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3 levels of Quality

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Expected, Perceived, Actual

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Expected Quality

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level of quality of the product or service that is expected by the customer

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Perceived Quality

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customer's perception of the product or service. Customer's perception is highly subjective

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Actual Quality

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uses statistical data to measure outcomes and considers all factors that can influence the final outcome

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SMDA

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Safe Medical Devices Act (1990)

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MQSA

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Mammography Quality Standards Act (1992)

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MQSRA

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Mammography Quality Standard Reauthorization Act (1998)

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OSHA

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Occupational Safety and Health Administration

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EPA

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Environmental Protection Agency

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FDA

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Food and Drug Administration

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TJC

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The Joint Commission-Hospital accreditation agency

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QA

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Quality Assurance

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TQM

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Total Quality Management

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Cost of Quality

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expense of not doing it right the first time

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Frederick Winslow Taylor

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Father of Scientific Management

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Consumer-Patient Radiation Health and Safety Act (Public Law 112-90)

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addresses unnecessary repeat examinations, QA, referral criteria, radiation exposure and unnecessary mass screenings

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MIPPA

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Medicare Improvement for Patients and Providers Act (2008)

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Responsible for monitoring workplace environment, including requirements for occupational radiation exposure and chemicals in found in processing solutions

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OSHA

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Death from a medical device or death from a malfunctioning piece of equipment must be reported to

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FDA and Manufacturer Within 10 working days

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Serious Injury from a malfunctioning device or piece of equipment must be reported to

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Manufacturer if know, FDA if Manufacturer not known Within 10 working days

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Annual Report of Death and Serious Injury Due to:

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FDA by January 1

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HIPPA

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Health Insurance Portability and Accountability Act (1996)

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PHI

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Protected Health Information

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DNV Healthcare Inc

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Det Norske Veritas Global foundation from Norway Very similar to TJC

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Quality Assurance (QA)

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all encompassing management program used to ensure excellence in healthcare through systematic collection and evaluation of data Enhances patient care

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Quality Control (QC)

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part of QA that deals with the techniques using in monitoring and maintaining the technical elements of the systems that affect the quality of images

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CQI

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Continuous quality improvement

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85/15 Rule

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Process in place is the cause of the problem 85% of the time People or Personnel are the problem 15% of the time

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82/20 Rule

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80% of the problems are the result of 20% of the causes

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Process

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is a ordered series of steps that help achieve a desired outcome

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System

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Group of related processes

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Supplier

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individual or entity that furnishes input Or provides the institution with goods or services A variable factor that influences the next portion in the process

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Input

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Information or knowledge necessary to achieve desired outcomes A variable factor that influences the next portion in the process

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Action

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means or activity used to achieve the desired outcome A variable factor that influences the next portion in the process

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Output

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refers to the desired outcome, result, product or characteristic that satisfy the customer

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Customer

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Person, Department or organization that needs or wants the desired outcome

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Internal Customer

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Groups or individuals in the organization Doctors, other departments, hospital employees

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External Customer

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People outside the organization: patients, families, community and third party payers

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Key Process Variables

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Components of any process that may affect the final outcome

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5 Major Key Process Variables

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Manpower Machines Materials Environment Policies

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Manpower

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personnel involved in a process

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Machines

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refers to equipment used in a process

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Materials

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type and quality of materials used in process

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Environmental

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physical and psychological aspects on people involved in the process

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Policies

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Steps in procedure or policy manual that have been used in the process

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Brainstorming

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Group process used to develop a large collection of ideas WITHOUT regard to merit or validity

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Focus Group

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small group that focuses on a particular problem and then hopefully develops a solution

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Quality Improvement Team

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group of individuals who implement the solutions that were derived by the focus groups

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Quality Circles

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composed of supervisors and workers from the same department working together to identify potential problems in a department

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Multivoting

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used after brainstorming to dismiss nonessential or nonrealistic ideas

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Concensus

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used after brainstorming an agreement on most important ideas

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Work Teams

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team focus on solving a complete problem or completing and entire task

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RCA

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Root Cause Analysis

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Problem Solving Teams

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teams work on specific tasks and meet to solve particular problems

