Transcript ch10 quality and safety

 Discuss the findings/conclusions of the IOM and
Committee on Quality of Health Care in America
investigation.
 Examine the Rules for Health-Care Reform in the
21st Century.
 Identify HOM’s Aims for Improving Quality in
Health-Care.
 Explore various aspects of Quality Improvement
(QI).
 Discuss the processes of Continuous Quality
Improvement (CQI) and the nurse’s role in
QI measures and quality health care.
 Investigate strategic planning’s role in
Quality Improvement.
 Differentiate commonly used structured care
methodologies (SCMs)
 Discuss how the various SCMs can be used to
improve quality care.
 Discuss how critical pathways are used in the
delivery of care and can be used to measure
patient outcomes.
 Examine the aspects to be evaluated in health
care CQI: structures, processes, and outcomes.
 Explore risk management in health care and
explain the role of the nurse in risk
management.
 Examine varying aspects related to an
incident report.
 Review the aspects of documentation related
to an incident reporting.
 Differentiate the categorization of risk
events.
 Discuss the economic perspective in HealthCare Systems and its regulation.
 Identify the factors increasing and
containing costs of health care.
 Examine factors associated with the
Nursing Labor Market.
 Identify various types of errors.
 Examine characteristics associated with a
Culture of Safety.
 Identify and discuss National Patient Safety
Goals and Core Measures.
 Examine the ANA nursing sensitive quality
indicators in acute care settings.
Identify IOM core competencies for health
professionals.
 Historical trends and issues
 The Institute of Medicine and the
Committee on the Quality of
Health Care in America
 Economic
 Societal demographics and diversity
 Regulation and legislation
 Technology
 Health care delivery and practice
 Environmental and globalization
The IOM concluded that
1. Quality can be defined and measured
2. Quality problems are serious and
extensive
3. Current approaches to quality
improvement are inadequate
4. There is an urgent need for rapid
change
The IOM recommended (Box 10-3)
 Enhance knowledge and leadership
regarding safety
 Identify and learn from errors
 Set performance standards and
expectations for safety
 Implement safety systems within health
care organizations
The gaps between actual care and highquality care could be attributed to key
inter-related areas in the health care
system
 The growing complexity of science and
technology
 An increase in chronic conditions
 A poorly organized delivery system of
care and constraints on exploiting the
revolution in information technology
1. Care is based on a continuous healing
2.
3.
4.
5.
relationship
Care is provided based on patient
needs and values
Patient is source of control of care
Knowledge is shared and free-flowing
Decisions are evidence-based
Ten Rules to Govern Health Care
Reform for the 21st Century (cont’d)
6. Safety as a system property
7. Transparency is necessary; secrecy
is harmful
8. Anticipate patient needs
9. Waste is continually decreased
10.Cooperation between health care
providers
 Quality improvement
 Using CQI to monitor and evaluate quality of
care
 Quality improvement at the organizational
and unit levels
 Aspects of health care to evaluate
 Risk management
The Institute of Medicine (IOM) defines quality as
“the degree to which health services for individuals
and populations increase the likelihood of desired
health outcomes and are consistent with current
and professional knowledge”
(IOM, 2001, p. 232)
Health care should be
 Safe
 Effective
 Patient-centered
 Timely
 Efficient
 Equitable
QI
 Began with Florence Nightingale
 Structured organizational process
 Included evidence-based methods for
gathering data and achieving goals
CQI
 Purpose
 Identify, collect data, analyze, evaluate,
change
 Responsibility
 Structure
 Process
 Outcomes
 Service occurrence
 Serious error
 Sentinel event
 Economic perspective
 Regulation and competition
 Nursing labor market
 Economic
 Regulation
 Competition
 Nursing labor market
 Types of errors
 Error identification and reporting
 Developing a culture of safety
 Organizations, agencies, and initiatives
supporting quality and safety in the
health-care system
 Diagnostic
 Treatment
 Preventive
 Other
 Near miss
 Adverse event
 Accident
 Roles of leadership, individuals, and
teams
 Event reporting systems
 Methods
 Organizations, agencies, and initiatives
Role of nursing in system reform
The ANA’s Agenda
Inf luence of Nursing
American Nurse’s Association
 Nursing’s agenda for health care
reform
 ANA’s health care agenda
You
 Become informed
 Plan
 Take action!