Question

Describe in detail using examples what you see as the three most critical aspects of CQI and how they will directly influence achieving the 6 AIMS in healthcare.  

Answer 1

Ans) A solid foundational administrative structure is a critical component in the development of a well-functioning continuous quality improvement (CQI) system. Strong administrative oversight and commitment by leadership is an obvious element of this component.

- The Quality Chasm report described broader quality issues and defines six aims—care should be safe, effective, patient-centered, timely, efficient and equitable—and 10 rules for care delivery redesign.

- CQI is used by hospitals to optimize clinical care by reducing variability and reducing costs, to help meet regulatory requirements, and to enhance customer service quality.

- Six aims for the health care system.

Safe: Avoiding harm to patients from the care that is intended to help them.
Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).
Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.
Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

- Existing measures address some domains more extensively than others. The vast majority of measures address effectiveness and safety, a smaller number examine timeliness and patient-centeredness, and very few assess the efficiency or equity of care.

- Frameworks like the IOM domains also make it easier for consumers to grasp the meaning and relevance of quality measures. Studies have shown that providing consumers with a framework for understanding quality helps them value a broader range of quality indicators. For example, when consumers are given a brief, understandable explanation of safe, effective, and patient-centered care, they view all three categories as important. Further, when measures are grouped into user-friendly versions of those three IOM domains, consumers can see the meaning of the measures more clearly and understand how they relate to their own concerns about their care.