SCHM3315 Quality Management

Clinical quality measures (CQMs)

tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals, and critical access hospitals within CMS health care system

Domains of healthcare quality

Safe

Effective

Patient-centered

Timely

Efficient

Equitable

Who defines quality metrics in healthcare?

Federal, State, and local governments (CMS, CDC, FDA, AHRQ)

National quality strategy

1. Improve safety

2. Increase patients and families’ engagement as partners in their care

3. Promote effective communication and coordination of care among providers

4. Adopt the most effective prevention and treatment practices

5. Ensure wide use of best practices

Prevention costs

costs incurred to prevent, minimize, or eliminate failure or defects from occurring in the first place

Appraisal costs

Costs associated with inspection, evaluation, and testing to assess quality of supplies, final product, service, etc.

Internal failure costs

Costs associated with failure or defects found before the customer receives the product or service

External failure costs

Costs associated with defects found after customer receives the product or service

Total Quality Management (TQM)

a managerial philosophy that emphasizes the pursuit of quality throughout the entire organization

Flowcharts

Graphic representations of the sequential steps of a process

Failure modes and effects analysis (FMEA)

Used to identify potential failure points in the process; assess the relative impact of these failures; and prioritize the steps that need improvemen

Spaghetti Diagrams

Depicts traffic intensity and patters within an area or across areas

Check sheets

Fact-finding tools that record problem occurences and organize them by category

Cause-and-effect diagrams (aka Fishbone or Ishikawa diagrams)

Used to analyze or display potential sources of quality problems

Diagram fundamentals: Materials, Process/Methods, Measurement, People, Equipment, Environment

Pareto charts

Used to identify and prioritize main cause of quality problems. Based on 80/20 rule

Control charts

Depicts the behavior of a process through continuous tracking of performance indicators; Purpose - to ensure that the process performs as expected

Lean system

a system focused on eliminating waste in the organization processes. Involves producing what is needed when it is needed with no waste. Also entails examining the system/processes to identify value-adding activities to be optimized and non-value adding activities to be eliminated

Six sigma

a process improvement methodology focused on eliminating defects and reducing variation = 6 standard deviations from a target value

Principles of six sigma