Question

Quality Care

We often think of quality as a perception, a feeling, or an impression, such as “this is a comfortable chair” or “this shirt fits nicely” or “this book is very informative” or “that sales clerk gave me great customer service.” The Institute of Medicine’s definition quality is the “degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

Giddens describes what quality care looks like. The text lists the attributes of quality care as:

·         Safe

·         Effective

·         Timely

·         Patient centered

·         Efficient

·         Equitable

The following is from the AHRQ website:

Components of Health Care Quality

Quality health care means doing the right thing, at the right time, in the right way, for the right people—and having the best possible results. Quality health care is care that is:

Effective—Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit.

Safe—Avoiding injuries to patients from the care that is intended to help them.

Timely—Reducing waits and sometimes harmful delays for both those who receive and those who give care.

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.

Equitable—Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and SES.

Efficient—Avoiding waste, including waste of equipment, supplies, ideas, and energy.

Health care quality is measured in several ways, including:

Clinical performance measures of how well providers deliver specific services needed by specific patients, such as whether children get the immunizations that they need.

Assessments by patients of how well providers meet health care needs from the patient's perspective, such as whether providers communicate clearly.

Outcome measures, such as death rates from cancers preventable by screening, that may be affected by the quality of health care received.

http://archive.ahrq.gov/research/findings/nhqrdr/nhdr08/Chap2.html

We ask you to write outcomes in care plans and we want those outcomes to be measureable. If you are doing research or asking the nursing commission to approve your nursing program J you have to have measureable outcomes. How do you measure quality?

For example, If I own a car company and I want a quality outcome based on passenger safety, it could have something to do with the results of crash tests. The data would be gathered based on results from the NTSB crash tests and it could be used to redesign the structure of the car to be more safe (bumpers, airbags, etc.) If I want a quality outcome based on customer satisfaction with navigation software in my cars, I could design a survey and send it out to people who own the cars and ask them to rate how satisfied they are with their navigation system. I could use the feedback to redesign the user interface, change the voice, or whatever else they were not satisfied with.

After doing the assigned readings for this module, answer the following questions.

1. Think about the facility or agency that you work for. List at least one measure of quality care that is used there. How is the data gathered for this outcome and how do you think the data is used to improve care?

2. Using either the attributes or the components or quality care listed above, come up with at least two measures that a healthcare facility or provider could use to indicate they are providing quality care.   Please choose different areas for each of the outcomes (e.g. only one from safety, etc) and use something different than the examples given above.

3. Compare and contrast the following classifications of safety events: near miss, adverse event, sentinel event and give an example of each type of event.

4. Is it important to track near miss events? If so, why? Do you track these at your workplace? If so, how are they tracked and what is done with the data?

5. What is a root cause analysis, why would one be initiated, and what can it accomplish?

6. As a student nurse, what is your role in the provision of quality care?   What are your responsibilities to the individual patients you care for at the clinical site and what are your responsibilities to the clinical facility itself?

Answer 1

Health care quality outcome measures .by health of the population.. Health care factors that contribute to well-being ..standards of health care can provide information about health care quality.. Public health records including mortality, morbidity, specific disease among community provide quality information about health care..

1, Patient centered is the one measure of quality care that we used in our facility..health informatics advanced in technology,they share information in critical situation with family and friends..physicians are using EHR to coordinate care and have discussion with other Physicians.

Patient centered care valuable for individual patient preference,needs,and values..it put responsibility for some aspects of self care and monitoring patient centered care.. Patient centered care through technology improve the Patient doctor relationship..it includes Patient' s functioning and well being.

Reliable data useful for basic survey.patient communication, cultural competency, health literacy important for collecting data .The first step to improve care is communication skills and tools must be applied to challenge work of maintaining healthy behaviour..

2, safety: Patient safety provide health care quality..It means prevention of harm to Patient, build a culture safety,freedom from accidental injuries.. Patient safety includes prophylaxis treatment to prevent Patient risk,safety practices like use of simulator,bar coding, computerized Physicians order entry, resources management it provides patient safety and improve health care processes..

Timely quality care includes patient admission, discharge,timing within 4 hours and hospital length of stay, unplanned emergency department visit.. Patient treatment with in time hours, design of hospital structure bed management etc.. example Patient waiting for some diagnostic procedures and investigation must be avoided..it should be planned timely t improve quality of care.

3, near miss is an adverse event it is unplanned results in injury,illness or damage.. example :good incentives can improve workers Activities and prevent them from risk ..This activities helps to report their culture with meaningful to continue their process..

Adverse events is a preventable or non preventable one..it is an serious eventcdue to negligence.example: patient with colon bleeding diagnosed with some other causes and treatment given superficially..after few months Patient coming with same problem with extra symptoms it was diagnosed that time with colon cancer. This is due to doctors negligence in treatment..

Sentinel events is a event in health care settings results with death or serious physical or mental injury to patient for their illness.. example: surgery performed in other area instead of diseased area may cause serious harm or death..

If we compare these three events atlast it cause harm to the patient in different stages..

If we contrast each events have different types and seriously harm to Patient with severe illness..