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Professional Development Exam 3 > Quality Improvement > Flashcards

Quality Improvement Flashcards

1
Q

What does the Institute of Medicine (IOM) say about what type of errors take place in hospitals?

A

98k die from medical errors in hospitals
Mainly medication errors than workplace injury

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2
Q

To Err is Human meaning

A

From the IOM - The problem isn’t bad people - it is good people working with bad systems.

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3
Q

Crossing the Quality Chasm

A

From IOM as well
Need to make a fundamental change in the hospital system to close the quality gap which led to the American health system redesign

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4
Q

Six aims of IOM

A

Safe
Effective

Patient centered
Timely
Efficient
Equitable

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5
Q

How did the focus of safety change in general?

A

Healthcare cared about safety but then it became a main focus

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6
Q

T/F
Healthcare has been using simulation for teaching for decades

A

False. We still don’t have enough simulations

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7
Q

Explain the Fifth and final step of the Management Process (3 steps)

A
  1. Evaluate services given to patient.
  2. Compare the care given to them to the standard
  3. And if workers don’t meet those standards, we take action to correct the gap.
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8
Q

Management controlling functions (3)

A
  1. Periodic evaluation
  2. Measurement of performance of individual and group
  3. Auditing goals
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9
Q

Hallmarks of effective quality control programs?

A

Support from top-level administration
Commitment of resources (human & fiscal)
Goals that exceed the standard
Continuous processing and improvement

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10
Q

What type of goals do quality improvement programs have?

A

Goals that exceed the standard

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11
Q

What type of resources do quality control programs have?

A

Fiscal and human resources

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12
Q

What type of support do quality programs have?

A

Support from top level administration

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13
Q

What type of progression do quality improvement programs have?

A

Continuous progress and improvement

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14
Q

First steps of the Quality Control Process

A
  1. Determine the criterion or standard
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15
Q

Second steps of the Quality Control Process

A
  1. Collect information to determine if the standard was met
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16
Q

Third steps of the Quality Control Process

A
  1. Education or corrective action taken so that we can meet the criteria
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17
Q

Steps in Auditing Quality control (8)

A

Establish control criteria
Identify the information relevant to he criteria
Determine ways to collect info
Collect and analyze info
Compare info
Make judgement about the quality
Provide information take corrective action if necessary
Re-evaluate

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18
Q

Define Standards

A

Predetermined baseline condition or level of excellence that constitutes a model to be followed and practice
- should be individual to each organization and profession for safety

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19
Q

Define Quality Gap

A

Difference in performance between top performing health care organization and the national average
- if its a big gap, you want take action to close it

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20
Q

Define Benchmarking

A

Process of measuring products, practices, or services against a best performing organization
- can be in any industry
Used to determine how your own organization differences from a top competitor & to use them a role model as a quality for the brand

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21
Q

What strategies can help us determine why a benchmark difference occurs?

A

Critical event analysis
Root cause analysis
- they analyze the why so we can learn from our mistakes and prevent future mistakes

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22
Q

Root cause analysis

A

Investigate the errors and factors that that took place by risk management department which lead up to the mistake

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23
Q

Frequent audits used in quality control (3)

A

Structure
Process
Outcome

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24
Q

Explain structure audit

A

Monitor setting structure in which patient care occurs
- inputs, environment , patient room
- staffing ratios and mix , wait time
Things that contribute to less quality

25
Q

Explain process audit

A

Measuring the process of care or how the care was carrie out (how nursing care was provided)
- bp checks, fetal heart tones, etc

26
Q

Explain outcome audit

A

Determine the results that occurred because of specific nursing interventions

27
Q

What is the best indicator of quality outcomes from the audits?

A

Outcome audit

28
Q

Why do we use standardized nursing language?

A

It helps nurses stay on the same page. Usually used with the software. And helps make gathering audits a lot easier.

29
Q

T/F

We can separate the nursing interventions from other disciplines to see how nursing effects patient outcomes

A

True. This is good because it allows us to have accountability and to grow

30
Q

Nursing sensitive structure audit

A

supply o fnursing staff

skill

educatoin of staff

31
Q

Nursing sensitive process audit

A

assessment, intervention, and job satisfaction

32
Q

nursing sensitive outcome audit

A

patient outcomes that improve if there is better nursing care and quality

33
Q

T/F

Nurses should practice to the full extent of your license

A

False. This means minimal standards. Nurse should practice to full extent of their education.

34
Q

What should the relationship be between nurses and doctors

A

Full partnership

35
Q

What are Clinical Practice Guidelines

A

Diagnosis based step by step interventions for physicians and nurses to follow to provide good care

  • based off the evidence
36
Q

What model has the American health system chagned to

A

Went from quality assurance to quality improvement

37
Q

Quality assurance vs quality improvement

A

Quality assurance - targets existing quality

Quality improvement - targets ongoing and continually making improvements

38
Q

TPS - toyota production system

A

Complete elimination of waste ?

39
Q

The joint commission includes

A

Oryx

Core measures

National Patient Safety Goals

40
Q

Oryx of Joint commision

A

Took outcome measures of quality and make it apart of the accreditation processes

41
Q

Core measures of joint commission

A
42
Q

Core measures includes

A

Sentinel event

errors, misses

re-admissoin rates for same problems

rate of HAI

43
Q

Core measures of 2019

A

pg. 635

Recordable and reportable data

  • acute MI
  • children asthma care
  • ED visits
  • hospital outpatient department
  • inpatient psych
  • immunizatoin
  • prenatal care
  • stroke
  • venous thrombo embolism
  • pneumonia
  • heart failure
44
Q

National patient safety goals

A

Augment and promote specific improvements in safety

45
Q

Sentinel events (serious) that have to be reported to the Joint commission

A

serious med errors

significant drug reactions

wrong surgical sites

blood transfer reactions

infant abductions

46
Q

Define sentinel event

A

Patient safety events that results in death, permanent harm, or severe temporary harm

47
Q

What is CMS

A

Centers for medicare and medicaoid

48
Q

Pay for performance by CMS

A

Hospital performance effects reimnbursement

49
Q

HCAHPS

A

Hospital consumer assessment of healthcare providers and systems

50
Q

What HCAHPS

A

National, public survey for patients

  • first of kind
    • measures their perception of hospital performance
51
Q

T/F

Vast majority of med errors are on the individual

A

False. Usually a system issues. Hospitals should be more focused on the system

52
Q

EBP referral

A

Send a patient to a better hospital

53
Q
A

Better reporting of the error

Leapfrog initiative

Reform medical liability system - diligent in civil law suit

Point of care strategies

  • bar coding
  • smart iv pumps
    • med reconciliation
54
Q

National quality forum

A

Endorses safe practices

55
Q

4 Leapfrog initiatives

A

Computerized physician order entry to cut down safety issues

EBP referral

ICU physician staffing

Leapfrog safe scores

56
Q

Computerized physician order entry

A

to cut down safety issues and readibility

57
Q

Computerized physician order entry to cut down safety issues

EBP referral

ICU physician staffing

A

Intesivist or specialized icu doctors help outcomes

58
Q

QSEN

A

patient centered care

teamwork colloboration

EBP

Quality improvement

safety

informatics

59
Q

What type of resources do quality control programs have?

A

Fiscal and human resources

Professional Development Exam 3 (2 decks)

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