Define quality care and quality improvement
Quality care
• Exceeding patient requirements
Quality improvement
• Ongoing process of innovation, prevention of error and staff development that is used by institutions that adopt the quality management philosophy
Describe the philosophy of quality improvement
- Patient (customer) focus
- Identification of key processes to improve quality
- Use of quality tools and statistics to support improvements
- Involvement of the HCT in problem solving
- Committed leadership
- Long term commitment
Outline the dimensions of structure, process and outcomes
- Structure
• Focuses on internal characteristics of an organization and personnel - Process
• Focuses on whether the activities are being conducted appropriately - Outcome
• Refers the whether the services provided make a difference
Describe how to measure quality
Define opportunities Measure performance Analyze opportunity Improve performance Control performance
Identify quality improvement process
- Identify consumers needs
- Assemble a team
- Collect and analyze data
a. Flow charts
b. Line graphs
c. Histograms
d. Bar charts
e. Fishbone diagrams - Establish outcomes
- Discuss plans
- Evaluate
Apply quality improvement principles
- Involvement
- Goal
- Consumers
- Focus
- Decisions
Apply quality improvement principles examples
Senior leader
o Sets priorities for house-wide activities, staffing effectiveness and patient outcomes
o Builds infrastructure, provides resources and removes barriers for improvement
o Defines procedures for immediate response to errors involving care, treatment or services and contains risk
Nurse manager
o Communicates performance priorities and targets to staff
o Works with staff to develop and implement action plans for improvement of measures that do not meet target
o Directly observes staff and coaches as needed
Followers
o Follows policies, procedures and protocols to ensure quality and safe patient care
o Communicates with and educates peers immediately if they are observed not following quality and safety standards
o Reports quality and safety issues to supervisor/manager
Describe the role of the CRNBC and CNA in establishing and maintaining standards of practice for RNs
• Quality control
• Develops standards
o Predetermined level of excellence that serves as a guide for practice
quality management
•Philosophy of health care culture that emphasizes customer satisfaction, innovation and employee involvement
benefits of quality management
- Greater efficiency and proactive planning
- Increases in patient safety with quality care
- Enhanced job satisfaction
pts at greatest risk for harmful medication errors
- Children
* Pts in intensive care units
benchmarking
- Tool for identifying desired standards of organizational performance
- Continual and collaborative discipline of measuring and comparing the results of key work processes with those of the best performers
implications for patient care
- Must be measured by the value of care
- Value is a function of cost and quality outcomes together
- Outcomes include a patients clinical or functional outcomes
- Cost includes direct and indirect patient care needs
major types of documentation errors
- Omission of vital signs
- Lack of signature
- Inaccurate data
- Incomplete data
- Illegible
Canadian patient safety institute
- Has coordinating and leadership role across health care sectors and systems
- Promotes leading practices and raises awareness of patient safety
- Not-for-profit organization
- Inspires improvement in patient safety and quality by developing evidence-informed practices
quality assurance
- Method used to monitor health care
- Focuses on clinical aspects of provider care
- Many activities focus on standards
standards
• Standard of care
o Focuses on the pt
• Standard of practice
o Focuses on the nurse as provider
goal of quality improvement
- Not assign blame
- Responsibility of all nurses and seeks to improve patient care at the minimal level
- Working together to prevent problems is far more effective than correcting or dealing with problems after they occur
