Week 1 Quality Improvement in Healthcare4.pdf

8480 Quality Improvement in Healthcare Week One This Week Introductions: Getting to Know One Another Key definitions The origins and evolution of quality improvement The six domains of Health Quality Improvement Introducin...

8480 Quality Improvement in Healthcare Week One This Week Introductions: Getting to Know One Another Key definitions The origins and evolution of quality improvement The six domains of Health Quality Improvement Introducing the essential role of culture in Health Quality Improvement  Getting To Know Each Other First and last name, pronouns, and any name-related preferences; Share 3Ps Personal fact Professional fact Peculiar fact In a maximum 10 words, what is something that you have improved, or made better in your life?  Orientation to Class E-Platform Instructional Plan Evaluations, due dates, and rubrics Course text “This Week’s Activities” Orientation to Class Decorum Attendance Participation Speaking and speaking OUT Academic Integrity What is Quality? …it varies! Copyright 2009 A Warm Blankets Story Developed by David Gray, cofounder of Xplane Consultants. Copyright 2009 What’s “Good”? Breaking into pairs, with your partner, Recall a good, or positive healthcare experience that you or a loved one has had. Close your eyes, and recall what you were: Saying? Thinking? Doing? Feeling? Now, let’s recall a bad, or negative experience. What were you: Saying? Thinking? Doing? Feeling? Defining Quality Improvements and Change Improvements are changes that make something: easier faster more effective safer less expensive more efficient Change Ideas in QI increasingly satisfying to Something that you the end user can specifically test to see if they make a Discussion: difference. Are all changes improvements? Do all improvements require change? Quality Control Approach to ensuring the quality of a product or process quality is maintained. Absence or presence of errors or risk Measurement throughout the process or following, depending on control. Examples:  Auditingpatient charts to ensure clinical standards adherence.  Secondary staff conducts a check of medication before distribution. Quality Assurance A systematic process of measuring a process or product against a set of standards. Measurement against a set of performance, quality, or practice benchmarks. Examples:  Accreditation of organization.  QBPs – Quality Best Practices Quality Improvement Health services that increase the likelihood of a desired health outcome (individual or population); Consistent with current knowledge Measurement against a set of performance, quality, or practice benchmarks. Examples:  Advanced access project to improve access to care. Health Quality Improvement Defined A specific approach to improving care. Swanwick and Vaux Health Quality Improvement Defined A continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes that achieve equity and improve the health of the community. Centre for Disease Control Health Quality Improvement Defined The combined and unceasing efforts of everyone—healthcare professionals, patients and their families, researchers, payers, planners, and educators—to make the changes that will lead to better patient outcomes (health), better system performance (care), and better professional development. Baltalden and Davidoff, 2007 Health Quality Improvement Defined Better patient experience and outcomes are achieved through changing provider behaviour and organization using a systematic change method and strategies. John Ovretveit, 2009 IGNAZ SEMMELWEIS Variation in maternal and infant deaths between the midwifery and physician maternity wards; Could it be the priest’s bell? Change Ideas Recognition of the bacterial risks associated with autopsies occurred following the death of a friend; Previously, doctors were moving between autopsies and deliveries without handwashing. Chlorine solution was introduced to wash hands. Between 1848 and 1859, death rates dropped dramatically within the physician’s ward.  FLORENCE NIGHTINGALE Recognized a correlation between poor living conditions and solider deaths in the Crimean War; Change Idea If the patient is provided a hygienically good environment in the health care setting then there is probability of having occurrence of If patients are in complications will be reduced. a hygienic environment, This included ventilation, light, noise, complications are cleanliness of rooms, walls, bed and reduced bedding, personal cleanliness, and taking the patient’s food via the “invalid’s kitchen.”  