelines
25
other name of standardized clinical guidelines
clinical pathway
clinical protocol
26
example of standardized clinical guidelines
IMCI
27
RPSEA
record
process
structure
environment
account
28
systematic and formal examination of RPSEA
audit
29
3 types of audit dependening WHEN is the audit done
retrospective
concurrent
prospective
30
performed AFTER patient receive service
retrospective
31
performed WHILE patient receive service
concurrent
32
utilized for future direction
prospective
33
other 3 types of audits
structure audits
process audits
outome audits
34
incude resource inputs
7M's
ex. not enough staff
structure audit
35
flow, steps, procedures
ex. medication error
process audit
36
evaluation of results/product
ex. acomplishments
outcome audit
37
TQM also reffered as
continuous quality improvement
38
the quest for quality is ONGOING PROCESS and there is always room for improvement
Total quality management (TQM)
39
where did TQM originated
Japan
40
Its goal is quality nursing with a difference
Quality assurance/CQI/TQM
41
standards/critria includes
structure
process
outcome
42
involves 7M's
quality sevice
environment
resources
mechanisms/strategies
ex. qualification standards are met when hiring personnel and managers
structure
43
whare are the 7M's
manpower
machine
materials
manager
methods
moment
money
44
nursing practice
clinical guidelines and protocol
SOP
steps or process flows
ex. identify pt prior in giving medication; shorten admission time
process
45
performance appraisal
performance evaluation
self/personnel evaluation
customer satisfaction
percentage of accomplishments
ex. pt reported 80% satisfaction
outcome
46
customer satisfaction
outcome
47
continuouslong term improvement in processes an output
process
48
steps to ensure full involvement of entire workforce
structure
49
four processes of TQM
kaizen
atarimae hinshitsu
kansei
miryukoteki`
50
continuous process imrprovement
kaizen
51
will work as they are supposed to
atarimae
52
examine how uses apply the product (warranty)
kansei
53
aesthetic quality
miryukoteki
54
systematic process
proactive
overall management rather than single program
quality improvement
55
improve outcome based on customer needs
systematic process
56
doing the right thing
proactive
57
QA methods - chart audits
quality assurance (QA)
58
manufacturing industry
performance improvement (PI)
59
client focus
total organizational involvement
use of quality tools an statistics
identification of key process
Total Quality Management (TQM)
60
quality asssurance
doing it right (efficiency)
assess/measure performance
whether performance meet standard
improve if not meeting the standard
efficiency
reactice process
61
quality improvement
doing the right thing
meet customers need
build assess work process
identify opportunities for improved perormance
scientific approach to assessment and problem solving
continuous imorivement - on going management strategy
interpret process an outcome
effectiveness
proactive
62
training for quality
lean 6 sigma
63
belt colors
white
yellow
green
black
master black
64
neophyte, novice
white
65
understanding of basic principles
yellow
66
support and start keading project
green
67
able to manage project with quality
black
68
adviser for quality, consultant, coach, trainor
master black
69
components of lean 6 sigmA
DMAIC
8 WASTES (DOWNTIME)
5S LEAN workplace
FMEA
70
DMAIC
define
measure
analyze
improve
control
71
8 Waste (DOWNTIME)
Defect
Overproduction
Waiting
Non-utilized talent
Transport
Inventory
Motion
Extra processing
72
errors in HC caused by rework, scrap, & incorenct infor
defects
73
production more than needed before it is needed
oveproduction
74
wasted time waiting for next step process
waiting
75
underutilizing peope talent, skills, knwoledge
non-utilized talent
76
unecessary movements of produts & materials
transportation
77
excess products/materials not being processed
inventory
78
unecesssary movement of people (ex. walking)
motion
79
more work/higher quality is required by customet
extra processing
80
5s Lean workplace
sort
set in order
shine
standardized
sustain
81
keep what is only necessary and discard
(when in doubt throw it out)
sort
82
arrange and labell only necessary items for easy use and return by anyone
set in order
83
keep everything swept & clean for inspection...
