how is quality defined? - answerno errors, degree of excellence, do the right thing and
do it well. Meeting customers expectations, exceed expectations.
What is quality mgmt.? - answerexamine the process to delivery of care, the outcomes
measured
plan-do-check-act - answerWalter Shewhart
Edward Deming - answerintroduced statistical process to improve quality
He recognized importance of having accurate and meaningful infor to improve quality
Demings 7 deadly diseases - answerlack of consistency, emphasis on short term
profits, eval of performanmce,job hopping, excessive medical cost, excessive liability
Joseph Juran - answerintroduced Total Quality Control
Philip Crosby - answerHe added financial consequences to quality performance
Savings are generated by "doing things right the first time"
Quality Mangt. QM - answerapproaches to imporving quality
emphasis on preventing errors, empowerment of employees, improve performance,
focus on supplier relationships
Quality Improvement - answerimproving on outcomes that are consider satisfactory, get
better.
Typically focus on process and systems, no individuals
Continuous Quality Improvement - answeruses a systematic process, enhance
performance. Looks at processes, not individual. ( ex laparoscopy, less hospt stay)
Total quality management - answeruses QA, QI, CQM and focuses on customer desire
Sentinel Event - answerunexpected death, unrelated loss of function, IP suicide, infant
abduction, transfusion rxn, wrong site surgery
Root Cause Analysis - answerAnalyzing a sentinel event, must assess the culture.
, Credentialing - answerKey part of QM.Make sure the right person , right knowledge in
the right position
Risk Mgt. - answerFocus on monetary loss by eliminating negative outcomes. Includes
insurance, pt satisfaction and legal issues.. Improve documentation. Medical records
analysis is very helpful
Ultimate responsibility is the governing body of the hospital.
UR - answerformal review of the consumption of all resources in the delivery of care.,
Can be prospective, concurrent or retrospective .Reduce resources to achieve the same
result.
Infection Control - answerFocus on Outcomes, looks at transmission of illness to
providers, staff and visitors. Reduce risk of future infection
Outcome studies - answerimportant to analyze effectiveness. Computer generated
outcomes best. self report survey are vulnerable to inaccuracy, single review least
reliable.
Peer review - answerAn individual c similar training and the one being reviewed.
1-chart rev
2-patterns
3- peer intervention
PRO- peer review organization - answer1972-82 was physician controlled, nonprofit org
that looked at Medicare IP, Utilization and quality. Changed to PSRO in 1982 via the
Tax Equity and Fiscal Responsibility act
QARI- quality assurance reform initiative - answer1993- to assist states develop QI
systems, focus on clinical studies
QISMC- quality improvement for system of Managed Care - answer1996-Federal govt
formed as a guide for quality mgt, esp for Medicare and Medicaid
-Designed to strengthen the efforts to protect and improve health and satisfaction to
Medicare and Medicaid enrollees
-clarifies responsibility in promoting quality
-promotes partnership
-develop coordinated quality oversight
-looks for new developments
BBA-balanced budget Act - answer1997-comprehensive revision of federal statutes
governing Medicaid
Revised 1999. Uses QISMC to set quality assurance provisions.
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