Quality Improvement

by Paul de Roos

1. the global source for improvement solutions that achieve superior quality and sustainable results.

2. Theories

2.1. PDSA

2.2. Six Sigma

2.2.1. DMAIC

2.2.2. a systematic approach and information-driven methodology for eliminating process deficiencies and variation that increase costs and reduce revenues by striving for near perfection in all processes.

2.2.3. Can it be applied to Health care effectively

2.3. Quality improvement model

2.4. To err is human

2.5. Gap Analysis (IHI)

2.6. IOM Reports

2.6.1. Quality Chasm

3. Analysing the Problem

3.1. Nolan's 3 Question Model

3.1.1. what are you trying to accomplish (goal/aim)

3.1.2. how will you know a change is an improvement (measurement)

3.1.3. what changes can you make that will result in an improvement (improvement ideas)

3.2. Determine the source

3.2.1. Process

3.3. Healthcare: Incident Reports

3.3.1. case examples

3.4. Clinical Quality Problems

3.4.1. Misuse

3.4.2. Overuse

3.4.3. Underuse

4. Tools

4.1. Process Model

4.2. Flow charts

4.3. Paretochart

4.4. Objective data

4.5. Self Report

4.5.1. Reliability?

4.6. Brainstorm

4.6.1. Colaborate

5. Methods

5.1. PDSA

5.1.1. Shewhart & Edward Deming

5.1.2. Plan, Do, Study, Act

5.2. Kaizen

5.3. TQM

5.4. Cause and Effect / Fishbone

5.5. Practice specific models

6. Related Associations

6.1. National Association for Healthcare Quality

6.1.1. provides education, leadership development opportunities, and products to support quality professionals

6.2. Juran Institute

6.2.1. global source for improvement solutions that achieve superior quality and sustainable results.

6.3. Agency for Healthcare Research and Quality

6.3.1. home to research centers that specialize in major areas of health care research such as quality improvement and patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and health care organization and delivery systems.

6.4. IHI

6.4.1. Improvement maps available for healthcare improvement

7. Evaluation - how do we know the method is working?

7.1. Formative

7.2. Process

7.2.1. Follow up meausrment

7.3. Outcome

7.4. Quality Improvement tool/cycle

7.5. evidencebased

8. Desired outcome

8.1. What is quality?

8.2. Measuring quality is the first step towards improving quality and thus value in health care

9. History

9.1. 1914: Surgeon Ernest Codman began data collection pertaining to surgeries

9.2. •1960s: Donabedian Model

10. Challenges

10.1. Technology

10.2. Structure

10.3. Psychological Climate

10.4. Leadership

10.5. Culture

10.6. Legal Issues

11. New node