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The centers for Medicare and Medicaid defined Quality as:
The right care for the right person every time.
The Juran Institute defined quality as both:
1. Freedom of deficiencies, and
2. Product features.
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The Institute of Medicine defines quality as:
"The degree to which health care services for
individuals and populations increase the
probability of desired health outcomes and are
consistent with current professional knowledge of
best practice."
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The US Government Agency for Healthcare Research and Quality (AHRQ) defines quality healthcare as:
Quality Healthcare is Healthcare that is accessible, effective, appropriate, safe, efficient, timely.etc
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Types of indicators
Structure Indicator
Describes characteristics of the setting that supports and has an impact on care (examples: availability of approved least restraint devices on a unit,
RN:patient ratio).
Process Indicator
Measures an activity that is carried out to care for patients Focuses on the nature and amount of care nurses provided during the
hospital stay (examples: rate of patients on fall prevention program, nurse
satisfaction).
Outcome Indicator
Describes the patient's status at the defined time following care interventions.
Measures the result of nursing care/process (examples: pressure ulcer prevalence rate, fall injury rate).
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Indicators are reliable and valid measures used to screen/assess
organizational and practitioner performance issues, but not direct
measures of quality
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An indicator is a measurable variable (or characteristic) that can be used to determine the degree of adherence to a standard or achievement of quality goals
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Well defined
Objective
Measurable (reliable and valid)
Comparative and
Graphically displayed
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Out come indicators
Process indicators
Structure indicators
Sentinel events
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Knowledge
Design Information
Data Collection Analysis
Hypothesis Interpretation Understanding
Information Management
Cycle
Quality Assurance Quality Control Quality Improvement
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Knowledge
Design Information
Data Collection Analysis
Hypothesis Interpretation Understanding
Information Management
Cycle
Quality Assurance Quality Control Quality Improvement
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but remember, bad data will result in bad information (GIGO)
Garbage In , Garbage Out
Also, data can be no more accurate than the instruments and the systems used for
recording them and reporting them
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... 65
Control Chart
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Colonic biobsy / day Average Upper Limit Lower Limit
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Sequence of interdependent and linked procedures which, at every stage, consume one or more resources to convert inputs into outputs. These outputs then serve as input for the next stage until a known goal or end result is reached.
BusinessDictionary.com
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Value Chain Analysis
Define the process
Draw a flow chart (understand the steps)
Identify the value of each step
Suggest the changes and results
Pilot study
Implement 68
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FOCUS Plan-Do-Check-Act
Find Organize Clarify Understand Select P D C A
Define the process
Draw a flow chart (understand the steps)
Identify the value of each step
Suggest the changes and results
Pilot study
Implement
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