Schakeljaar: Master In De Verpleegkunde En Vroedkunde
Kwaliteit van zorg
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Samenvatting Kwaliteit van zorg 2023/2024
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Course
Kwaliteit van zorg
Institution
Katholieke Universiteit Leuven (KU Leuven)
Book
Improving Patient Care
Beknopte samenvatting Kwaliteit van zorg. Gedoceerd door Theo van Achterberg. Bevat alle informatie die in de lessen zijn behandeld. Ook de hoofdstukken die zelfstudie zijn, zijn samengevat.
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September 28, 2024
94
2023/2024
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kwaliteit van zorg
theo van achterberg
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5/5 Samenvatting Improving Patient Care, Onderzoek en Implementatie (KGWV04014) geschreven in GoodNotes met afbeeldingen en tabellen uit het boek.
4/5 Samenvatting Improving Patient Care, Onderzoek en Implementatie (KGWV04014) geschreven in GoodNotes met afbeeldingen en tabellen uit het boek.
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Schakeljaar: master in de verpleegkunde en vroedkunde
Kwaliteit van zorg
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Samenvatting kwaliteit van zorg
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Hoofdstuk 1: introductie.........................................................................................................................6
De 6 dimensies van kwaliteit van zorg................................................................................................6
1. Safety..........................................................................................................................................6
2. Effectiveness...............................................................................................................................7
3. Efficiency.....................................................................................................................................7
4. Accessibility (& timeliness, affordability)....................................................................................7
5. Person-centeredness..................................................................................................................8
6. Equity..........................................................................................................................................8
Algemeen besluit............................................................................................................................8
Hoofdstuk 2: kwaliteitsverbetering en implementatiewetenschap........................................................9
Beoordelen kwaliteit van zorg............................................................................................................9
Implementatiewetenschap.................................................................................................................9
Verschillende interventies...............................................................................................................9
Nieuwe inzichten............................................................................................................................9
Implementatieprobleem...............................................................................................................10
Implementatie..................................................................................................................................10
Geschiedenis van implementatie......................................................................................................10
Voor 1980.....................................................................................................................................10
In 1980..........................................................................................................................................10
In 1990..........................................................................................................................................11
In 2000..........................................................................................................................................11
In 2010..........................................................................................................................................11
Nu.................................................................................................................................................12
Conclusie (voorgaande)................................................................................................................12
Implementatiemodellen...................................................................................................................12
1. systematische aanpak...............................................................................................................12
2. PARiHS framework....................................................................................................................12
3. Implementatie veranderingsmodel...........................................................................................13
Conclusie modellen......................................................................................................................14
Hoofdstuk 3 Beoordelen kwaliteit van zorg..........................................................................................15
Waarom meten van kwaliteit van zorg.............................................................................................15
Samengevat..................................................................................................................................15
Soorten kwaliteitsindicatoren...............................................................................................................16
1
, kwaliteitsindicatoren........................................................................................................................16
Focus op:.......................................................................................................................................16
Besluit...........................................................................................................................................17
Ontwikkelen van kwaliteitsindicatoren.................................................................................................17
1. De meetdoelen definiëren............................................................................................................17
2. Voorlopige reeks indicatoren selecteren of ontwikkelen..............................................................17
3. Consensus vinden onder de beoogde gebruikers.........................................................................18
Twee methoden............................................................................................................................18
Voorkomende operationalisaties..................................................................................................18
Andere operationalisaties.............................................................................................................18
4. De indicatoren empirisch testen...................................................................................................18
5. Feedbackrapport opstellen...........................................................................................................19
Voorbeeld.........................................................................................................................................19
Twijfels en kritiek..................................................................................................................................20
Bedenkingen.....................................................................................................................................20
Case mix........................................................................................................................................20
Selectie indicatoren en data.........................................................................................................20
Bronnen van data..........................................................................................................................20
Wat is de norm?............................................................................................................................20
Effect feedback.............................................................................................................................20
Bureaucratie of kwaliteit?.............................................................................................................20
Perverse effecten..........................................................................................................................21
Goede oplossing...........................................................................................................................21
Hoofdstuk 4: Factoren in kwaliteitsverbetering....................................................................................22
Belangrijke barrières/factoren om te implementeren van acties..................................................22
Belangrijk......................................................................................................................................22
Methoden.........................................................................................................................................22
1. Literatuur review (gebruik van literatuur).................................................................................23
2. Interview...................................................................................................................................23
3. Vragenlijst.................................................................................................................................23
4. Geroutineerde datacollectie.....................................................................................................23
5. Observaties...............................................................................................................................24
Belangrijk......................................................................................................................................24
State of te art (het nieuwste van het nieuwste)................................................................................24
CFIR (consolidated framework for implementation research)......................................................25
TICD/ Flottorp (checklist voor determinanten uit praktijk)...........................................................25
2
, Conclusie..........................................................................................................................................25
Hoofdstuk 5 Kiezen van verbeteringstrategieën...................................................................................26
Inleiding............................................................................................................................................26
Het probleem....................................................................................................................................26
Implementatie in de gezondheidszorg..........................................................................................26
Reflectie............................................................................................................................................27
Hoe kiezen we de juiste strategieën?...................................................................................................27