WILLIAM EDWARDS DEMING Following the 2nd World War, William Edwards Deming, an engineer, mathematician, and physicist helped to revive Japanese manufacturing using statistical methods to improve processes and eliminate the waste within them; Deming has been deemed the pioneer of quality improvement, beginning in Japan and then in the US. WILLIAM EDWARDS DEMING CRITICAL CONVERSATIONS IN HEALTH QUALITY To Err is Human (2000) “Improved health, greater Full of shocking longevity, less pain and statistics about the suffering, and increased degree to which personal productivity for medical error influences health those who receive their outcomes. care.” Crossing the Quality Chasm Challenged public perceptions of the “infallibility” of Crossing the Quality Chasm (2001) healthcare A more forward-looking report, professions inclusive of a strategic proposal to improve quality.  CRITICAL CONVERSATIONS IN HEALTH QUALITY CONT’D RECOMMENDATIONS FROM CROSSING THE QUALITY CHASM 1. Redesign Health Care Processes to transform healthcare delivery systems to focus on patient-centered care, streamline workflows, and integrate evidence-based practices to enhance overall quality. 2. Adopt Evidence-Based Practices and Treatments that are proven effective through rigorous research, ensuring that care is based on the best available evidence. 3. Leverage Information Technology, such as Electronic Health Records (EHRs), to improve coordination, accuracy, and efficiency in patient care. 4. Foster Continuous Improvement and Learning by promoting cultures that encourage healthcare organizations to learn from errors and best practices to drive sustained quality improvements.  The Institute of Medicine’s (IOM) SIX DOMAINS of health quality improvement There are many clear connections between the recommendations made within Crossing the Quality Chasm and the six domains of health quality as defined by the Institute of Medicine (IOM): Effective: Patient-centered: Providing services based on Providing care that is respectful of Safe: scientific knowledge to all who and responsive to individual patient Avoiding harm to patients from the could benefit and refraining from preferences, needs, and values and care that is intended to help them. providing services to those not likely ensuring that patient values guide to benefit (avoiding underuse and all clinical decisions. misuse, respectively). Equitable: Timely: Efficient: Providing care that does not vary in Reducing waits and sometimes Avoiding waste, including waste of quality because of personal harmful delays for both those who equipment, supplies, ideas, and characteristics such as gender, receive and those who give care. energy. ethnicity, geographic location, and socioeconomic status. 1. Discuss each HQI domain. 2. Suggest two ideas within each domain. I.e., Equity: Mobile clinics to reach isolated communities; Transportation vouchers to assist those in poverty to attend appointments. Course Text: What to Read Course Text: ABC of Quality Improvement in Healthcare (2020) Eds Stanwick and Vaux Week One Readings: Chapters 1 & 2 Pages 1-9  We Will: 1. Uncover some of the essential roles of culture in QI; 2. Examine the various human- centered roles and responsibilities within a quality improvement initiative; Class 3. Gain an understanding of the PDSA cycle, and the model of improvement; 4. Develop a quality improvement concept using the model of improvement’s three (3) guiding questions. References and Resources ABC of Quality Improvement in Healthcare - ABC Series Tim Swanwick (editor), Emma Vaux (editor) eBook (14 Feb 2020) Wiley Blackwell. Batalden PB, Davidoff F. What is "quality improvement" and how can it transform healthcare? Qual Saf Health Care. 2007 Feb;16(1):2-3. doi: 10.1136/qshc.2006.022046. PMID: 17301192; PMCID: PMC2464920. Courtney Young, MBA, MD, FRCPC, Maya Ignaszewski, MD, Margot Wilson, RN, MSN, CHE, Moe Baloo, DC, MHA, Ken G. Gin, MD, FRCPC, Andrew Ignaszewski, MD, FRCPC. Roots of quality improvement in health care. BCMJ, Vol. 59, No. 10, December 2017, Page(s) 517-522 - Clinical Articles. Hughes RG. Tools and Strategies for Quality Improvement and Patient Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 44. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2682/ References and Resources Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C: National Academy Press; 2001. Little, Becky. (2020). "It Took Surprisingly Long for Doctors to Figure Out the Benefits of Hand Washing." https://www.history.com/news/hand-washing-disease-infection Date Accessed: March 16, 2024. Original Published Date March 6, 2020. Schwarz , Chelsea. What is Quality Improvement Anyways? 2021. Saskatchewan Health Quality Council https://www.saskhealthquality.ca/blog/what-is-quality-improvement-anyway/ Accessed March 16, 2024. Tirupathi R. Chandrupatla, Rowan University, New Jersey; Date Published: January 2009; availability: Available; format: Hardback; ISBN: 9780521515221. Video Deming the Man. The Deming Institute. https://deming.org/deming-the-man/