Project Presentation
Quality and Performance Improvement in Healthcare: Theory, Practice, and Management Seventh Edition
Chapter 3
Identifying Improvement Opportunities Based on Performance Measure
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Objectives
Demonstrate how the principal aspects of healthcare are targeted for performance measurement
Assess the significance of outcomes and proactive risk reduction in performance improvement methodology
Apply brainstorming and the nominal group technique to performance improvement activities
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Focus of Healthcare QI Philosophies
Systems: The foundations of care giving
Buildings
Equipment
Professional staff
Appropriate policies
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Focus of Healthcare QI Philosophies
Processes: Interrelated activities in healthcare organizations, which promote effective and safe patient outcomes across services and disciplines within an integrated environment
Outcomes: The final results of care, treatment, and services in terms of the patient’s expectations, needs, and quality of life, which may be positive and appropriate or negative and diminishing
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Continuous Improvement Monitoring: Steps to Success
Step 1—Identify performance measures
Step 2—Identify the customers for each monitored process
Step 3—Identify customers’ actual requirements with respect to the outcomes
Step 4—The organization asks whether the outcomes of the current process actually meet the customers’ requirements
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The Organization Identifies Its Performance Measures
Process measure: Focuses on a process that leads to a certain outcome
Outcome measure: Indicates the result of the performance of a function or process
Benchmarking: Systematic comparison of the products, services, and outcomes of one organization with those of a similar organization
Sentinel events: Significant injury to or the death of a patient or employee through avoidable causes
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The Organization Identifies the Customers for Each Monitored Process
Who is the receiver of the organization’s outcome or end product
Internal customers: Individuals within the organization or department who receive products or services from an organizational unit or department
External customers: Individuals from outside the organization or department who receive products or services from within the organization
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Customers’ Actual Requirements Are Identified
Factors most valued by the customer
Examples:
Good-tasting food at the right temperature
Charts available for physician completion
Qualified clinical staff
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Are Our End Products Actually Meeting Customer Requirements?
If yes, then no PI activities need to be performed
If no, then a PI team may be formed to examine the process in greater detail, or
An educational program may be developed to fine-tune organization members
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QI Toolbox Techniques
Brainstorming
Affinity diagrams
Nominal group technique
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Registration for Day Surgery
Step 1: Performance measure
Registration information provided and surgery scheduled by physician’s office
Preoperative workup completed
Step 2: Customers for monitored process
Patient and patient’s family
Physician and office staff
Surgery staff
Registration staff
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Registration for Day Surgery (continued)
Step 3: Customers’ actual requirements
One-time communication of registration information
Preoperative workup completed before surgery and coordinated in one visit
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Registration for Day Surgery (continued)
Step 4: Customers’ requirements met
Patient satisfaction surveys showed only 76% satisfaction with same-day surgery registration and preoperative workup processes
Registration staff and physician office staff were hearing complaints from patients that registration process was cumbersome and not user-friendly
Duplicate data collection occurred between physician’s office registration and same-day surgery registration
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