shine
84
state that exist when the first 3 pillars (sort, set in order, shine) are properly maintained
standardized
85
make habit of properly maintaining correct procedure
sustain
86
FMEA
failure
mode
effect
analysis
87
potential
failure
88
type, ways, possibilities
mode
89
negative effect on process under study
effect
90
study risk and reduce it
analysis
91
strategies for quality improvement
(6) PFBRSB
PDCA
FOCUS methodology
benchmarking
regulatory requirements
sentinel events monitoring
balanced scorecard concept
92
PDCA
(plan do, check, act)
93
pdca begins with
3 questions (WHW)
94
what are the 3 questions
what - trying to accomplish
how - change is an improvement
what - changes will result in improvement
95
develop a change, test, activity aimed for imrpovement
Plan
96
carry the change, test out - small scale
Do
97
study results to evaluate what wa learneda and what can be predicted
Check
98
Adopt the change, send through cycle again, under different conditions, abandon the idea
Act
99
improvement area
key: what is the problem
oppurtunity for improvement, obtain support data of existence
Focus
100
key: focus efforts on the activities that will get maximum results
Pareto Principle
101
who made pareto principle
Vilfredo pareto
102
20% focused results in _________
80% unfocused results in __________
80% outcomes
20% outcomes
103
team that knows the process
identify:
staff - directly participate in the process
Team Leader
Organize
104
Many pt few nurses
functional nursing
105
many nurses few patient
case method
106
happenings in the current process
Clarify
107
what to use to illustrate process
Flow diagram
108
level of process
- identify TOO MANY steps in a process
- not well defined
- long waits in between process
Macro
109
level of process
- examining decision points
- redundancy of processes
- waiting time areas
- rework loops & handoffs
Micro
110
intervention to these level of processes
Focus on SBAR
111
SBAR means
situation
background
action
recommendation
112
degree of change neede
Understand
113
select solution for improvement - involve staff
implementation plann - check progress of solution
Solve the problem
114
measure vs comparing results
key work process vs "best performers"
collaborative and on going process
identify gaps in performance and options for improvement
focus on key services or processes
benchmarking
115
best practices of best performers
benchmarking
116
national patient safety standard
preparing for accreditation survey used to begin improvement strategies
Regulatory requirements
117
JCAHO
joint commision on accreditation of healthcare organizations
118
JCI
joint commision international
119
unexpected occurence causing death or serious physical or psychological injury
adverse SENTINEL event
120
provides oppurtunities for improvement
Analysis
121
identifies strategies for future events
linking sentinel event review
122
key: sharing information to all
Sentinel events monitoring
123
operating wrong side of the body
use of skin markers to identify correct site
124
wrong patient operated
2 patient identifier
125
2 patient identifier
- state full name
- date of birth
if pt is groggy bcoz of anes check valid IDs
126
wrong type of surgery
Time out
127
progress measurement-balance between:
- medical patient satisfaction
- cost outcomes
Balanced scorecard concept
128
4 key areas evaluated
(FCPC)
functional status of pt
clinical status of pt
patient satisfaction
cost of care
129
quality improvement tools
(5) IDASQ
problem identification
problem description
problem analysis
solution development tools
quality monitoring tools
130
problem identification tools
(4) ABFN
affinity diagram
brainstorming
flowchart
nominal group technique
131
qualitative data analysis
tool used to organize ideas and data
one of the 7 M abd planning tools
allow large numbers of ideas to be sorted into groups for review and analysis
Affinity diagram
132
who authored affinity diagnram
Jiro Kawakita (1960)
133
other name of affinity diagram
JK method
134
process of affinity
-record ea ideas on card
- look for ideas that seem to be related
- sort cards into groups untill all have been used
- sort large clusters into subgroups
-affinity diagram may be used to create CAUSE and EFFECT diagram
- large group
135
- disenting opinion
- group creativity technique
- generate large number of ideas for solution of a problem
- small group
Brainstorming
136
author
Alex falckney
book: applied imagination
137
4 basic rules in brainstorming
(FWWC)
focus on quantity
withhold cirticism
welcome unusual ideas
combine an improve ideas
138
"quantity breeds quality"
the greater the ideas generated, the greater the chance of producing radical and effective solution
focus on quantity
139
criticisms should be put on hold
focus on extending ideas
withhold criticism
140
to get a good and long list of ideas, ________
looking from new perspectives and suspending assumptions
welcome unusual ideas
141
goo ideas to form a single better good idea as suggested by the slogan 1+1=3
stimulate the building of ideas by process of association
combine and improve ideas
142
the whole is more than the sum of its part
Gestalt Theory
143
common type of chart that represents algorithm or process
used in analyzing, designing, documenting or managing a process or program
flowchart
144
author
Frank Gillbreth
145
4 types of flowchart
(DDSP)
Document
Data
System
Flowchart
146
document flow through system
document flowchart
147
data flows in the system
data flowchart
148
control at physical or resource level
