ABQUARPE A L QuestionsandAnswers

ABQUARPE A L QuestionsandAnswers

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howisqualitydefined?-ANSWER-noerrors,degreeofexcellence,dotherightthinganddoitwell.Meetingcustomersexpectations,exceedexpectations.Whatisqualitymgmt.?-ANSWER-examinetheprocesstodeliveryofcare,theoutcomesmeasured plan-do-check-act-ANSWER-WalterShewhart EdwardDeming-ANSWER-introducedstatisticalprocesstoimprovequality Herecognizedimportanceofhavingaccurateandmeaningfulinfortoimprovequality Demings7deadlydiseases-ANSWER-lackofconsistency,emphasisonshorttermprofits,evalof performanmce,jobhopping,excessivemedicalcost,excessiveliability JosephJuran-ANSWER-introducedTotalQualityControl PhilipCrosby-ANSWER-Headdedfinancialconsequencestoqualityperformance Savingsaregeneratedby"doingthingsrightthefirsttime" QualityMangt.QM-ANSWER-approachestoimporvingquality emphasisonpreventingerrors,empowermentofemployees,improveperformance,focusonsupplier relationships QualityAssurance-ANSWER-addressesnegativeoutcomes(sentinelevents).Hxpunishmentofpeers QualityImprovement-ANSWER-improvingonoutcomesthatareconsidersatisfactory,getbetter.Typicallyfocusonprocessandsystems,noindividuals ContinuousQualityImprovement-ANSWER-usesasystematicprocess,enhanceperformance.Looks atprocesses,notindividual.(exlaparoscopy,lesshosptstay) Totalqualitymanagement-ANSWER-usesQA,QI,CQMandfocusesoncustomerdesire SentinelEvent-ANSWER-unexpecteddeath,unrelatedlossoffunction,IPsuicide,infantabduction, transfusionrxn,wrongsitesurgery RootCauseAnalysis-ANSWER-Analyzingasentinelevent,mustassesstheculture.Credentialing-ANSWER-KeypartofQM.Makesuretherightperson,rightknowledgeintheright position RiskMgt.-ANSWER-Focusonmonetarylossbyeliminatingnegativeoutcomes.Includesinsurance,pt satisfactionandlegalissues..Improvedocumentation.Medicalrecordsanalysisisveryhelpful Ultimateresponsibilityisthegoverningbodyofthehospital.UR-ANSWER-formalreviewoftheconsumptionofallresourcesinthedeliveryofcare.,Canbe prospective,concurrentorretrospective.Reduceresourcestoachievethesameresult.InfectionControl-ANSWER-FocusonOutcomes,looksattransmissionofillnesstoproviders,staff andvisitors.Reduceriskoffutureinfection 1 / 2

Outcomestudies-ANSWER-importanttoanalyzeeffectiveness.Computergeneratedoutcomesbest.selfreportsurveyarevulnerabletoinaccuracy,singlereviewleastreliable.Peerreview-ANSWER-Anindividualcsimilartrainingandtheonebeingreviewed.1-chartrev 2-patterns 3-peerintervention PRO-peerrevieworganization-ANSWER-1972-82wasphysiciancontrolled,nonprofitorgthatlooked atMedicareIP,Utilizationandquality.ChangedtoPSROin1982viatheTaxEquityandFiscal Responsibilityact QARI-qualityassurancereforminitiative-ANSWER-1993-toassiststatesdevelopQIsystems,focus onclinicalstudies QISMC-qualityimprovementforsystemofManagedCare-ANSWER-1996-Federalgovtformedasa guideforqualitymgt,espforMedicareandMedicaid -DesignedtostrengthentheeffortstoprotectandimprovehealthandsatisfactiontoMedicareand Medicaidenrollees -clarifiesresponsibilityinpromotingquality -promotespartnership -developcoordinatedqualityoversight -looksfornewdevelopments BBA-balancedbudgetAct-ANSWER-1997-comprehensiverevisionoffederalstatutesgoverning Medicaid Revised1999.UsesQISMCtosetqualityassuranceprovisions.QIO-qualityimprovementOrg-ANSWER-2002-definedhowqualitymeasurementandperformance improvementshouldbeappliedtoM/M -improvequalityofcaretobeneficiary -protectintegrityofMedicareTrustFund Medicarecontractsc1QIOineachstate not-forprofit,staffedbyprofessional PQRI-physicianqualityreportingInitiative-ANSWER-2006-TheTaxReliefandhealthCareAct2006 authorizedimplementationofaphysicianreportingsystem,Financialincentive.APSF-anesthesiapatientsafetyfoundation-ANSWER-Firstorgtodevelopjusttoimproveptsafety Dr.Pierce"40ybehindthemask"1982 TheDeepSleep-6000willdieswason20/201982 IHI-instituteforHealthcareimprovement-ANSWER-1988-foundedbyBerwickandBatalden -focusonallaspectsofquality,espsafety

AdverseEvents-stats:-ANSWER-1991-in3.7%ofhospitalization

27.6%duetonegligence 70.5%ofadverseeventsgavedisabilityof>6m, 2.6%permanent 13.6%death Dr,LucianLeape-ANSWER-"ErrorinMedicine" Promoterofptsafety Culturechangethattoerrorisinevitable.JC-jointcommision-ANSWER-1990-onlyaccreditingbodyforhospandotherhealthcareorginUS

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