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PUBH 155 EXAM 1 Questions & answers
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PUBH 155 EXAM 1✅✅
Definition of healthcare quality (from Wikipedia article) - -is a level of value
provided by any health care resource, as determined by some measurement.
✅✅
Goal of healthcare quality (reduce variation) - -The goal of health care is to
provide medical resources of high quality to all who need them; Goal: reduce
variation
One of the 5 major reports discussed in the chapter and the main contributions of
each report
"The Urgent Need to Improve Health Care Quality" (IOM, 1998) - ✅✅ --included
two notable contributions to the quality movement. The first was an assessment
of the current state of quality (Chassin and Galvin 1998, 1000): "Serious and
widespread quality problems exist throughout American medicine. These
problems . . . occur in small and 1 6 The Healthcare Quality Book large
communities alike, in all parts of the country, and with approximately equal
frequency in managed care and fee-for-service systems of care. Very large
numbers of Americans are harmed."
-The second contribution was the categorization of quality defects into three
broad categories: underuse, overuse, and misuse.
STEEEP Framework - ✅✅ -safe- Harm should not come to patients as a result
of their interactions with the medical system. ACCURACY OF DIAGNOSIS,
APPROPIATE THERAPIES, SKILL WITH PROCEDURES ARE PREFORMED.
timely- Patients should experience no waits or delays when receiving care and
service.
effective- The science and evidence behind healthcare should be applied and
serve as standards in the delivery of care.
efficient- Care and service should be cost-effective, and waste should be
removed from the system.
, equitable - Unequal treatment should be a fact of the past; disparities in care
should be eradicated.
patient centered- The system of care should revolve around the patient, respect
patient preferences, and put the patient in control.
Stakeholders' perspectives - ✅✅-CLinicians- see quality in terms of technical
performance
Patients- see performance in terms of outcomes and value
Payers- see quality on the basis of costs
Administrators- see quality in terms of amenities and access
Society- sees the quality in terms of efficiency and cost effectiveness
✅✅
Framework for measuring quality (structure, process, outcome) -
-STRUCTURE
• Characteristics of individuals and settings in which care is delivered• "Setting
the table"
PROCESS
• Series of events that take place during delivery of care along 3 dimensions•
Appropriateness: were the right actions taken?• Skill: were the actions carried out
skillfully?• Timeliness: was care delivered in a timely fashion?
OUTCOME
Were goals achieved?• Is the patient satisfied?• Did the patient receive value?
Clinicians and outcomes* - ✅✅-• Clinicians are ambivalent concerning
outcomes
• Many factors account for outcomes that are beyond the physician's control•
Genetics• Environment• Patient's agency
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