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Quality Improvement

Transcript: quality improvement for client care can be measured by the overall value of care Value= (Quality of outcome)/Cost (Kelly & Crawford, 2013) a. Unexpected survey b. Patient satisfactory survey c. Accrediting Health Region Focus on an improvement idea Organize a team that understands the process Clarify what is happening in the current process Understand the degree of change needed Solution. Selection a solution for improvement. (Kelly & Crawford, 2013) Vinittha, Samiya, Olina Think about the following when formulating your answer: why is it an issue? who is involved? who does it affect? (Noseworthy, 2011; Canadian Institute for Health Information, 2014) ( Accreditation Canada, 2015) -hospitals • Reducing wait times -physicians -drugs • Controlling cost Process Improvement Tools The Plan-Do-Study-Act Cycle (PDSA) goal: increase the ability to predict the effect that one or more changes would have if they were implemented (Kelly & Crawford, 2013) Quality Improvement Quality Improvement Principles History of Quality Assurance To conclude: Quality improvement ensures that it, the product, service or process, is of sufficient quality tools such as the PDSA cycle and the FOCUS methodology can be used as guidelines for change QI strategies direct allocation of resources to increase the value of care Thanks for listening! Regulatory Requirements: Accreditation Canada (AC) Quality Assurance (QA) "doing it right" Total Quality Management (TQM)-also referred to as Continuous Quality Improvement (CQI) and Performance Improvement (PI) "doing the right thing" (Kelly & Crawford, 2013) voluntary process helps health care organizations improve their performance for the benefit of clients and the health system Who gets accredited? community care hospitals and health systems specialty health services seniors' care (Accreditation Canada, 2015) Discussion Quality Improvement Equation References (Kelly & Crawford, 2013) WHO WANTS TO BE A MILLIONAIRE: NURSING EDITION Compare and contrast the two quality improvement tools: Quality Assurance Vs. Continuous Quality Improvement Today, you will learn the following: 1. Definition and history of performance improvement/quality assurance activities. 2. Some commonly used process improvement tools e.g. PDSA cycle, the FOCUS methodology. 3. The impact of performance improvement measures on client care and resource utilization. The Focus Methodology References Accreditation Canada. (2015). The value and impact of health care accreditation: A literature review. Ottawa, ON: Accreditation Canada. Available on http:// http://www.accreditation.ca/ pp. 1-6. Canadian Institute for Health Information. (2014). How much does Canada spend on health care? National health expenditure trends, 1975 to 2014. Ottawa, ON: Canadian Institute for Health Information. Available on http://www.cihi.ca/ Ettorchy-Tardy, A., Levif, M., & Michel, P. (2012). Benchmarking: A method for continuous quality improvement in health. Healthcare Policy, 7(4), pp.101-119. doi: 10.12927/hcpol.2012.22872 Kelly, P., & Crawford, H. (2013). Nursing leadership and management (2nd Canadian ed.) Toronto, ON: Nelson Education. Li, M., & Green, E. (2013). The Ontario psychosocial oncology framework: A quality improvement tool. Psycho-Oncology, 22(5), pp.1177-1179. doi: 10.1002/pon.3116 Noseworthy, T. (2011). Health Resource Allocation: A made-in-Canada description. Journal of Legal Medicine, 32(1), 11-26. doi:10.1080/01947648.2011.550823 FOCUS Methodology Focus on an improvement idea Organize a team that understands the process Clarify what's happening in the current process Understand degree of change needed Select a solution for improvement What is quality improvement? process of monitoring and assessing a product, service, or process uses data to drive decisions Purpose? to ensure that it, the product, service or process, is of sufficient quality focused on improving client care processes and outcomes (Kelly & Crawford, 2013) priority to benefit the client quality is achieved through the participation of everyone in the organization improvement opportunities are developed by focusing on the work process decisions to change or improve a system or process are made based on data committed leadership necessary education and long-term commitment are required (Kelly & Crawford, 2013) Quality Improvement Implications for Resource Allocation Imagine you are a nurse manager. Infection-control practitioners have revealed that your unit's use of Foley catheters is above average. It is your responsibility to form a solution to this issue. brainstorm reasons why the Foley catheter use is so high after you have identified the root causes for the above-average use of Foley catheters, use the PDSA Cycle to identify improvement strategies present your ideas (Ettorchi-Tardy, Levif & Michel, 2012) Focus of Continuous Quality Improvement (doing the right thing) Meeting the needs of the customer Building quality performance into work process Assessing the

