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Block 7 PID Exam 5 > Quality Management > Flashcards

Quality Management Flashcards

1
Q

Quality =

A

Measure of excellence or free from defects/deficiencies

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2
Q

Quality is typical measured by

A

Subjective opinion of relevant others

Outcomes and/or processes

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3
Q

Triple Aim

A

Decrease Costs
Better care for individuals (quality, satisfaction)
Better health for population

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4
Q

6 dimensions/aims for quality of health care

A 
Safety - most important 
Effective
Patient entered
Timely 
Efficient (EBP)
Equitable
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5
Q

Ability to influence quality - how can the consumer influence it

A

Give feedback
Compliant with episode of care
Using their resources

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6
Q

Ability to influence quality - how can the provider of service influence it

A

EBP
Seek feedback
Striving to always improve

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7
Q

Ability to influence quality - how can management influence it

A

Policies and procedures that are implements
Listen to staff to know what is working or not
Supporting their staff in ability to attain additional education

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8
Q

Ability to influence quality - how can regulatory bodies influence it

A

Make sure their min standards are met

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9
Q

Ability to influence quality - how can the media influence it

A

People are influenced by what they see
News stories
Commercials/ads

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10
Q

Ability to influence quality - how can the organization influence it

A

Amount of time they allow for pt - or if there is overlap
Support for con ed
Structure of the organization and their mission

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11
Q

Performance improvement

A

methodology to improve performance of organization and individual

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12
Q

Performance management

A

Process of improving effectiveness to accomplish mission and goals

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13
Q

Quality Improvement

A

Look more closely to define and close a gap between current and expected performance outcomes

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14
Q

Ways to establish, measure and monitor quality

A

Quality assurance
Quality Management
Total Quality Management
Continuous Quality Improvement

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15
Q

Quality Assurance

A

Identification of a process to determine the quality of a product or service

Systematic process to check to see if a product or service is meeting specified requirements

Retrospective

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16
Q

Quality Management

A

Structured system to achieve max customer satisfaction while maintain org efficiency and cont to improve process

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17
Q

Quality Management - A system of

A

Org structures
Policies and procedures
Responsibilities
Evaluation mechanisms

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18
Q

Total Quality Management

A

Integrates all functions to meet customer needs and organizational objectives
Optimal would be that needs = objectives

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19
Q

Total Quality Management - Emphasis on 4 aspects

A

1 Adequate processes
2 Competence
3 Soft elements
4 Infrastructure

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20
Q

Continuous quality improvement

A

Always looking for a better way
Learn from every interaction to improve
Most things can be improved

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21
Q

Systems/methods/approaches

A

5 Whys
FOCUS PDSA
Lean
Six Sigma

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22
Q

Systems/methods/approaches - 5 whys

A

Ask why 5 times
Why the failure has occurred - and then why - why and keep going
Get to the root cause/causes of the problem

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23
Q

Systems/methods/approaches - FOCUS PDSA or PDCA

A

F - find a process to improve
O - organize a knowledgeable team
C - clarify current knowledge of process
U - understand variability and capability
S - select plan for continuous improvement

PDSA or PDCA
Plan - Do - Select/Check - Act

Provides rapid feedback

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24
Q

Systems/methods/approaches - Lean

A

reduce or minimize variability
Eliminates waste
Usually combined with another

25
Q

Systems/methods/approaches - Lean - 7 types of waste and then will look at things you can do to decrease the waste

A 
Waiting
Overproduction
Rework/defects
Motion
Inventory
Processing
Unnecessary Transporting
26
Q

Systems/methods/approaches - Another aspect you look at with Lean process

A

Value added - added and makes it better for customer
Nonvalue added - is it really necessary to keep that component
Business value added - not really add value to pt but might be regulatory for the business

27
Q

Systems/methods/approaches - 2 common activities with Lean

A

5 S events - look at inventory where it is and make changes

Kaizen events - bring group of people together and make incremental changes - as you make changes you do obs and ensure that changes are meeting expectations that you wanted them to

28
Q

Systems/methods/approaches - Six sigma

A

Trying to reduce waste to a percentage of 99.99966%

Focus on improving quality by reducing number of defects

Go through significant training to get master black belt

29
Q

Systems/methods/approaches - Six sigma based on

A 
DMAIC
Define
Measure
Analyze 
Improve
Control
30
Q

QA vs. CQI

A

QA - inspecting, after the fact, blame gets put on people, and each dept is responsible for looking at it

