Quality Concepts in Healthcare Management

<p>Effectiveness and respect/caring (B)</p> Signup and view all the answers

<p>access to specialty care (B)</p> Signup and view all the answers

<p>a weakness in implementing quality improvement. (C)</p> Signup and view all the answers

<p>a service is more heterogeneous than an object. (A)</p> Signup and view all the answers

<p>encouraging leaders to commit to a culture of excellence. (D)</p> Signup and view all the answers

<p>the patient remains in control of treatment. (B)</p> Signup and view all the answers

<p>Newly diagnosed hypertensive patients are controlled within 6 months (D)</p> Signup and view all the answers

<p>incorporates information from strategic planning (C)</p> Signup and view all the answers

<p>caring staff and physician. (B)</p> Signup and view all the answers

<p>most problems with service delivery result from systems difficulties (D)</p> Signup and view all the answers

<p>Universal coverage (B)</p> Signup and view all the answers

<p>quality control/measurement. (C)</p> Signup and view all the answers

<p>cease dependence on inspection. (C)</p> Signup and view all the answers

<p>broad choice of providers. (A)</p> Signup and view all the answers

<p>Causal: Structure leads to process and process leads to outcome. (B)</p> Signup and view all the answers

<p>broker. (B)</p> Signup and view all the answers

<p>hotel and resort industry (A)</p> Signup and view all the answers

<p>Customer satisfaction (C)</p> Signup and view all the answers

<p>Structure of care (C)</p> Signup and view all the answers

<p>systems and processes (D)</p> Signup and view all the answers

<p>Outcome of care (B)</p> Signup and view all the answers

<p>the measurement of the patient's functionality and quality of life. (B)</p> Signup and view all the answers

The appropriateness of care is a key dimension of quality care, focusing on whether provided services are suitable for the patient's needs and condition.

The capacity of a medication to improve health status is its effectiveness, reflecting its impact on the patient's health outcomes in real-world settings.

A quality dimension evaluated through the perspectives of recipients and observers of care, such as patients, families, and healthcare providers.

The quality of care depends on the skills, expertise, and knowledge of healthcare professionals and other care team members.

The appropriateness of treatment setting involves choosing the most suitable place for care delivery, considering the patient's needs and available resources.

Incorporating TQM concepts, compartmentalizing quality management activities by department or discipline is a weakness in implementing quality improvement, as it hinders a holistic approach.

The heterogeneity of services makes them more challenging to measure and verify in advance compared to standardized products, due to factors like provider variability and patient uniqueness.

A quality professional can foster a quality culture by assessing the organization's readiness to embrace change, encouraging leadership commitment to excellence, and leading cultural transformation efforts.

Evaluating the effectiveness of physician care in an ambulatory setting is challenging due to the patient's control over their treatment and the varying nature of ambulatory conditions.

A primary care clinic would select indicators that measure the impact of physician care on patient outcomes, such as controlling newly diagnosed hypertension within a specific timeframe.

The Quality Management Cycle is a framework for continuous improvement, incorporating elements from strategic planning, quality planning, quality control/measurement, and quality improvement.

The perception of quality in an ambulatory care center is greatly influenced by the patient's experience with the caring staff and physician, as it creates a sense of trust and comfort.

Total quality management philosophy assumes that most problems with service delivery arise from systemic difficulties, requiring a focus on improving processes rather than blaming individuals.

Most industrialized nations outside the U.S. offer universal coverage, meaning healthcare is a fundamental right accessible to all citizens.

In Juran's Quality Management Cycle, the initial analysis of data and information is part of quality control/measurement, focusing on identifying potential issues and measuring performance.

Deming's principles often clash with TQM in healthcare because they advocate for ceasing dependence on inspection, which can be challenging for healthcare due to regulatory requirements and patient safety concerns.

The core components of managed care include prepaid financing, controlled access to services, and comprehensive services at multiple levels and settings.

Structure, process, and outcome indicators are interdependent, where structure affects both process and outcome, creating a cause-and-effect relationship.