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5 Whys

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used to explore cause and effect relationships developed by Toyota

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TPM

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Thought Process Map

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5 steps of Thought Process Map

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1-define projects goals 2-list knows and unknowns 3-ask grouped questions focusing on unknowns 4-sequence and link the the questions 5-identify possible tools to be used

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TJC 10 Step Process

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monitoring and evaluation process as mechanism for satisfaction and accreditation

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Adverse Event Indicator

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untoward, undesirable, and usually unanticipated event that is caused by a medical management rather than the underlying disease or condition Adverse events prolong hospitalization , produce a disability at discharge or both

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Sentinel Event

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unexpected event causing death or serious physical or psychological injury

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Sentinel Event Indicator

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identifies and individual or series of events that is significant enough to trigger further review each time it occurs

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Aggregate Data Indicator

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Quantifies a process or outcome related to many cases

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Appropriateness of Care

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whether the type of care is necessary

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Continuity of Care

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degree to which the care/intervention for the patient is coordinated among practitioners or organizations

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Effectiveness of Care

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level of benefit when services are rendered under ordinary circumstances by average practitioners for typical patients

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Efficacy of Care

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level of benefit expected when healthcare services are applied under ideal conditions and the best possible outcomes

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Efficiency of Care

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outcome obtained when the highest quality of care is delivered in the shortest amount of time with the least expense and positive outcome for patients

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Safety in the Care Environment

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degree to which the risk of intervention and the risk in the care environment are reduced for the patient and others

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Timeliness of Care

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degree to which the care/intervention is provided to the patient at the most beneficial or necessary time Delivery of healthcare within a reasonable amount of time with minimal waiting

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Cost of Care

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cost of healthcare delivery that is reasonable of the marketplace

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Availability of Care

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degree to which appropriate care/intervention is available to public

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Cycle for Improving Performance

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Design Measure Assess Improve

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Design

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Systematic planning and implementation are key to design of any function or process

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Measure

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defined by TJC as collection of valid and reliable data to demonstrate effectiveness and efficiency of care

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Assess

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translating data collected during measurements into information that can be used to change process and improve performance improvement

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Baseline Performance

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comparison of current performance levels with those occurring previously (Example: Comparing repeat reject rates from last year to this year)

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Desired Performance Limits

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patients and physicians expect a certain level of performance should be compared with the level achieved and as indicated in current data Organizations can set own limits

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Practice Guidelines and Parameters

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procedures developed by professional societies, expert panels or in house to use best practice for diseases

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Performance Measurement System

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consisting of one or more automated databases that facilitate performance improvements in healthcare organizations

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Benchmarking

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comparing one organizations performance standard with another organizations Can be internal or external

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Internal Benchmarking

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compares performances within the best practices of the organization

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External Benchmarking

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compares performances with outside organizations

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Improve

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once knowledge is gained through measurements and analysis, actions can then be taken to improve processes

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SWOT Analysis

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Can be helpful in matching resources and capabilities to the competitive environment in which it operates

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SWOT

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S-Strenghts W-Weakness O-Opportunities T-Threats

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FADE

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F-Focus-choose problem and describe it A-Analyze-learn about problem, collect and analyze data D-Development-develop solution/plan E-Execute-implement and monitor the results, adjust as needed

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FOCUS

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F-Find a process to improve or problem to solve O-Organize a team that knows how to process and work on improvement C-Clarify the problem and knowledge of the process U-Understand the problem and causes of process variation S-Select method to improve the process

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FOCUS-PDCA

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Combines the FOCUS principals and PDCA principals

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PDCA

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P-Plan D-Do C-Check A-Act

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FMEA

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Failure Mode and Effectiveness Analysis analysis of potential failure within a system

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Six Sigma

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management strategy that seeks to identify and remove the causes of error in business Consists of 5 steps

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Six Sigma Steps

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1-Define 2-Measure 3-Analyze 4-Improve 5-Control

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Lean Process Improvement

answer

systematic approach to identifying and eliminating waste, where waste is defined as any non valued task

Chapter 1-Intro to Quality Management – Flashcards

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