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Compliance CA2 Revision > Quality Healthcare > Flashcards

Quality Healthcare Flashcards

1
Q

State and descirbe the 6 dimensions that constitute quality in healthcare as defined by WHO and IOM

A
  1. Safety: Minimise risk, catch near-miss, address root cause
  2. Effectiveness: Evidence based healthcare with improved health outcomes based on needs
  3. Equity: respectful to patient preferences, needs and values
  4. Efficiency: ensure timeliness and right setting/resources provided during care
  5. Accessibility: Min. cost to achieve max benefits
  6. Patient-centeredness: align with patients’ values and goals
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2
Q

Describe the relationship between timeliness and accessibility

A
  1. Accessibility: are patients able to access healthcare promptly? Any barriers to access?
  2. Timeliness: affect system responsiveness –> any delay in giving treatment, and hence reducing accessibility?
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3
Q

According to the Eurobarometer 2009 survey, what are the top 3 criteria when patients think of high quality healthcare? Relate each statement to the 6 dimensions of healthcare

A
  1. Medical staff well trained: Safety, Equity, effectiveness, patient-centeredness, equity
  2. Treatment that works: Effectiveness, Efficiency, Safety
  3. No waiting lists to get treated: Timeliness/Accessibility, Efficiency
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4
Q

The Gist of Quality Healthcare

A
  1. Meet the needs of patients and community in a timely manner
  2. Most effective, evidence-based treatment providing best outcomes
  3. Minimise risks
  4. Optimise use of resources
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5
Q

Describe the 4 Barriers to quality healthcare

A
  1. Rapid changes
  2. Growing complexity of healthcare (due to chronic diseases and increased life expectancy)
  3. Change in Public Health needs (e.g. aging population, chronic diseases)
  4. Disorganised healthcare delivery especially during care transition between institutions and care settings
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6
Q

List some factors influencing healthcare decisions

A

Education, Knowledge, experience, info, drug promotion, monitoring, habits, cultural beliefs, medication management systems, Demands/expectations, peer influence, supervision, restrictions, Infrastructure, Access to info, workload, consultation time

(idk, juz go see slide15 lemao)

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7
Q

State IOM’s 10 approaches for redesigning healthcare, and think about how they attempt to overcome each barrier of healthcare

A
  1. Care based on CONTINUOUS healing relationships
  2. Care is customised according to patient needs and values
  3. Patient is source of control
  4. Knowledge is shared, info flows freely amongst HCP, and between HCP and patients
  5. Decision making is evidence-based
  6. Safety is a system property
  7. Transparency is necessary
  8. Needs are anticipated
  9. Waste continuously decreased
  10. Cooperation among clinicians is a priority
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8
Q

Briefly outline the levels of care in Singapore

A
  1. Primary care: Polyclinics (20%), private GP (80%)
  2. Secondary and Tertiary care: 9 restructured hospitals and 8 national specialty centres (80%), 10 private hospitals (20%)
  3. Step Down and Long Term Care: Run by VWO, includes nursing homes, daycare, etc.
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9
Q

Outline the three principles in Singapore’s Healthcare philosophy

A
  1. Anchored on individual responsibility: Co-payment
  2. Achieve better health for all via healthy living and preventive care (e.g. health programmes)
  3. Ensure quality and affordable basic medication service for all
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10
Q

Reasons for healthcare transformation in Singapore

A

Ageging population will be acompanied by the increase in prevalence of chronic disease. Hence needs of health care will increase, but fewer people to support. Thus healthcare shift to a concept “Hospital to Home”

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11
Q

Singapore’s three “beyonds” in Beyond Healthcare 2020

A
  1. Beyond Hospital to community: patients receive care in community, nearer to home
  2. Beyond quality to value: Optimise use of resources
  3. Beyond Healthcare to Health
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12
Q

Briefly describe the 4 schemes of Singapore’s Healthcare Financing. What are the principles behind these schemes?

A

S + 3Ms

  1. Subsidies up to 80% at public healthcare institutions
  2. Medisave (from CPF)
  3. Medishield Life to aid larger hospital bills
  4. Medifund as safety net

Principles: Individual responsibility, and affordable healthcare for all (ensure no one denied to basic healthcare)

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13
Q

How is Singapore moving towards quality healthcare using Legislative framework?

