Quality Improvement - Quality 101 links:  general quality    health disparities    immunization resources   quality homepage

Quality Defined:

Webster New World Dictionary:

  • peculiar and essential character
  • an inherent feature
  • degree of excellence
  • superiority in kind

Institute of Medicine (IOM):

  • Defines healthcare quality as the extent to which health services provided to individuals and patient populations improve desired health outcomes.

HRSA Center for Quality, 2007:

  • Quality healthcare is evidenced based; increases the likelihood of desired health outcomes; and addresses six aims: safe, effective, patient-centered, timely, efficient, and equitable – using a systems approach to continuously improve clinical, operational, and financial domains.

Q Solutions: Essential Resources for the Healthcare Quality Profession:

  • Defines total quality as an attitude, an orientation that permeates an entire organization, and the way in which an organization performs its internal and external business.

Evolution of Quality Theories in Health Care:

  • Quality Control (QC): Activities to ensure safe equipment and competent employees
  • Quality Assurance(QA): Measures so vital to assuring quality, no matter how good the results the measures will always be taken
  • Total Quality Management (TQM): Developed by W. Edwards Deming in general industry during the early 1950’s.  Healthcare industry didn’t start using TQM concept until the 1980’s.
  • A key to Deming’s Philosophy was the concept that problematic processes, not people caused inferior and outcomes.
  • Continuous Quality Improvement (CQI): The examination of all work processes to continually improve outcomes.  CQI involves attention to process, commitment to the customer, involvement of employees, and data based decision.
  • Performance Improvement (PI): By the end of the 1990’s, recognition developed that quality in healthcare was tied very closely to the performance of individuals.  Products of healthcare organizations are the serves provided by professionals who define the process of practice.  Quality improvement initiatives have become known as performance initiatives.
  • Common Themes - PI Models:
  • Data driven
  • Cyclical in nature-continuous
  • Processes must always be evaluated (80% of quality issues are process related, 20% are people related)

 

Why strive for a reputation of quality and continuous improvement?

  • Quality helps patients achieve optimal health outcomes in an atmosphere of excellent service
  • Commitment to quality reduces expenditures
  • Attention to quality spares patient and staff frustration = patient and staff retention
  • Attention to quality promotes pride that will attract and retain talented staff
  • A focus on quality and improvement is key to meeting regulatory, licensing, and accrediting requirements (JCAHO, OPR, CMS, etc.)
  • Patients are choosing their healthcare provider and facility on the basis of quality.
  • Commercial payers (insurance, PPOs, HMOs) prefer to negotiate with organizations that provide high-quality, yet cost effective services
  • Government sponsored health plans are asking for more information on the quality of services they receive and pay for.
  • Health care organizations must be able to back up their espousal of quality with reliable objective data.
  • Quality is the right and ethical thing!

Strategies that Advance Continuous Quality Improvement in Organizations:

  • Leadership Commitment/Managing for Quality
  • Engaging Patient (Customer) Expectations
  • Accountability throughout the entire organization
  • Measurement and Feedback (Scoreboards, Report Cards, etc.)
  • Problem Solving, Process Improvement, and Prevention
  • Employee Involvement and Empowerment
  • Staff Development and Training
  • Communication and Teamwork
  • Recognition and Incentives
  • Resources Allocated to Quality

Who is responsible for quality?

  • Answer = EVERYONE
  • Quality and continuous improvement must be an integral part of the job for everyone in the organization. 

Attitudes in Culture of Quality:

  • Work smarter, not harder
  • Be a problem solver, not trash talker
  • No idea is a dumb idea
  • Failure is a step towards success
  • Quality Doesn’t Happen Overnight
  • “Make no mistake: realizing significant improvements is hard, hard work involving a serious amount of grunting and sweating and heavy lifting on the part of all.  It will mean “doing things better” but it will also mean “doing things differently”-which is to say, it will mean change.” Quote by John Guaspari, an expert on quality.

 

Resources/Links:

Agency for Healthcare Research and Quality:  The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. As one of 12 agencies within the Department of Health and Human Services, AHRQ supports health services research that will improve the quality of health care and promote evidence-based decision making.  The Agency for Healthcare Research and Quality Web site provides practical health care information, research findings, and data to help consumers, health providers, health insurers, researchers, and policymakers make informed decisions about health care issues.
www.ahrq.org 

Institute for Healthcare Improvement: The Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world.  IHI is a reliable source of energy, knowledge, and support for a never-ending campaign to improve health care worldwide.  The Institute helps accelerate change in health care by cultivating promising concepts for improving patient care and turning those ideas into action. 
www.ihi.org

National Association of Healthcare Quality: NAHQ empowers healthcare quality professionals from every specialty by providing vital research, education, networking, certification and professional practice resources, and a strong voice for healthcare quality.
www.nahq.org

National Committee for Quality Assurance:  The National Committee for Quality Assurance is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. Since its founding in 1990, NCQA has been a central figure in driving improvement throughout the health care system, helping to elevate the issue of health care quality to the top of the national agenda.
http://web.ncqa.org

National Healthcare Quality Forum:  The National Quality Forum is a private, not-for-profit membership organization created to develop and implement a national strategy for healthcare quality measurement and reporting.
www.qualityforum.org

 

 

 

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