Modellen..........................................................................................................................................27
Analyse.............................................................................................................................................28
Actie..................................................................................................................................................28
EPOC taxonomy............................................................................................................................28
TBCM taxonomy............................................................................................................................29
Samengevat......................................................................................................................................29
Evidentie voor strategieën en conclusies..............................................................................................30
Effecten.............................................................................................................................................30
Waar zoeken voor evidentie?.......................................................................................................30
Hoe rapporteren over implementatie interventies.......................................................................31
SAMENVATTING: Cruciaal in systematische aanpak.....................................................................31
Conclusie..............................................................................................................................................32
Hoofdstuk 6: Onderzoek naar kwaliteitsverbetering............................................................................33
Onderzoek naar kwaliteitsverbetering..............................................................................................33
Implementatie science..................................................................................................................33
Interventie is niet gelijk aan interventie........................................................................................33
Principes van implementatieonderzoek........................................................................................34
Het onderzoeksproces......................................................................................................................35
MRC framework............................................................................................................................35
Effectevaluatie..................................................................................................................................37
Onderzoeksdesigns.......................................................................................................................37
Developmental research...............................................................................................................43
Overzicht designs..........................................................................................................................44
Procesevaluatie.................................................................................................................................45
Economische evaluatie.....................................................................................................................45
Implementatie kosten...................................................................................................................45
Economische evaluatie.................................................................................................................46
......................................................................................................................................................46
Besluit...............................................................................................................................................46
3
,Hoofdstuk 12 (boek): eductional implementation strategies................................................................47
Introductie........................................................................................................................................47
Types van educatie strategieën.........................................................................................................47
Effectiviteit van educatie...................................................................................................................47
Educatieve materialen..................................................................................................................47
Educatieve bijeenkomsten............................................................................................................48
Outreach bezoeken.......................................................................................................................48
E-learling.......................................................................................................................................48
Determinanten van de effectiviteit van de educatie.........................................................................48
Discussie en conclusie.......................................................................................................................48
Hoofdstuk 13 (boek): clinical performance feedback and decision support.........................................49
Definities, kenmerken en componenten...........................................................................................49
Feedback.......................................................................................................................................49
Decision support...........................................................................................................................49
Effectiviteit van feedback en decision support.................................................................................49
Factoren geassocieerd met effecten.................................................................................................49
Onderliggende assumpties, relevante theorieën en mechanismen..............................................49
Discussie en conclusie.......................................................................................................................50
Hoofdstuk 14 (boek) : engaging patients in healthcare improvement and innovation.........................51
Impact van patiëntbetrokkenheid en directe zorg............................................................................51
Goed ingeburgerde conceptuele raamwerken..............................................................................51
Persisterende theorie-praktijk gat................................................................................................51
Bredere gevolgen..........................................................................................................................51
Impact van patiëntbetrokkenheid op organisationeel design en bestuur.........................................52
Impact van patiëntbetrokkenheid in beleid maken..........................................................................52
Conclusie..........................................................................................................................................52
Hoofdstuk 15 (boek): organizational implementation strategies..........................................................53
Revisie van professionele rol.............................................................................................................53
Versterkte patiëntenzorg teams........................................................................................................53
Kennis management (gebruik van IT)...............................................................................................53
Geïntegreerde zorgsystemen............................................................................................................53
Kwaliteit en veiligheid management.................................................................................................53
Conclusie..........................................................................................................................................53
Hoofdstuk 16 (boek): patient safety strategies.....................................................................................54
Strategies to measure patient safety................................................................................................55
Patiëntveiligheid verbetering strategieën.........................................................................................56
4
, Strategieën om patiëntveiligheid te verzekeren...............................................................................57
Conclusie..........................................................................................................................................57
Hoofdstuk 17 (boek): health system strategies for implementation.....................................................57
Strategies to enhance evidence-based policy making......................................................................57
Opschalen van interventies en praktijken.........................................................................................58
Wijzigingen in de financiële vergoeding van zorgaanbieders............................................................58
Veranderingen in financiële risico voor patiënten............................................................................58
Veranderingen in het gezondheidszorgsysteem................................................................................58
Conclusie..........................................................................................................................................58
Hoofdstuk 18 (boek): multifaceted implementation strategies............................................................59
Strategieën in veelzijdige implementatiestrategieën........................................................................59
Effectiviteit van veelzijdige implementatiestrategieën.....................................................................59
Maatwerk in veelzijdige strategieën.................................................................................................59
Volume en classificatie van strategieën............................................................................................59
Combinatie van specifieke strategieën.............................................................................................60
Conclusie..........................................................................................................................................60
Hoofdstuk 12-18 herhaling (andere samenvatting)..............................................................................60
kent de verschillende dimensies van kwaliteit van zorg en veel voorkomende
kwaliteitsproblemen
Kent de algemene principes vanuit implementatiemodellen
Weet hoe kwaliteit van zorg gemeten kan worden en kan verschillende typen
kwaliteitsindicatoren onderscheiden
Kan kwaliteitsproblemen analyseren
Kan reflecteren over theorie en evidence gebaseerde verbeterstrategieën, incl.
systeemveranderingen
Kan een gefundeerd plan voor kwaliteitsverbetering in de patiëntenzorg opstellen
Kan een plan voor de evaluatie van pogingen tot kwaliteitsverbetering opstellen
Kent de waarde en rol van de Master in de Verpleegkunde en de Vroedkunde m.b.t. kwaliteit
van zorg
5
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