Physicians within health maintenance organizations (HMOs) can be organized in various models, except for a 'broker model' where the HMO acts as a middleman between providers and patients.

In the context of quality improvement, the successful outcome is not just customer satisfaction, but also a combination of factors like improved processes, empowered employees, and effective communication.

Monitoring the specific organization and content requirements of a medical record system addresses the structure of care, as it defines the framework for documentation and information management.

The key difference between traditional quality assurance and expanded quality improvement/performance improvement is that QI/PI centers on improving systems and processes rather than individual practitioner competency.

Monitoring phlebitis associated with IV insertions by nurses in the Surgical Intensive Care Unit addresses the process of care, as it encompasses the actions and procedures involved in IV insertion.

The centerpiece of outcomes management in healthcare is the measurement of the patient's functionality and quality of life, as it assesses the impact of care on the patient's overall well-being.

"Common causes" of problems in processes are chronic situations, reflecting inherent variations within a system rather than isolated events or temporary issues.

Review of the timeliness of high-risk screening for diabetes addresses the process of care, reflecting the steps and procedures involved in screening and early intervention.

Risk management in U.S. healthcare developed due to increased physician malpractice liability costs, evolving into a system for identifying, managing, and mitigating potential risks.

The focus of quality improvement is on improving the efficacy and effectiveness of processes, not just on individual practitioner competency.

Within the context of total quality management, communication of quality is a shared responsibility, involving all stakeholders, and extending beyond internal organizational boundaries.

The doctrine of "charitable immunity" has been replaced by "corporate liability," making healthcare providers liable for the negligent actions of their employees in the same way as any other corporation.

The most common reimbursement method for primary care physicians in managed care is capitation with withholds, where providers receive a fixed payment per patient and are penalized for exceeding certain cost thresholds.

The probability of each step in a process occurring as intended is known as reliability, reflecting the consistency and predictability of a process.

A healthcare organization's liability for the negligence of its employees is known as the doctrine of "respondeat superior," meaning the employer is responsible for the actions of their employees.

Organizational culture refers to the shared beliefs, values, and assumptions about people and how work gets done, shaping the organization's overall operating style and behavior.

Liability for the conduct of independent practitioners acting as representatives of the healthcare organization is known as "ostensible agency," where the organization can be held liable for the actions of independent contractors.

Prospective payment systems provide reimbursement determined prior to care rendered, based on pre-established rates or criteria, rather than actual costs or charges incurred.

Applying the Pareto Principle in quality improvement involves prioritizing process issues by focusing on the vital few factors that contribute to the majority of problems or outcomes.

Special cause variation is an assignable, extrinsic, outlier in a process, representing a deviation from the typical pattern caused by a specific identifiable factor or event.

"Managed competition" in healthcare involves grouped healthcare providers competing within a geographic region, aiming to offer better quality and lower costs to attract patients and payers.

The key goal of reengineering is to redesign the organization fundamentally, transforming processes, structures, and systems to achieve significant improvements in efficiency and effectiveness.

An integrated delivery system represents a vertical healthcare system, encompassing a coordinated network of different healthcare organizations that provide services across the continuum of care.

A transitional care center best meets the needs of a patient like Steve Strong through case management, ensuring a coordinated approach to his complex needs and smooth transition from hospital to home.

In the case of common cause process variation, the goal of quality improvement is to reduce variation sufficiently to produce stability, rather than eliminating it entirely.

In an inpatient stay, specific patient conditions present on admission and requiring treatment during the stay are called comorbidities, reflecting co-existing medical conditions.

A team seeking breakthrough improvement in an admission process is looking for radical change, going beyond incremental adjustments to fundamentally transform the process and address underlying causes of delay.

If each step in a five-step process has a reliability rating of 99%, 95%, 95%, 90%, and 93%, the probability of the entire process succeeding is 75%, calculated by multiplying the probabilities of each step.

The best performance measure to evaluate the goal of 100% reliability in a five-step process is "# patients with all measures met ÷ total # patients in sample," as it assesses the percentage of patients successfully completing all steps.