CQI - focus is on prevention, looking at the processes - take blame game out and say everyone has will and skill to do their job, everyone has the responsibility

To meet triple aim we all need to be involved

31
Q

Comparative cost of quality

A

Prevention - $1 (prevent efforts/CQI)
Appraisal - $10 (inspection and trying to catch errors)
Failure - $100 (someone has really bad exp with your clinic)

32
Q

Key principles for total quality management

A 
Customer focused
Management commitment
Employee commitment
Employee empowerment
Fact based decision making
Continuous improvement
33
Q

Components

A 
Objective measurement of outcome
Identification of issue
Measurement of variation
Identification of causal factors
Develop process to address causal factors
Implement process
Reassessment of outcomes
34
Q

Variation =

A

Something different than what was expected

Can have a positive and negative impact (unexpected 30% inc in referrals for month)

35
Q

Basic assumption (with variation) =

A

A variation in input leads to inconsistency in output or outcome (so you have to look further to know if good or bad)

36
Q

Two types of variation

A

Common cause

Special cause

37
Q

Two types of variation - Common cause

A

Due to the process - thought of as a normal byproduct of the process

To reduce variation, must redesign the process

38
Q

Two types of variation - Special cause

A

Is not due to the process, is due to something outside of the process

To reduce variation, must identify the external cause and fix the cause

39
Q

Benchmarking

A

Look at your organizations internal processes and compare to similar organizations

Identify, understand and adapt exceptional practices

40
Q

Quality improvement tools

A

Tools to help identify and quantify the cause of the quality problem

41
Q

Quality improvement tools - Affinity diagram

A

Organize many ideas into groups, understand a process

42
Q

Quality improvement tools - Affinity diagram - Useful when

A

Identify and focus on major issues
At start of a project
In solution planning

43
Q

Quality improvement tools - cause and effect

A

Fishbone diagram

Helps identify many causes for a problem and sorts ideas into useful categories

44
Q

Quality improvement tools - cause and effect - example

A

PTs scheduled in gym have difficulty getting started on time for afternoon pts

Spine - pt late for apt
Ribs - causes

45
Q

Quality improvement tools - Check sheet

A

Used for data that can be observed and collected by same person
Collecting data on frequency or pattern

46
Q

Quality improvement tools - Check sheet - example

A

Telephone interruptions tally sheet - tally the reasons why

47
Q

Quality improvement tools - Flow chart

A

Tracks the actual work steps and the flow of those steps to understand a process and study it
Check in process for new patients

Identify main components - macro map and then get into the details

48
Q

Quality improvement tools - Histograms

A

Specialized bar chart that plots the freq of responses
Gives estimate of what does not meet specifications
Analyze whether process meets requirements

49
Q

Quality improvement tools - Pareto chart

A

Focus on key problems
Demonstrate the freq of or size of a problem
Helps define largest potential for improvement

50
Q

Quality improvement tools -Pareto rule

A

20% of the sources (of a variation) can cause 80% of any problems
So focus on that 20% and you will get 80% improvement

51
Q

Quality improvement tools - Run/Trend chart

A

Line graphs
Track data over a specified time period watching for trends
Once have process limits determined - can use control chart

52
Q

Quality improvement tools - Control chart

A

Monitor processes to show how it is performing and how the process and capabilities are affected by damage

This info is then used to ensure process is stable

53
Q

Once identified QI project that needs to complete - and gathered data and put things in place - now monitoring - Remaining steps?

A

Make sure the development of process (P and P) is to address causal factors

Implementation of PandP and everyone is aware

54
Q

Final step

A

Reassessment of outcomes
Use same assessment and tracking tools
Chart progress
Re evaluate new P and P for their effectiveness

55
Q

How do we participate?

A

We need to have a will
Do not be complacent - be out there and look for ways to do it better
Ideas
Execution

56
Q

Which tool for identifying reasons your referrals have declined

A

Cause and Effect - Fishbone

57
Q

Which tool for understanding why your accounts receivable is over 60 days

A

Flow chart or fishbone

Control chart might have told you that you have the problem, but fish or flow will tell you why

58
Q

Which tool to show you areas to focus on with documentation training with staff

A

Pareto chart
Will focus you to the areas where you have to do the most training
Will give you the biggest bang for you buck

59
Q

Which tool to track therapist productivity so you can see that they are seeing appropriate number of patients

A

Control chart or Run chart

Depends on if you are asking the question to get data or after something has been put in place

Block 7 PID Exam 5 (4 decks)

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