A
  1. Hospital/clinics: Private Hospitals and Medical Clinics Act
    - Mandatory for QA committees
    - Empower MOH officials to inspect premises and ensure compliance and standards
    - Mandates monitoring of services and clinical indicators
  2. Professional registration and conduct
    - Licensing HCP
    - Empower councils and boards to uphold professional standards, investigate complaints of professional misconduct and remove those deemed unfit to practice
    - Mandates continuing professional education for license renewal
  3. Medical products, procedures and diseases
    - Instructions for specific situations
    - Rigorous regulation of Health Products via Health Product Act
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14
Q

How is Singapore moving towards quality healthcare using Non-Legislative framework?

A
  1. Evidence-based clinical practice guidelines and practice standards (e.g. Agency for Care Effectiveness)
  2. Monitor patient satisfaction via annual survey from different healthcare institutions
  3. Market-based mechanisms to promote competition and transparency (e.g. compare performance index)
  4. Voluntary accreditation for Quality and Safety Standards (e.g. JCI, ISO9000, Singapore Quality Class)
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15
Q

Purpose of the National Pharmacy Strategy (NPS)

A

Make pharmacy services to ensure:

  • Timely, accessible medications and pharmacy expertise
  • Affordability
  • Quality focused via health and preventive care, ensuring safe and effective medication use,

to give patients a safer and more integrated care

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16
Q

What are the five pillars of the NPS initiative

A
  1. Pharmaceutical Care Excellence
  2. Confident Pharmacy Workforce
  3. Re-design Supply Chain
  4. Information Enablement
  5. Technology Enablement
17
Q

Why should we care about Quality Improvement?

A
  1. Healthcare is about improving health and disease conditions of patients
  2. It is an improvement mindset and an attitude that we want ourselves and patients to have
  3. It’s about attitude and mindset to strive for improvements and make healthcare better
18
Q

Describe the essential elements used by the Insitute of Healthcare Improvement (IHI) to improve systems

A
  1. Will: You must have will to improve
  2. Ideas: You must have ideas about alternatives to status quo
  3. Execution: Make your ideas real. Try and test
19
Q

What are the three questions and the one cycle that make up the model of QI?

A

Model: Plan, Do, Study, Act

Questions:

  1. What are we trying to accomplish
  2. How will we know change is an improvement
  3. What change can we make that will result in an improvement?
20
Q

Using the model for QI, describe the steps the ultimately lead to implementation of changes

A
  1. Set aim: How good, by when?
  2. Establish process and outcome measures to measure improvements
  3. Identify changes that will achieve aim
  4. Test changes using PDSA (small pilots)
  5. Implement changes: Once your plan works, can increase to large scale
21
Q

In the model for QI, in which of the steps is the that lead to implementation of changes is the cycle applied?

A

Step 4: Test changes using PDSA

22
Q

What are the plans included under the “Pharmaceutical Care Excellence” pillar of the NPS?

A
  1. Establish role of pharmacy in community care setting
  2. Improve drug stewardship in non-acute care settings
  3. Establish collab models of care for med recon
  4. Implement clinical governance framework for medication management
  5. Promote pharmacists as part of multidisciplinary healthcare team
23
Q

What are the plans included under the “Confident Pharmacy Workforce” pillar of the NPS?

A
  1. Implement Advanced Practice Framework for pharmacists
  2. Establish pharmacy residency programmes
  3. Enhance pre-reg training
  4. Develop and train pharmacy technicians
  5. Build manpower capabilities for community care setting
  6. Build capability in collaborative prescribing
24
Q

What are the plans included under the “Re-design Supply Chain” pillar of the NPS?

A
  1. Centralise procurement, packaging, compounding and distribution
  2. Deliver medications when patients need it, and where patients need it
25
Q

What are the plans included under the “Information Enablement” pillar of the NPS?

A
  1. Deliver common platform to stimulate and share clinical, practice-based research and innovation
  2. Increase consumer and patient access to contextualised health info and education
  3. Establish National Drug Formulary (NDF)
26
Q

What are the plans included under the “Technology Enablement” pillar of the NPS?

A
  1. Standardise drug terminology and code structures for seamless communication and accurate transfer of info
  2. Provide common pharm system for harmonised medication dispensing and implement national charging engine to streamline the medication-related billing process
  3. Enhance telepharmacy services

Compliance CA2 Revision (5 decks)

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