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Quality Improvement & Patient Satisfaction in the Emergency Department

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by Jason Nguyen on 30 October 2012

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Transcript of Quality Improvement & Patient Satisfaction in the Emergency Department

Background photo by t.shigesa To improve the quality of healthcare, one must achieve a high patient satisfaction in return. Challenge Strategies Quality Improvement & Patient Satisfaction
in the Emergency Department Define Quality Improvement
Why ???
AIM
FOCUS
PDCA
Donabedian's Framework
Fish Bone Diagram
STEEEP Outline Allegra Cabral
Lauren Quin
Jasonminh Nguyen
Germund Sua
Sean Bradley
Jessica Cameron "Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge" Health Care Quality Longer Life Expectancy
Customer Satisfaction
Advances in Medical Services
Growing of Healthcare What factors contribute to the need for quality improvement? Why the Emergency Department needs to improve? Entry point for patient seeking healthcare services
Another source of primary care
A revenue generated department
The most visible to the public AIM A decrease in quality of care is due to lack to patient satisfaction
Factors that Influence Patient Satisfaction in the Emergency Department
Length of Waiting Time
Overcrowding
Employee overworked
Misdiagnosed FOCUS Organize team that knows the process: multi-disciplinary patient satisfaction improvement team to initiate and cooperate satisfaction effort to meet with the goals and objectives Finding the process to improve: long waiting time, quality of care, patient satisfaction within the ER. Clarify current knowledge: Patient Satisfaction is correlate to the outcome measures within the ED; reviewing current patient and employee overview for entire hospital; ED ranking Understand causes of process variation: means scores from satisfaction survey Select the process improvement: Implementation of actions which aim to support the outcome FISHBONE Diagram To identify and analyze the root cause of a complex problem
If the traditional method is time consuming
When there are many possible causes to a problem Environment:
Entry point for patients seeking health care services
Time of day/week
Availability of treatment rooms
Procedure:
Admission
Scheduling
Timing
Equipments:
Malfunction
Not available
Not efficient users
Man power:
Overworked
Understaffed
Inexperienced Staff PDCA OBJECTIVE: To reduce patient waiting time before getting them into treatment room
PLAN: Inform patient about expected waiting time and delays
EXPECTED RESULT: Immediate improvement of interpersonal skills and interactions
MEASURES: Using surveys to monitor Plan Do TRIAGE SYSTEM: Treat cases with life-threatening or serious illnesses as rapid as possible
NON-EMERGENT PATIENTS: Fast-track section in the ED Check COMMUNICATION: Nurses, Patients and Patients' Family Act Determine all wait times were reduce by removing fast track concept
Team Approach
Hourly Updates
Document discussions in nursing notes
Educational initiative
Revision of Emergency Department patient brochures
Posting patient satisfaction surveys to motivate staff DONABEDIAN'S FRAMEWORK STRUCTURE: Personal involved, equipment, facilities, building, resources (finances)
PROCESS: All aspects of performance, technical and interpersonal, activities of care and services
OUTCOME: the results of care and service STEEEP SAFETY:Avoid Harm
TIMELY: Waiting times and potentially harmful delays are reduced
EFFECTIVE: Care is scientifically based and only provided to those who could benefit from the service
EFFICIENT: Avoid waste of equipment, supplies, ideas and energy
EQUITABLE: Quality care does not vary because of gender, ethnicity, location or socioeconomic status
PATIENT-CENTERED: Respectful of an individual's wishes, needs and values References Brockmeyer, Wanda, RN. "Reduce Emergency Room Wait Times. Roper St. Francis Healthcare. The Consult - Winter 2010 Issue - pp 4 - 7. Retrieved from http://www.ropersaintfrancis.com/Categories/Health_Professionals/Documents/consultWINTER09.pdf Bruce, Tammy A. MSN, RN; Bowman, Josie M. DSN, RN; Brown, Sylvia T. EdD, RN. "Factors that Influence Patient Satisfaction in the Emergency Department" Journal of Nursing Care Quality: December 1998 - Volume 13 - Issue 2 - pp 31-37. The Clinical Impact Of Cost Reduction. Retrieved from http://journals.lww.com/jncqjournal/Abstract/1998/12000/Factors_that_Influence_Patient_Satisfaction_in_the.5.aspx
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