Healthcare Quality and Improvement

Domains of Healthcare Quality

• The 6 domains of healthcare quality are: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.

Quality Improvement Framework

• The framework integral to improving the quality of care for older people is not specified, but it is likely to be a framework that considers the unique needs of older adults.

Key Stages of Quality Improvement

• The key stages of quality improvement are: identify, analyze, develop, test, implement, and sustain.

Quality Improvement Projects

• Four key components that quality improvement projects need are: a clear aim, established measures, tested change ideas, and a plan for implementation.

Successfully Completing a QI Initiative

• To successfully complete a QI initiative, it is required to have a clear aim, strong leadership, and a plan for sustainability.

Analysis Tools

• The tool used for qualitative analysis in the quality improvement process is not specified, but it could be a framework such as Root Cause Analysis (RCA) or a qualitative data analysis method.
• The tool used for quantitative analysis in the quality improvement process is not specified, but it could be a statistical method or a tool such as a run chart or control chart.

Sustaining and Spreading Improvements

• The stage of the QI process that involves sustaining and spreading the improvements is the implementation and sustain stage.

6 Domains of Healthcare Quality

• An element that is NOT one of the 6 domains of healthcare quality is not specified, but it could be an aspect of care that is not directly related to quality, such as cost.

Identifying Underlying Causes

• The tool that can be used to identify the underlying cause of a problem is a Root Cause Analysis (RCA) or a Fishbone diagram.

Developing and Testing Change Ideas

• The tool that is recommended for developing and testing change ideas is a Plan-Do-Study-Act (PDSA) cycle.

Preventing Project 'Scope Creep'

• A tool that can prevent project 'scope creep' is a project scope statement or a project charter.

Project Implementation

• The tool that can help in project implementation and ensuring long-term gains is a project implementation plan or a sustainability plan.

Visual Process Mapping

• A visual tool that shows the key activities and tasks in a process and how they relate to each other is a Process Map or a Swimlane diagram.

Identifying Problem Origins

• The tool that is used to identify where and how a problem started is a Root Cause Analysis (RCA) or a Fishbone diagram.

Human Factors Analysis

• The tool that is particularly useful when trying to understand problems involving human factors or interactions is a Root Cause Analysis (RCA) or a Human Factors Analysis.

Demonstrating Theories

• The tool that can be used to demonstrate theories about how proposed changes may achieve the project aim is a Theory of Change model.

Specific and Testable Concepts

• A specific and testable concept used in quality improvement projects is a hypothesis or a change idea.

Process Mapping

• A tool that can be used to outline the sequential steps in a process and identify any blockers or bottlenecks is a Process Map or a Value Stream Map.

Simple Problem Analysis

• A simple tool that helps understand why problems are occurring in the system is a Fishbone diagram or a 5 Whys analysis.

Communicating Problems

• The tool that is used to communicate a problem effectively and suggest areas for further improvement is a Problem Statement or a Gap Analysis.

Purpose of Fishbone Diagram

• The purpose of a Fishbone diagram in quality improvement is to identify the underlying causes of a problem and to facilitate team-based problem-solving.

Patient and Healthcare Professional Stories

• Stories from patients and healthcare professionals contribute to quality improvement initiatives by providing context and insights into the problems being addressed.

Patient Stories

• Jenny mentioned that a contributing factor to her fall was not specified, but it could be related to the environment or the care she received.
• Ahmed was unable to ask for help when he fell because he felt embarrassed and vulnerable.
• Tyler expressed concern about the risk of falling and the consequences of falling.
• Paula mentioned that a concern related to falls on the trauma ward is the lack of attention from staff and the need for better communication.

Potential Change Ideas

• A potential change idea to reduce falls on the trauma ward is to implement a falls prevention program that includes staff education and environmental modifications.
• One suggested change idea to reduce falls on the trauma ward is to improve the call bell system and ensure that patients can quickly get help when needed.
• A potential reason for patients trying to mobilize at night without calling a staff member is that they do not want to bother the staff or they feel that the staff are too busy.
• According to Ahmed's story, what hindered him from asking for help when he fell was feeling embarrassed and vulnerable.
• A potential change idea based on Paula's input is to improve the communication between staff and patients, and to ensure that patients feel comfortable calling for help when needed.