system flowchart
149
controls program within a system
program flowchart
150
all participants have an equal say in the process
used to generate rank ideas
participants write ideas anon
nominal group technique
151
- participants ideas wirtten anonnymously
- moderator collects
- voted on by show of hands
Distillation
152
participants ranks idea
nominal group technique (NGT)
153
experts rank ideas
Delphi Technique
154
problem description tools
(6) BCFLPP
bar graph
check sheet
forced field analysis
line graph
Pareto graph
Pie chart
155
- rectangular bars
- comparing two or more values
- min. 2; max. 10 values
bar graph
156
compare amount or frequency of occurence
bar graph
157
horizontally oriented
vertically oriented
bar chart
column chart
158
also called as tally sheet or checklist
check sheet
159
simple document used for collecting data in realtime and location where data if generated
typically a blank form
check sheet
160
used in quantitative information
recorded by making marks ("checks")
Tally Sheet
161
typical check sheet is
divided into regions and marks made in different regions
162
data is read by
observing the location and number of marks on the sheet
163
5 Basic types of Check Sheets
(CLFMC)
classification
location
frequency
measurement scale
check list
164
traits: defects or failure ➡️ category
Classification
165
physical location of trait
Location
166
presence or absence of trait
frequency
167
divided into intervals
Measurement Scale
168
items to be perfomed is accomplishe = completed
check list
169
factors that influences a situation systematically
forcefield analysis
170
driving movement
facilitating; motivating
helping forces
171
blocking movement
opposite; restraining
hindering forces
172
kurt lewin
unfreeze
status quo / moving on
refreeze
173
cause-variation analysis of problem
Pareto Graph
174
values are plotted by
descending order accompanied by a line graph
175
left vertical axis
frequency of occurence
176
right vertical axis
cumulative percentage of total number of occurences
177
in quality control pareto chart often represents
most common sources of defects
178
circular chart
most widely criticized
Pie chart
179
promlem analysis
(3) FMS
Fishbone diagram
Matrix Diagram
Scatter plot Diagram
180
cause and effect diagram
ishikawa diagram
fishbone diagram
181
big arrows
small arrows
primary cause
secondary causee
182
show relationship between items
Matrix Diagram
183
basic tool for quality control
use cartesian coordinates
Scatter plot diagram
184
Solution Development Tool
(3) PPT
Prioritization matrix
Process decision program chart (PDPC)
Tree diagram
185
- priotize items and describe in terms of weighted criteria
- combination of tree and matrix diagram
- pair-wise evaluation and narrow down ooptions to most desired effect
Prioritization matrix
186
contingency plan
Process decision program chart (PDPC)
187
identify failure mode/risk
sonsequences of failure
risk mitigation plan
Process decision program chart (PDPC)
188
strategic decision making
breakdown broad categories into finer and finer levels of detail
Tree Diagram
189
Quality monitoring tools
(3) CHR
Control Chart
Histogram
Radar Chart
190
allow significant change to be differentiated from natural variability of the process
control chart
191
if not in control, the pattern it reveals help determine _____
source of variance to be eliminated
192
control chart also called as
shewart chart or process-behavior chart
193
control chart also consist of
GANTT Chart
194
it show schedule and illustrate project from start to finish
GANTT Chart
195
summary graph showing count of the data point
graphical display of tabulated frequencies shown as bars
Histogramv
196
visual tool display important metrics of performance at the control stage
radar chart
197
graphical method displaying multivirate data in the form of 2D chart of 3 or more quantitative variables
radar chart
198
trained to identify, analyze, and solve work-related problems and present solution
Quality Assurance (QA) team
199
alternative to the dehumanizing concept of labor (workers➡️robots)
Quality Circles
200
formal groups that meet at least once a week on company time
quality circles
201
POMR
problem oriented medical recording
202
4 components of POMR
(DPIP)
data base
problem list
initial plan
progress notes
203
dependent on organization
done day by day with daily expected outcomes
clinical pathway
204
clinical pathway outcome
expected and timed outcomes
205
clinical pathway
multidisciplinary orders - comprehensive picture of patient porgress
206
documentation of the quality nursing care
prioritizes nursing care
identifies and corrects deficiencies
increases performance
nursing audit
207
review request for medical treatment
review of tx and services that have been administered
common in philhealth
utilization review
208
utilization review purpose:
plan provides coverage for the medical service
209
integral part of the provision of good quality care
conferences, voluntary meetings
outbreak of disease or deaths
Morbidity & Mortality Meetings
210
tool for assessment of outcomes and values
surgical M&M
211
DNT
Do not treat
212
DNA
Do not Admit
213
example: pt was not able to wake up bcoz of overdose of anesthesia; suffered dehisence & eviceration; nosocomial penumonia
there should be M & M meetings
214
difference between actual and expected result
continuous process
VAriance
215
achieve maximum benefit & discharged earlier
positive variance
216
untoward events, longer stay at hospital
negative variance
