Quality Management and Risk Management
Focused on optimizing patient outcomes and emphasizes the prevention of patient-care problems and the mitigation of adverse events.
Quality Terms p 391 Table 19-1
Important to understand because people use them interchangeably
Quality Management=
Evolution of Quality
W. Edwards Deming... Sent to Japan after WW2
Believed in constant improvement.
Structure of Quality Improvement
Do we have DELIVERY SYSTEM in place?
adequate staffing, med deliver system, effect of comp chart
Process of Quality Improvement
Timeliness and thoroughness of documentation
adherence to critical paths or care
Outcomes of Quality Improvement
Outcome of QI- pt falls, hospital acquired infection rate, pt satisfaction, mortality rates, pump time (how long on bipass pump=complications:circulation damage bleed time)
Involvement of Quality Improvement
Manager and Workers must be committed to QI
flat, democratic, organizational structure.
Customers define quality!
Patients see themselves as customers who can take business elsewhere
Internal Customer
Patients, Nurses on other shift/departments, Nurse Managers
External Customer
Physicians, Patient's Family, Manage Care Organizations, Community at Large
Quality Improvement Process
Continual analysis and evaluation of products/services
Products/services can ALWAYS be improved
In HC the JCAHO is outside agency helps evaluation Quality of Service
Steps in Quality Improvement Process (Three)
Combine the structure, process, and outcomes of standards
Plan
changes in Health Care
Implement
changes in Health Care
Evaluate
changes in Health Care-->Outside agency that helps evaluation Quality of Patient Care
Comparison of QI and QA Chart PG402
QI-prevention of errors
QA-ID and Correct errors
QI-Review nurse activities, innovation, staff development
QA- Inspections of nurse activities
QI-Multidisciplinary Team
QA-QA personnel/depart personnel
Quality Improvement
Continual Analysis; Evaluation of Products/Services to prevent error and achieve customer satisfaction.
NEVER STOPS. can ALWAYS be improved.
Goal of Quality Management
To IMPROVE SYSTEMS and PROCESSES
NOT to ASSIGN BLAME
Quality Management Term
Philosophy that defines Healthcare culture emphasizing customer satisfaction, innovation, and employee involvement.
Quality Improvement Term
Ongoing Process of innovation, prevention of error, and staff development that is used by institutions that adopt the quality management philosophy
Total Quality Management Term
COMBINATION OF QUALITY IMPROVEMENT IDEAS FROM THEORY AND RESEARCH
Emphasis is placed in the areas of patient safety and patient satifaction--> Leadership Fostered
enable the team
remove barriers
instill accountability
Customers define Quality
*Quality Imp
Quality Improvement Term
Combines the assessment of structure (ex. Adequacy of staff, effectiveness of computerized charting, availability of med deliver systems) process (timeliness, adherence to pathways) and outcomes (ex: pt falls, pt sat) standards.
Quality Assurance Term
Monitor Healthcare Through Inspection
Detecting Errors and determining the person responsible
Not intending to be punitive but an opportunity to improve pt care at UNIT LEVEL
Risk Management
attempts to analyze problems and mnimize losses after an adverse effect (JCAHO)