Quality Improvement Module 15 PDF

Module 15 Quality Improvement  What is Quality? Quality Health Care o Care that is safe, effective, patient-centered, timely, efficient, and equitable Quality Improvement (QI) o Uses data to monitor the outcomes of care processes and improv...

Module 15 Quality Improvement  What is Quality? Quality Health Care o Care that is safe, effective, patient-centered, timely, efficient, and equitable Quality Improvement (QI) o Uses data to monitor the outcomes of care processes and improvement methods o Design and test changes to continuously improve the quality and safety of health care systems Which AGCNS competencies are related to quality improvement? 11/12/2024 2  AGCNS and Quality Improvement To effectively influence improvements in the work setting and ensure that all patients consis-ently receive excellent care, it is important to: o Align national, organizational, and unit level goals for QI. o Recognize external drivers of quality, such as accreditation, payment, and performance measurement. o Develop skills to apply QI models and tools. 11/12/2024 3  National Healthcare Goals Health care improvement aims o Better care o Affordable care o Healthy people/healthy communities o Transition from volume-based care to value-based care ▪ Volume-based care: Fee for service ▪ Value-based care: Incentivizes population health goals 11/12/2024 4  National Healthcare Goals Focus on social determinants of health (SDOH) o Economic stability o Education o Social and community context o Health and healthcare access o Neighborhood and built environment Patient populations screened for social needs and referrals made for social services 11/12/2024 5  Influencing Quality Metrics: Strategy Levers Measurement and feedback Public reporting Learning and technical assistance Certification, accreditation, regulation Consumer incentives and benefits designs Payment Health information technology Innovation and diffusion Workforce development 11/12/2024 6  Quality Healthcare: Nursing Indicators 15 nursing-sensitive quality indicators o The National Database of Nursing Quality Indicators Benchmarking o A way to gather information about process or product performance and analyze performance differences between business units o Used to ▪ Develop plans to address improvement needs. ▪ Borrow and adapt successful ideas from others. ▪ Understand what has already been tried. 11/12/2024 7  QI Perspectives & Models The QI models emphasize o Customer satisfaction o Teams and teamwork o Continuous improvement of work processes o Transformational leadership o Use of data to make decisions o Standardization of work processes 11/12/2024 9  QI Perspectives & Models Major QI models used in healthcare o Total Quality Management/Continuous Quality Improvement (TQM/CQI) o Six Sigma o Lean o Lean Six Sigma 11/12/2024 10  Continuous Quality Improvement 11/12/2024 11  Six Sigma - Data-drive approach to process improvement, developed in the business sector - DMAIC : used for service delivery o D – Define o M – Measure o A – Analyse o I – Improve o C – Control - Six Sigma example 11/12/2024 12  LEAN & LEAN Six Sigma LEAN is a process improvement with emphasis on reducing waste and creative minimization in use of resources Often combined with Six Sigma LEAN Six Sigma: a process improvement strategy that seeks to eliminate inefficiencies in a company's process flow by identifying the causes of waste or redundancy and developing solutions to address them. 11/12/2024 13  QI in Healthcare: Nursing Informatics What do we do with nursing What is nursing informatics? informatics? Integration of nursing science, Improved patient care computer science, and information Improved patient outcomes science to manage and Enhanced patient safety communicate data, information, Streamlined workflow knowledge, and wisdom in nursing Research and quality improvements practice. Virtual care Data-centered approach to patient care Data-driven decision making Enhance the clinical experience for health care providers and patients 11/12/2024 14  Quality Improvement Process in Healthcare Steps 1. Assessing health system performance by collecting and monitoring data 2. Analyzing data to identify a problem in need of improvement 3. Developing a plan to treat the identified problem 4. Testing and implementing the improvement plan Tools and activities 1. Forming a team 2. Data collections, cause-and-effect analysis, benchmarking, charts and histograms 11/12/2024 15  Quality Improvement Process in Healthcare: Forming a Team Team composition o Multidisciplinary representatives ▪ Direct patient care, support staff, patients, families Team maintenance o Set a meeting schedule o Use effective meeting tools ▪ Meeting agenda ▪ Meeting roles with ground rules ▪ Brainstorming ▪ Multivoting 11/12/2024 16  Quality Improvement Process in Healthcare Step 1 Assessment Step 2 Analysis Step 3 Plan Development Step 4 Implementation 11/12/2024 17  Quality Improvement Process in Healthcare Step 1: Assessment o Complete a structured assessment to understand more about performance patterns o Collect system performance data ▪ May include check sheets, data sheets, surveys, focus groups, and interviews Step 2: Analysis o High priority goal: Minimize performance variation ▪ Two main types of system variation Common cause variation Special cause variation 11/12/2024 18  Data Analysis: Run Chart Graphical data display that shows trends 11/12/2024 19  Data Analysis: Control Chart Chart that shows average performance level 11/12/2024 20  Data Analysis: Graphs Bart Charts, pie charts, histograms, etc. 11/12/2024 21  Data Analysis: Cause & Effect Diagrams Fishbone diagram 11/12/2024 22  Data Analysis: Cause & Effect Diagrams Flow Chart 11/12/2024 23  Data Analysis: Pareto Chart Pareto Principle: The law of the vital few & trivial many) states that, for many events, roughly 80% of the effects come from 20% of the causes 11/12/2024 24  Quality Improvement Process in Healthcare Step 3: Developing a Plan Model for improvement o Aim: What are we trying to accomplish? Set a clear aim with specific measurable targets. Measures: How will we know that the change is an improvement? Changes: What changes can we make that will result in an improvement? Step 4: Testing & Implementation o Plan-Do-Study-Act (PDSA) Improvement Cycle ▪ Focus: experimentation using small and rapid tests of change Evaluate the success of the intervention in bringing about improvement. Track the stability and sustainability of the new work process by monitoring system performance over time 11/12/2024 25  QI in Healthcare: AGCNS Role Nursing leadership engagement o Setting organizational goals with stakeholder buy-in o Measurement and transparency o Finding better systems o Supporting PDSA activities, risk, and change o Providing resources Elements that make improvement work possible o Professional knowledge o Knowledge of improvement o Linking these two knowledge systems promotes continuous improvement in health care. 11/12/2024 26