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QI in Healthcare (SS2017)1.ppt - HTH SCI 4NR3: Session 4...

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HTH SCI 4NR3: Session 4Kathryn Fisher, PhD
Topics1.What is Quality Improvement (QI)?
1. What is Quality Improvement (QI)?
What is QI?A philosophy to continuously make things betterApplication of Best PracticeCan refine/improve with new knowledge producedUses multiple methods/tools to implement change &measure the impactApplies equally to clinical and non clinical processes“An organizational philosophy that seeks to meet clients’ needs andexceed their expectations by using a structured process thatselectively identifies and improves all aspects of service.”Accreditation Canada
What is a QI Intervention?
Source: Hughes, R.G. Senior Health Scientist Administrator at Agency for HealthcareResearch and Quality (AHRQ). Patient Safety and Quality: An Evidence-Based Handbook forNurses. Chapter 44. Tools and Strategies for Quality Improvement and Patient Safety., pg. 3-1. 2008.
The choice of a QI intervention isdependent on the nature and aim of theQI project, examplesQI InterventionExample of ActivitiesAim of QI ProjectProvider educationWorkshops,conferences,educational outreachvisits, distribution ofeducational materialsIncrease knowledge anduse of evidence-basedpractices of providersdelivering services toclients enrolled inDiabetes EducationCentersOrganizationalChangeCase management,disease management,multidisciplinary teams,increased staffing, skill-mix changes, changefrom paper tocomputer-based recordsReduce hospital length-of-stay for patients withmultiple chronicconditions
Identifying Quality ProblemsIf you wanted to get a sense of the quality of healthcaredelivery, how would you go about it?You could ask providers if they were following the guidelines fora specific diseaseYou could ask providers to keep track of their errors or “nearmisses”These methods fraught with validity and reliability issues.Self-report of errors is shown to be low and, particularly if thereis a potential punitive response, reporting would be infrequentand inaccurate.
Systems IssuesHuman LimitationsBad DesignCommunication
Video: Communication & Hand Offs
The majority of medical errors result from faultysystems and processes, not individualsU.S. Institute of Medicine (IOM) (1999)Source: Institute of Medicine. To err is human: building a safer healthsystem. Washington D.C.: National Academy Press. 1999.
Accountability and CultureA systems approach is imperativeHowever, this does not negate our responsibility to:Report adverse events and near missesMaintain competenciesRe-train if necessaryDifferentiate between:Adverse events and errorsPreventable and non-preventable

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Term
Summer
Professor
NoProfessor
Tags
Patient safety, PDSA, R G Senior Health, QI Strategies

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