Ch. 23 - Quality Control

i am literally shitting myself about this test

root cause analysis

primary purpose is to analyze a problem in terms of what and why it happened and as well as taking the steps needed to prevent the problem from recurring

medication reconciliation

the process of ensuring accurate and complete medication information at transitions of care, reducing the risk of errors

• involves comparing a patient's current medication orders to all medications they have been taking.

• 5 steps:

  • identify meds the pt is currently taking

  • identify med info

  • compare the med info the pt brought w/ the meds ordered for the pt

  • provide the pt w/ written info on the meds they should be taking when they get discharged

  • explain the importance the managing med info to the pt when they are discharged

sentinel event reporting

event/incident/condition that could have resulted or did result in death/harm to a pt

• signal a need for immediate investigation and response

• policy – organizations either voluntary reporting a sentinel event or responding to TJC’s inquiry

quality assurance

targets currently existing quality

quality improvement

targets ongoing and continually improving quality

total quality management

continuous quality improvement

• assumes that production and service focus on the individual and that quality can always be better

• never-ending process

• involves all employees

what is an audit

tool for assessing quality and compliance with standards

• provides a systematic evaluation of processes and performance.

outcome audit

the result of care

• capture whether the services provided actually improved the pt’s health and sense of well-being

• determine what results, if any, occurred because of specific nursing interventions for pt

• most valid indicators of quality of care

process audit

measure how nursing care is provided

• assumes a connection between the process and the quality of care

• tends to be task oriented and focus on whether practice standards are being fulfilled

• provide a tool to measure deviations from accepted best practice process standards

structure audit

measure/ensure a safe and effective environment

• assume that a relationship exists between quality care and appropriate structure

• includes resource inputs – environment health care is delivered, staffing ratios/mix, ER wait times, etc.

• does not address the actual care provided

what is benchmarking

the process of measuring products, practices, and services against those of best performing organizations

• tool for identifying desired standards of organizational performance

what is the management role in quality improvement

responsible for monitoring the quality of the product (pt care) that their units produce

what is the leadership role in quality improvement

inspire subordinates to establish and achieve high standards of care

what are the leapfrog initiatives

a set of safety and quality standards aimed at improving healthcare in the US by promoting transparency and encouraging high-value care

• computerized physician-provider order entry

• evidence-based hospital referral

• intensive care unit physician staffing

• use of national quality forum-endorsed safe practices

hospital consumer assessment of health care providers and systems (HCAHPS)

survey pts take after discharge – asks everything about the organization as a whole, not just the doctors/nurses

• measures pt’s perceptions of their hospital experience

• no common metrics or national standards

• increases transparency of the quality of hospital care