Quality Of Care

Question 0

IOM 2001

Heath care should pursue 6 major aims:

Answer 0

1. Safe
2. Effective
3. Patient-centered
4. Timely
5. Efficient
6. Equitable
   SEPC TEE

Question 1

IOM definition of quality of care (1990)

Answer 1

The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge

Question 2

William Edwards Deming (1900-1993)

Answer 2

1. well known for helping Japanese companies apply Sheward’s statistical process control
2. Best known for the “plan-do-check-act” cycle

Question 3

Avedis Donabedian (1919-2000)

Answer 3

1. physician and founder of the study of quality in health care and medical outcome research
2. Health care measure/framework in health service research:
   
   • Structure
   • Process
   • Outcome

Question 4

Structure

Answer 4

• Personnel characteristics

- Institutional features

Question 5

Process

Answer 5

Activities in providing care

Question 6

Outcome

Answer 6

Results of care

Question 7

Most common QI methods used in the health care

Answer 7

1. PDSA
2. Lean methods
3. Six sigma

Question 8

PDSA

Answer 8

1. Plan
2. Do
   Carry out the plan
3. Study
   Analyze data
4. Act
   What changes are to be made
   Next cycle

Question 9

Six sigma

Answer 9

• A measure of quality that strives for near perfection
• at the level of 6 sigma, a process has about 3.4 defects per million opportunities (DPMO) and is virtually error free (99.9996%)

Question 10

Lean method

Answer 10

Toyota production system
The core idea of lean is to maximize customer value while minimizing waste
Lean =
- maximize value-added steps
- removing non-value-added activities

Question 11

Joint Commission

Answer 11

Hospital accreditation

Question 12

Utilization Review Accreditation Commission (URAC)

Answer 12

Accredits Healthcare plans (eg. PPO, HMO)

Question 13

CARF (Commission on Accreditation of Rehabilitation Facilities

Answer 13

Accreditation programs:

• Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
• Medical rehabilitation

Question 14

CHAP (Community health accreditation program)

Answer 14

Accredit Home Health

Question 15

HFAP (Healthcare Facilities Accreditation Program)

Answer 15

Accredits Hospital laboratories

Question 16

NCQA (national committee for quality assurance)

Answer 16

Developed HEDIS (Health Effectiveness Data and Information Set) - a tool to measure performance of healthcare plans, allows consumers, purchasers and CMS to compare health plan

Question 17

Baldrige National Quality Program

Answer 17

Managed by National Institution of Standards and Technology, US Dept of Commerce

Question 18

Six sigma

Answer 18

3.4 DPMO

Question 19

Lean method

Answer 19

VSM

Question 20

Six sigma is achieved through?

Answer 20

A series of steps - DMAIC:

1. Define
2. Measure
3. Analyze
4. Improve
5. Control

Question 21

Tool or technique of lean

Answer 21

VSM (Value stream mapping)

Question 22

Value stream mapping

Answer 22

Graphically displays the process of services or product delivery using

• inputs
• throughputs
• output

Question 23

AHRQ definition of quality of care?

Answer 23

Doing the right thing, at the right time, in the right way, for the right person and having the best possible results.