1. By Christina Lauderman RN, BSN, CEN

2. The learner will be able to..  Define Quality Care  Identify Standards of Care/Benchmarks  Identify drivers of quality and their roles in the continuous quality improvement (CQI) process.  Describe How Total Quality and Continuous Quality Management, Six Sigma, and Lean Six Sigma Addresses Quality.

3.  Identify when an Incident report needs filed.  Perform a Chart Review on Given Stroke Charts  Develop a continuous quality improvement project on a nursing unit.

4. What Is Quality?

5.  Right Care at the Right time to the Right Patient.  Compassionate/Empathetic  Competent  No Harm  Meets Standards  No Complications  Nondiscriminatory/Fair

6.  Involves the pursuit of excellence in the delivery of care and ongoing prevention of potential errors  The degree to which patient care services increase the probability of desired patient outcomes and reduce the probability of undesired outcomes given the current state of knowledge (JCAHO, 2009)

7.  Florence Nightingale  Jean Watson- Theory of Caring  Dorothea Orem-Self care Deficit  June Larabee-Quality Theories

8.  Medicare and Medicaid  The Joint Commission (JCAHO)  State regulators  Payers  Professional groups  Patients

9. Why Is Poor Care Sometimes Given?

10.  Under Or Inexperienced Staff  Human Error  Time, Money, and Space Constraints  Attitude

11.  Ineffective Communication  Complications  Inability To Meet Patient’s Expectations.  System Error

12.  Care Deemed Appropriate Based on Scientific Evidence and Expertise of Expert Professionals in that Area of Care.  Come From JCAHO, DOH, ANA, NLN, NIH, AHA, ATA, ABA, UPMC Standards, Medicare/Medicaid, Insurance Companies etc.

13.  First learn standards in Nursing School.  Learn Policies and Procedures of Facility employed by.  As you incorporate Evidence Based Practice  As you become involved in Research.

14.  Structure Standards- Physical Environment, Organization  Process Standards-Delivery Of Care  Outcome Standards-The End Results

15. Examples of Standards

16.  After the Fact Identification  Prevention of Failed Standards and Problems  Based on Data Collection and Accountability  Uses Measurement Tools  Focus on “No Blame”

17.  4 Characteristics  Customer/Client Focused  Total Organizational Involvement  Use of Quality Tools and Statistics for Measurement  Key Processes for Improvement Identified

18.  Customer Client Focused  Internal Clients  Employees, lab, housekeeping  External Clients  Patients, Visitors, Physicians  Insurance Companies

19.  Total Organizational Involvement  Team Approach  Empowerment of Employees  Management-Team

20.  Use of Quality Tools and Statistics for Measurement  Tools such as Graphs, charts  Statistic tools such as percentages, Probability

21.  Key Processes for Improvement Identified  Systems Related  Clinical  Managerial

22.  Plan, Do, Check, Act Cycle

23.  TQM Philosophy CQI Process  Never Ending Process  Involves Evaluation, Actions, and a Mind Set to Constantly Strive for Excellence

24.  4 Key Players  Resource Group  Coordinator  Team Leader  Team

25.  Comprehensive Quality Management Plan  Multidisciplinary  Standards  Benchmarking  Critical Paths  Indicators

26.  Performance Appraisals  Intra/Interdisciplinary Assessments and Improvements

27. Audits  Retrospective  Concurrent Peer Reviews Utilization Reviews Outcomes Management

28. Six Sigma Uses Quantitative Data As a Measure As a Goal

29.  As a Management System  Customer focus  Data Driven  Process Emphasis  Proactive Management  Boundary-less Collaboration  Aim for Perfection, Tolerate Failure

31.  Institute of Medicine- To Err Is Human:  JCAHO- Patient Safety Goals  Institute of Healthcare Improvement

32.  Right Patient, Right Medication, Right Dose, Right Route, Right Time  Patients Involved In Own Care  Educate Patients About Medications  Errors Need Reported

33.  Problem Focused-  Identify  Analyze  Evaluate Risks  Develop Plan

34.  Education Based  Monitors Laws and Codes Related To Patient Safety.  Collects Data In Legal Complaints  Provides Reports to Administration, Medical Staff, and Board of Directors.

35.  Incident  Actual or Potential Risk.  Document in Chart and in Incident Report.  Be Factual, Non Disciplinary, Honest  Case Followed Up by Risk Management

36.  Medication Errors  Falls  Complications from diagnostic or treatment procedures  Patient/Family dissatisfaction with care  Refusal of Treatment or to sign consent  Skin Breakdown  Iv Infiltrations

37.  Encourage Staff To Report Incidents  No Blame or Disciplinary Action Unless Absolutely Necessary  No Finger Pointing  Encourage a Culture of Safety and Quality

38.  Clear Communication  Maintain Professional Caring Attitude  Listen to Complaints  Determine Expectations of Patient or Family  Quick Follow Up and Action

39.  Personal Contact-Utilize Charge Nurse, Nurse Manager, Nursing Supervisor.  Maintain Safety For Yourself and For the Patient.  Make Restitution/Meet Expectations When Applicable.

40.  Meeting Standards Helps to Provide Quality  TCM- Philosophy Uses Plan, Do, Check, Act  CQM-Never Ending, Strive for Excellence.  Six Sigma- Reduce Waste Increase Productivity

41.  Risk Management Role in Quality  Increase Patient Safety  Incident Reporting  Handling Complaints

43.  Textbook- Effective Leadership and Management in Nursing by Pearson  Google Images