Quality Improvement

Question 1

Definition of Quality

Answer 1

Remember that quality is NEVER an accident it represents the wise choices of many alternatives

It can be defined as exceeding patient requirements

Overall it is a continuum to excellence

Question 2

Quality Management in Health Care

Canadian Pt Safety Institute (CPS) domain

Answer 2

Contribute to a patient safety culture.
Work in teams, communicate effectively.
Manage safety risks.
Optimize human and environmental factors.
Recognize, respond to, and report adverse events

Question 3

Quality Management…

Answer 3

Quality management refers to a philosophy of health care culture that emphasizes customer satisfaction, innovation, and employee involvement

Question 4

Quality Improvement…

Answer 4

Quality improvement refers to an ongoing process of innovation, prevention of error, and staff development that is used by institutions that adopt the quality management philosophy

Question 5

Benefits of Quality Management

Answer 5

Greater efficiency and proactive planning
Increases in patient safety with quality care
Enhanced job satisfaction

Question 6

Main cause of Medical Errors

Answer 6

poor processes

Question 7

6 Principles of Quality Improvement

Answer 7

• A patient (customer) focus
• Identification of key processes to improve quality
• Use of quality tools and statistics to support improvements
• Involvement of the HCT in problem solving
• Committed leadership
• Long term commitment

Question 8

Quality Control as a Process

Answer 8

1. The criteria or standard must be determined

Information is collected to see if the standard has been met

Action must be taken if the criterion is unmet

Question 9

Standards for Benchmarking

Answer 9

1. Structure (Audits) - Measures or Standards – focuses on internal characteristics of an organization and personnel.
2. Process (Audits) -Measures or Standards – focuses on whether the activities are being conducted appropriately.
3. Outcome (Audits)- Measures or Standards – Refers to whether the services provided make a difference

Question 10

Implications for Patient Care

Answer 10

Must be measured by the value of care
Value is a function of cost and quality outcomes together

Outcomes according to Kelly include a patients clinical or functional outcomes
Cost includes direct and indirect patient care needs

Question 11

Benchmarking…

Answer 11

Is the tool for identifying desired standards of organizational performance (Marquis & Huston)
Kelly states that “it is the continual and collaborative discipline of measuring and comparing the results of key work processes with those of the best performers

Question 12

Who is involved in Quality Control?

Answer 12

Organization
Canadian Government
CRNBC

Question 13

Canadian Patient Safety Institute

Answer 13

Has coordinating and leadership role across health care sectors and systems
Promotes leading practices and raises awareness of patient safety
Not-for-profit organization
Inspires improvement in patient safety and quality by developing evidence-informed practices

Question 14

Quality Assurance

Answer 14

• This is a method used to monitor health care.
• It focuses on clinical aspects of provider care.
• Many activities focus on standards

Question 15

Development of Standards

Answer 15

A standard” is a predetermined level of excellence that serves as a guide for practice”
The CRNBC has played a major role in developing professional standards for the BC Nurses.

Question 16

Standard of CARE

Answer 16

focuses on the pt

Question 17

Standard of PRACTICE

Answer 17

focuses on the nurse as provider

Question 18

Standardized Clinical Guidelines

Answer 18

High risk ( med errors, complications, falls, refusal of treatment, patient dissatisfaction etc.)

High volume

High cost

Problem prone

Question 19

Key Feature of a Profession

Answer 19

it monitors its own practice

Question 20

Solutions

Answer 20

• Mandatory continuing Education
• Development and use of critical paths
• Risk Management

Question 21

Measures to implement if Standards are not met

Answer 21

1. report and re-mediation

Reporting mechanisms set up in the system

Incident report and documentation

Question 22

Goal of Quality Improvement

Answer 22

• The goal of QI programs is not to assign blame
• It is the responsibility of all nurses and seeks to improve patient care at the minimal level.
• Working together to prevent problems is far more effective than correcting or dealing with problems after they occur