The doctrine of "res ipsa loquitur" applies to situations where the negligence is evident, meaning the event itself speaks for itself, like leaving a surgical implement inside a patient.

Healthcare quality professionals assessing the impact of organizational culture on quality should evaluate the organization's degree of compliance with policies and procedures, as they reflect the organization's commitment to established guidelines.

The merger and redesign of multiple healthcare organizations into an integrated system represents reengineering, involving a fundamental transformation and redesign of processes, structures, and systems to improve efficiency and effectiveness.

For a successful integrated quality strategy, the redesign team must solicit input from all identified stakeholders, including patients, staff, providers, and community members, to ensure inclusivity and a shared vision.

The key leadership skills needed for redesign efforts include communication, negotiation, and systems thinking, enabling leaders to effectively guide the process, address conflicts, and understand the interconnectedness of changes.

In an integrated delivery system, the success of the quality strategy is most dependent on the effectiveness of the information system, as it enables data sharing, communication, and coordination across different entities within the system.

In inpatient care, the key difference between a comorbidity and a complication is that a complication arises during the inpatient stay and is not present at the time of admission, while a comorbidity is a pre-existing condition.

In evaluating their system's structure, OHS leaders must include interrelationships, decisions, and attitudes, as they reflect the underlying dynamics and culture that shape the system's performance.

After describing the problem, the best way to look at "patterns of behavior" over time is to use line graphs and story telling, as it allows for visualization of trends and narrative explanations of underlying factors.

In statistical process control, it is important to prioritize causes of variation first, identifying the most significant factors contributing to variability in the process and focusing on addressing them first.

The philosophy that best supports the initiative of redesigning administrative processes to eliminate unnecessary steps and become more efficient is "lean thinking," focusing on identifying and eliminating waste in all aspects of operations.

The most significant benefit of transitioning from quality assurance to quality management/quality improvement is focusing primarily on process rather than individual performance, shifting the focus from individual accountability to system-wide improvements.

Organizational change that involves centralizing functions at the regional level while expanding them at the local level, necessitating changes in staffing, positions, and processes, represents a paradigm shift, a fundamental change in the organization's approach.

Aligning financial incentives of purchasers, payers, and providers with provider performance on clinical process and outcome measures can encourage overutilization, as providers may be motivated to perform more services to increase revenue.

When identifying "internal" and "external" customers, the next best question to ask staff is "Who in your workday do you serve?" as it helps to clarify the direct recipients of their services and the stakeholders influenced by their work.

When incorporating lean thinking into process improvement, the quality professional teaches the team to identify and eliminate wasteful steps, focusing on reducing unnecessary tasks and delivering value to the customer more efficiently.

A process indicator measures an activity carried out to provide care or service, reflecting the steps and actions involved in delivering care.

The key difference between TQM and Six Sigma is that TQM focuses on the management philosophy of achieving quality through continuous improvement, while Six Sigma is a set of tools for reducing variation in a process to achieve near-perfect performance.

The capacity of a medication to improve health status under ideal conditions, demonstrating effectiveness in controlled studies.

The ability of a service to be accessible and obtainable when needed, based on factors like location, time, and availability of resources.

The continuity and consistency of patient care across different providers, settings, and time periods, ensuring smooth transitions.

A core principle of quality improvement that emphasizes improving processes and systems rather than focusing solely on individual performance.

The variability and unpredictability of services due to factors like provider differences and patient uniqueness, making them harder to standardize.

The principle of focusing on the purpose and meaning of work, identifying and eliminating waste, and delivering value to customers.

A team dedicated to achieving radical improvements in a process by addressing root causes and seeking fundamental change rather than incremental adjustments.

A method for analyzing problems by repeatedly asking

A condition present at the time of admission that requires treatment during the inpatient stay, reflecting a co-existing medical issue.

A condition that develops during the inpatient stay and was not present at admission, often related to the primary reason for hospitalization.

The process of identifying and eliminating wasteful steps and activities within a process, maximizing efficiency and value delivery.

The application of a set of tools and techniques to reduce variation in a process and achieve near-perfect performance, aiming for six standard deviations from the mean.