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Quality IOM defines it as the degree to which health services for individuals & populations increase the likelihood of desired health outcomes & are consistent w/current professional knowledge Quality assurance began as inspection approach to ensure healthcare institutions maintained minimum stand...

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Nursing 342 Final Exam Questions and
Correct Answers
Quality ✅IOM defines it as the degree to which health services for individuals &
populations increase the likelihood of desired health outcomes & are consistent
w/current professional knowledge

Quality assurance ✅began as inspection approach to ensure healthcare institutions
maintained minimum standards if care. "doing things right". Consists of chart audits

Clinton's presidential advisory commission ✅addressed concerns about quality care &
the need to make changes. Purpose was to advise the president about the impact of
healthcare delivery system changes on quality, consumer protection, & availability of
needed services

Beginning of QI ✅quality first:better healthcare for all americans-1998 but failed. It
stimulated the development of the quality chasm series in 1998

Quality improvement ✅management philosophy to improve level of performance of key
processes in organizations. Developed by industrial quality experts

Key words used interchangeably w/QI ✅total quality management (TQM) continuous
quality improvement (CQI) performance improvement (PI)

Concepts of QI ✅2 ways to improve quality=structures & processes. Customer is
central to every process, productive work requires work processes. Main sources of
quality defects are problems in the work processes. Quality defects are costly. Focus on
most important work process to improve, involve every worker & set high standards for
performance

Health care quality ✅IOM provides independent, objective, evidence based advice to
policy makers, hcps, private sector & the public

IOM ✅1st comprehensive system to monitor healthcare, judge improvement, &
determine best strategies to improve healthcare.

Quality problems ✅3 problems used in measurement of quality. Misuse-avoidable
complications that prevent pts from receiving the full potential benefit of a service
(wrong site sx)
Overuse-potential for harm from the provision of service that exceeds the possible
benefit (antibiotics)
Underuse-failure to provide a service that would have produced a favorable outcome for
the pt (hospice)

, IOM rules for 21st century to guide care delivery & improve health care system ✅care
based on continuous healing relationships, customization based on pt needs/values, pt
as source of control, share knowledge, free flow of info, evidence based decision
making, safety is a system property, need for transparency, anticipation of needs,
continuous decrease in waste, cooperation among clinicians

To err is human ✅focused on safety within the healthcare delivery system. System is
experiencing frequent important medical errors. 4 messages= magnitude of harm
resulting from medical errors is great. Errors result largely from system failures.
Voluntary & mandatory reporting programs needed to improve pt safety. HC systems
must focus on error reduction as an important part of their operation

Crossing the quality chasm ✅focus on developing a new HC system that improves
care. The system is in need of repair. HCP can't keep up w/rapid changes

Priority areas for national action ✅care coordination & self management/health
literacy. Continuum of care, preventive care, inpatient/surgical care, chronic conditions,
end of life care, behavioral care

Leadership by example ✅examined the federal governments quality enhancement
processes. Concluded that the federal government should lead by example &
coordinate roles in improving healthcare quality

Who will keep the public healthy ✅needs for public health in a world affected by
globalization, rapid travel, scientific/technological advances & demographic changes

Health professions education ✅education of health professions in the bridge to quality
care. 5 core competencies for all hcps- provide pt centered care, work in
interprofessional teams, employ EBP, apply QI, & utilize informatics. Example=QSEN

Keeping pts safe: transforming the work environment of nurses ✅focus on nursing
care & nurses. Examines quality issues from perspective work environment.

Ioms quality improvement core competency ✅identify errors/hazards in care,
understand & implement basic safety principles-standardization & simplification.
Understand & measure quality of care-structure/process/outcomes & pt needs. Design
& test interventions to change processes & systems of care

Increased legislation ✅was influenced by IOM reports & the DHHS. In 2005-patient
safety & quality improvement act was signed, a blame free culture was encouraged &
patient safety organizations (psos) were developed

2010 health care reform legislation (affordable care act) ✅increased accessibility for
nearly 50 million americans. It recognized the need to streamline processes in

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