Quality Improvement

Transcript: Root Cause Analysis Action Research When conceptualized as measurable action, beginning researchers are less inclined to run right into taking an action step without seriously considering how they will measure the outcomes of their actions. Root cause analysis (RCA) is a process designed for use in investigating and categorizing the root causes of events with safety, health, environmental, quality, reliability and production impacts. Without complete information and an understanding of the event, the causal factors and root causes associated with the event cannot be identified. The majority of time spent analyzing an event is spent in gathering data. Guiller Augustin C. Carpio, RN, MAN After all the causal factors have been identified, the investigators begin root cause identification. This step involves the use of a decision diagram called the Root Cause Map to identify the underlying reason or reasons for each causal factor. Steps Steps Quality! AR is, in the most basic sense, a type of research that creates and measures change in a cyclical manner with the intention of overall positive growth through- out the process Dr. Lenore Pasol Professor Quality Improvement Strategies Presented to Thank you and God bless! Action research (AR) and its counterpart, participatory action research (PAR), are powerful tools for people in business, nonprofits, public administration who seek to create change in complex situations for the sake of sustainable improvement. 1. Data collection 2. Causal factor charting 3. Root cause identification 4. Recommendation generation and implementation Causal factor charting provides a structure for investigators to organize and analyze the information gathered during the investigation and identify gaps and deficiencies in knowledge as the investigation progresses. The causal factor chart is simply a sequence diagram with logic tests that describes the events leading up to an occurrence, plus the conditions surrounding these events The next step is the generation of recommendations. Following identification of the root causes for a particular causal factor, achievable recommendations for preventing its recurrence are then generated. Presented by First, you have to discover what is true now then investigate what others have done about the problem you wish to improve when in similar circumstances. Action Research This type of research is generally conducted in a collaborative manner by an individual person or team of people who are interested not only in studying a particular problem but also in creating solutions. Root Cause Analysis "Be a yardstick of quality. Some people aren't used to an environment where excellence is expected." - Steve Jobs Involved in the reflection step in AR is an implied willingness to delve deeply into both what is working and what is not working in your research process.

Quality Improvement

Transcript: Questions??? What do they say ? What is Quality Improvement ? Healthcare Must Be Safe Healthcare Must be Effective Healthcare must be patient centered Healthcare Must be timely Healthcare must be efficient Healthcare must be equitable Objectives: Select the process improvement Structure & Leadership Understand Sources of Process Variation "A blueprint for action" RCA/QI Root Cause Analysis Fish Bone Diagram Team Meeting Process Complete a process analysis worksheet Janice Servick BSN, RN MSN Student Waynesburg University Institute Of Medicine, 2001 Institute of Medicine (IOM) Quality and Safety/ Education for Nursing (QSEN) American Nursing Association and NDNQI Center for Medicare Medicaid Services (CMS)/ Quality Improvement Organizations (QIO) "F" F ... Find a subject to improve O ... Organize to improve the process C ... Clarify current knowledge of the problem U ... Understand sources of process variation S ... Select the process improvement "S" "U" The learner will define Quality improvement and identify the view of healthcare organizations regarding this topic. The learner will discuss the roles quality improvement including Identification of standard, monitor of compliance, & compliance where indicated The learner will identify and describe the components of quality improvement such as FOCUS, PDSA, & Critical Pathways Collect data to understand scope of the problem Quality Improvement What is a QI Plan? Creating a Critical Pathway Quality Improvement Roles The End Tips for Successful Teams Set a timeline Define major milestones Responsible group/Individual Find a Process to Improve Quality Improvement Plan FOCUS & Develop a change in process Identify an improvement from the root cause analysis Create a team Create a goal statement Plan-Do-Study-Act Thank You! "C" Elements of an effective QI plan "O" Clarify Current Knowledge of the Problem Organize to Improve the Process Implement Change How do I begin to plan? Team Leader Team Facilitator Team Member Quality Improvement

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