HA425 Unit 3 Seminar Option 2
mary89
HA425_Unit3.pptxFATHER of CQI
DEMING
APPRECIATION FOR A SYSTEM
KNOWLEDGE ABOUT VARIATION
THEORY OF KNOWLEDGE
PSYCHOLOGY
FOCUS
FIND A PROCESS TO IMPROVE
ORGANIZE TEAM THAT KNOWS THE PROCESS
CLARIFY KNOWLEDGE OF THE PROCESS
UNDERSTAND CAUSES OF PROCESS VARIATION
SELECT THE PROCESS IMPROVEMENT
PDSA (SHEWHART)
DEFINITIONS of QUALITY
QUALITY REFLECTS THE VALUES OF THE HEALTH SYSTEM AND WIDER SOCIETY (DONABEDIAN)
3 ASPECTS TO CARE: STRUCTURE, PROCESS, AND OUTCOMES
INCLUDES INTERPERSONAL RELATIONSHIPS, TECHNICAL CARE, ACCESS, AND CONTINUITY OF CARE
QUALITY OF CARE IS THE DEGREE TO WHICH THE PROCESS OF CARE INCREASES THE PROBABILITY OF DESIRED OUTCOMES AND REDUCES UNDESIRED OUTCOMES (US OFFICE OF TECHNOLOGY ASSESSMENT)
PATIENT (AND THEIR PERSPECTIVE) AT THE CENTER OF CARE
MUST BE LINKED TO EFFECTIVE TREATMENTS FOR A CONDITION
4
CONTINUOUS QUALITY IMPROVEMENT (CQI)
STRUCTURED ORGANIZATIONAL PROCESS
REQUIRES MEASUREMENT
INVOLVES PERSONNEL
TO PLAN AND EXECUTE A CONTINUOUS FLOW OF IMPROVEMENTS
PROVIDES QUALITY HEALTH CARE
MEETS OR EXCEEDS EXPECTATIONS
EVOLVED OVER TIME AND ACROSS COUNTRIES
NEED FOR CQI IS INCREASING
EVIDENCE SHOWS LITTLE IMPROVEMENT IN SAFETY AND QUALITY OF CARE OVER THE PAST DECADE!
IMPROVING QUALITY of CARE
DONALD BERWICK, INSTITUTE FOR HEALTHCARE IMPROVEMENT
IMPROVE THE EXPERIENCE OF CARE (PERCEPTION)
IMPROVE THE HEALTH OF POPULATIONS
REDUCE THE PER CAPITA COSTS OF HEALTH CARE
AT THE MICRO LEVEL, IT INVOLVES PROFESSIONAL RESPONSIBILITY AND DEVELOPMENT
CQI and the SCIENCE of INNOVATION
DONALD BERWICK, FOUNDER OF THE INSTITUTION FOR HEALTHCARE, HAS IDENTIFIED 7 RULES FOR DISSEMINATION OF INNOVATION IN HEALTH CARE
FIND SOUND INNOVATIONS
FIND AND SUPPORT INNOVATORS
INVEST IN EARLY ADOPTERS
MAKE EARLY ADOPTER ACTIVITY OBSERVABLE
TRUST AND ENABLE REINVENTION
CREATE SLACK FOR CHANGE
LEAD BY EXAMPLE
ORGANIZATION CENTERED QI STRATEGIES
DEMING
14 POINTS BECAME ACCEPTED
OFFERED A SYSTEM VIEW OF QUALITY IMPROVEMENT
HOSPITALS
ACCREDITATION MOVEMENT EARLY IN THE 20TH CENTURY
TCM CAME TO ATTENTION FROM JAPANESE INDUSTRY IN 1980
JCAHCO WAS AN EARLY ADOPTER AND PROMOTER OF QI
NCQA FOLLOWED SOON WITH ITS ACCREDITATION PROCESSES
FEATURES
MAJOR FOCUS BECAME THE CONTEXT OF QI WORK
KNOWLEDGE WORK BECAME AN ACCEPTED PART OF QI
CUSTOMER FOCUS BEGAN TO ENTER QI
CONCEPTUAL FRAMEWORK of QUALITY
QUALITY HEALTH CARE MUST BE: (IOM)
SAFE (AVOIDING INJURY TO PATIENTS)
EFFECTIVE (BENEFIT THOSE IN NEED)
PATIENT-CENTERED (RESPECTFUL AND RESPONSIVE)
TIMELY (REDUCING WAITS AND/OR HARMFUL DELAYS)
EFFICIENT (AVOIDING WASTE)
EQUITABLE (CARE DOES NOT VARY BECAUSE OF GENDER, AGE ETC.)
REGULATORY AGENCIES and ACCREDITATION
REGULATORY MECHANISMS (ACCREDITATION) HAVE LED TO GREATER DIFFUSION OF CQI
CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) HAVE LED A SERIES OF INITIATIVES THAT REQUIRE HOSPITALS TO REPORT ON QUALITY MEASURES
QUALITY IMPROVEMENT ORGANIZATIONS (QIOS) REPORT EXTENSIVE CQI ACTIVITIES AND FINDINGS ASSOCIATED WITH THESE ACTIVITIES
JOINT COMMISSION HAS NOTED THE USE OF ROBUST, EVIDENCE BASED MEASURES, LINKING PROCESS PERFORMANCE AND PATIENT OUTCOMES
ORGANIZATIONS
GOVERNMENT
NONPRFOFIT
FOR-PROFIT
ACCREDITATION
What are examples from each category that focus on healthcare quality improvement?
SIX SIGMA (Deming/Juran)
SIX SIGMA (GREEK SYMBOL IN STATISTICS TO MEASURE VARIATION) UTILIZES STATISTICAL METHODS TO IDENTIFY AND REMOVE ERRORS AND MINIMIZE VARIABILITY IN PROCESSES
LEAN METHODOLOGY IS USED WITH SIX SIGMA
A SYSTEMATIC APPROACH TO IDENTIFYING AND ELIMINATING WASTE
LEAN SIX SIGMA USED IN A WIDE RANGE OF HEALTH CARE APPLICATIONS, AND PROVIDES A SYNERGISTIC METHODOLOGY FOR ANALYZING, AND REDUCING OR ELIMINATING WASTE IN HEALTH CARE PROCESSES
LEAN AND SIX SIGMA METHODS ARE PARALLEL TO AND CAN BE USED WITH APPROACHES LIKE PDSA
P
Process mapping
C
Control
D
M
A
I
Define
Measure
Analyze
Improve
