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Professional Development Exam 3 > quality control in creating a culture of patient safety > Flashcards

quality control in creating a culture of patient safety Flashcards

1
Q

what is the institute of medicine?

A

a institute that regulates medicine and prevents patient death by encouraging safety

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2
Q

To err is human is about what?

A

asserts the problem is not bad people, it is good people working in bad systems

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3
Q

what is the focus of the IOM?

A

to make healthcare safer

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4
Q

what is Crossing the quality chasm about?

A

an urgent call that we had to do fundamental change to close the quality gap, redesign of the healthcare system!

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5
Q

What came from the redesign of crossing the quality chasm? (6 aims)

A 
safe
effective
patient centered
timely
efficient 
equitable
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6
Q

what is the fifth and final step of the management process?

A

quality control

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7
Q

characteristics of quality control? (3)

A
  • activities used to monitor and regulate services given to customers
  • performance is measured against predetermined standards
  • action is taken to correct discrepancies between these standards and actual performance
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8
Q

what are some management controlling functions? (3)

A
  • periodic evaluation of unit philosophy, mission, goals and objective
  • Measurement of individual
    and group performance
    against preestablished
    standards
    -Auditing of patient goals
    and outcomes
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9
Q

hallmarks of effective quality control programs? (4)

A 
-Support from top-level 
administration
-Commitment by the 
organization in terms of 
fiscal and human 
resources
-Quality goals reflect search 
for excellence rather than 
minimums.
-Process is ongoing 
(continuous).
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10
Q

three steps of the quality control process?

A
  • the criteria or standard is established
  • information is collected to determine whether the standard has been met
  • educational or corrective action is taken If the criteria has not been met
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11
Q

what are the steps in auditing quality control?

A
  1. establish control criteria
  2. identify the info relevant to the criteria
  3. determine ways to collect the info
  4. collect and analyze the information
  5. compare collected info with the established criteria
  6. make a judgement about quality
  7. provide info and if necessary take corrective action regarding findings
  8. reevaluate
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12
Q

what are standards? (2)

A

-Predetermined baseline condition or level of
excellence that constitutes a model to be followed
and practiced
-Each organization and profession must set standards
and objectives to guide individual practitioners in
performing safe and effective care.

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13
Q

what is a quality gap?

A

The difference in performance between top-performing health-care organizations and the national average is called the quality gap.

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14
Q

benchmarking #1

A

the process of measuring products or services against best performing organizations
organizations can determine how and why their organization differs from these exemplars, and then use the exemplar as a role model to create the standards.

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15
Q

benchmarking #2

A

critical event analysis and root cause analysis help to identify what and how an even happened, and also why it happened with the end goal being to ensure that a preventable negative outcome doesn’t occur.

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16
Q

what is a root cause analysis?

A
  • process designed for use in investigating and -categorizing the root causes of events (errors)
  • identifies all factors leading up to the event
  • conducted by agencys risk management department -results given to the quality improvement department.
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17
Q

What are the 3 audits frequently used in quality control?

A
  1. structure
  2. process
  3. outcome
18
Q

what is the structure audit?

A

monitor the structure or setting in which patient

care occurs

19
Q

what is the process audit?

A

measure the process of care or how the care was

carried out

20
Q

what is the outcome audit?

A

determine what results, if any, followed from specific nursing interventions for patients

21
Q

what are nursing sensitive outcomes?

A

the patients outcome in relation to nursing, patients outcomes are improved related to nursing care

22
Q

clinical practice guidelines

A

-provide diagnosis based step-by-step interventions for
providers to follow in an effort to promote quality care

-Also called standardized clinical guidelines

-Should reflect evidence-based practice (EBP); that is,
they should be based on cutting-edge research and best
practices

23
Q

quality improvement and assurance #1

A 
-Over the past three decades, the 
American health-care system 
has moved from a quality 
assurance (QA) model to one 
focused on quality improvement 
(QI). 
-The difference between the two 
concepts is that QA models 
target currently existing quality; 
QI models target ongoing and 
continually improving quality.
24
Q

what is total quality management?

A

aka CQI
the individual is the focal element on which production and service depend
the focus is on doing the right things, the right way, the first time and problem prevention planning

25
Q

what are the 5 parts of total quality management?

A
  1. customer focus
  2. personal involvement
  3. permanent improvement
  4. process approach
  5. system approach
26
Q

which company originated total quality management

A

toyota

27
Q

quality measurement as an organizational mandate? (4)

A
  • The joint commission- all of these are part of JCO
  • ORYX - quality measures as part of the accreditation process
  • core measures
  • National patient safety goals
28
Q

core measures that must be reported to JCO?

A
  • sentinel event
  • near misses
  • hospital readmission rates
  • HAI’s (CLABSI, CAUTI)
29
Q

what are core measures? pg. 635

A

things that are reportable to JCO

  • acute MI
  • children’s asthma care
  • ED visits
  • Hospital outpatient department
  • immunization
  • VTE
  • pneumonia
  • HF
  • surgical adverse events
30
Q

national patient safety goals

A

augment and promote specific improvements in patient safety

may be specific to certain hospital facilities

31
Q

Examples of sentinel events? (5)

A

Serious events by HCP’s and looks at the underlying causes

  • serious medication errors
  • significant drug reactions
  • wrong surgical sites
  • blood transfer reactions
  • infant abductions
  • suicide
  • discharge of infant to wrong family
32
Q

true or false

It is up to the nurse manager if they should report a sentinel event.

A

NOOOOOOO

ALL SENTINEL EVENTS SHOULD BE REPORTED TO JOINT COMMISSION

33
Q

what Is a sentinel event?

A

patient safety events that result in severe harm to the patient, or severe temporary harm

34
Q

what is CMS

A

centers for medicaid and Medicare services

35
Q

what role does CMS play ?

A

they play an active role in setting standards for and

measuring quality in health care including pay for performance.

36
Q

what is HCAPS?

A

Hospital consumer assessment of healthcare providers and systems

first national standardized publicly reported survey of patients perspectives of hospital care

Measures recently discharged patients perceptions of the hospital experience

37
Q

what is the cause of the vast majority of errors?

A

the system is the cause

38
Q

strategies to prevent med errors? (6)

A

-better reporting or errors that occur
-the leapfrog initiatives
-reform of the medical liability system
-barcoding
-smart IV pumps
med reconciliation

39
Q

What are leapfrog initiatives?

A

-Computerized physician–provider order entry
-Evidence-based hospital
referral
-ICU physician staffing
-The use of Leapfrog safe
practices scores

40
Q

4 examples of the leapfrog initiatives?

A
  • CPOE
  • IPS
  • NQF
  • evidence-based hospital referral
41
Q

Where did QSEN come from?

A

IOM initiatives

Professional Development Exam 3 (3 decks)

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