Lecture 1 Introduction.pptx

Healthcare Quality and Patient Safety HS 415 Lecture 1 Introduction Dr. Fahad Khan Azeez [email protected] General Information • 2 credit hour theory course • Mark distribution : – 10 Marks Quizzes – 25 Marks Mid Term – 10 Marks Assignment – 5 Marks Participation and attendance Learning Obj...

Healthcare Quality and Patient Safety HS 415 Lecture 1 Introduction Dr. Fahad Khan Azeez [email protected] General Information • 2 credit hour theory course • Mark distribution : – 10 Marks Quizzes – 25 Marks Mid Term – 10 Marks Assignment – 5 Marks Participation and attendance Learning Objectives • Get familiar with the concept of Quality in a general and Healthcare context • Understand the historical perspectives on healthcare quality • Define and understand the dimensions of quality What is Quality? • “ Quality is often used to signify ‘excellence’ of a product or service ”. • “ Meeting the customer requirements ”. • Quality management ensures that an organization, product or service is consistent. Quality in Healthcare • An organization should be able to define and measure what it produces or what service it provides • In Healthcare, quality management seeks to improve effectiveness of treatments and increase patient satisfaction with the service Healthcare Quality over the years Healthcare Quality over the years Defining Quality • Healthcare quality is optimal care from the appropriate provider in the most appropriate setting in the most appropriate manner for the patient’s unique circumstances • (Nash, Coombs and Leider 1999) Defining Quality • Juran institute defines quality: • Freedom of deficiencies : – a deficiency is any avoidable intervention required to achieve patient outcome. – Product features both services and goods that attract and satisfy patient, meet customer expectations and distinguishing one practitioner or organization from the other. Defining Quality • Institute of Medicine – 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. Dimensions of “Quality” • ‘STEEEP’ framework outlined by the Institute of Medicine (IOM) – Safe: • avoiding injuries to patients from the care that is intended to help them – Timely: • reducing waits and harmful delays for both those who receive and those who give care – Effective: • providing services based on scientific knowledge (avoiding underuse and overuse) Dimensions of “Quality” – Efficient: • avoiding waste, in particular waste of equipment, supplies, ideas, and energy – Equitable: • providing care that does not differ in quality because of personal characteristics such as • gender, ethnicity, geographic location, and socioeconomic status – Patient-Centered: • providing care that is respectful of and responsive to individual patient preferences, needs, and values • ensuring that patient values guide all clinical decisions Dimensions of Quality • The Joint Commission (1993) has also identified the following dimensions of clinical performance that could be used to categorize indicators: • • • • • • • • • • Appropriateness Availability Competency Continuity Effectiveness Efficacy Efficiency Respect and caring Safety Timeliness IOM Dimensions of Quality • Appropriateness – "The degree to which the care and services provided are relevant to an individual's clinical needs, given the current state of knowledge” • Availability: accessibility /obtainability – The ease with which healthcare can be obtained in the face of financial, organizational, procedural, emotional, and cultural barriers (access). Dimensions of Quality • Continuity – The coordination of needed healthcare services for a patient or specified population among all practitioners and across all involved organizations over time. • Competency – The practitioner's ability to produce both the health and satisfaction of customers; – The degree to which the practitioner adheres to professional and/or organizational standards of care and practice 3 Aspects of Quality • Measurable Quality • Compliance with or adherence to standards. – practice guidelines or protocols, – or acceptable expectations for care processes and patient outcomes. • Performance measures or indicators are measurement tools used for measuring quality • Also known as KPIs (Key Performance Indicators) • basis for granting healthcare organizations licensure and/or accreditation, certification, awards, and, in some cases, reimbursement. 3 Aspects of Quality • Appreciative quality • Comprehension and appraisal of excellence beyond minimal standards and criteria – Peer review bodies rely on the judgments of like professionals in determining the quality or non-quality of specific patient-practitioner interactions. 3 Aspects of Quality • Perceptive quality • essential to prevent dissatisfaction but do not necessarily contribute to patient satisfaction. – Patient perception about a particular doctor or hospital – Ample parking space What is the purpose of measuring the quality? What should be the next step? Improving or controlling performance • Measure of control : you can’t control what you can’t measure Performance Management • Performance Management is what you do with the information you’ve developed from measuring performance.” • Source: Guidebook for Performance Measurement – “Know where to find the information and how to use it - That's the secret of success” Albert Einstein Performance Improvement • Performance refers to the way people do their jobs and the results of their work • Performance improvement is measuring the output of a particular business process or procedure then modifying the process or procedure to increase the output, efficiency, or effectiveness. Performance Improvement • Performance improvement at the operational or individual employee level usually involves – processes such as statistical quality control. • At the organizational level, performance improvement usually involves – softer forms of measurement such as customer satisfaction surveys – used to obtain qualitative information about performance from the viewpoint of customers. Traditional and Current PI • Weakness in Traditional Monitoring and Evaluation – Frequent compartmentalization of QA activities rather than around the flow of patient care (where processes are often cross-disciplinary and crossdepartmental); – initiation of action only when a problem is identified, rather than also trying to improve the process itself. • Change in emphasis: Now: In past: • The how of care • The what of care – patient care given • The who of care – patient care giver – patient care process • THE RESULT OF CARE – Patient Care Outcome References • Shaw, P., Elliott, C., Isaacson, P., & Murphy, E. (2003). Quality and performance improvement in healthcare: A tool for programmed learning. Chicago, IL: American Health Information Management Association. • Brown, J. (2010). The Healthcare Quality Handbook: A Professional Resource and Study Guide. JB Quality Solutions. • Joshi, M., Nash, D. B., & Ransom, S. B. (2008). The healthcare quality book: vision, strategy, and tools (Vol. 16). E. R. Ransom (Ed.). Chicago, IL: Health Administration Press.