Unit 2: Measuring Quality Lori Seargeant, MS,RHIA

 Read Chapters 3, 4 and 5  Discussion Post  Quiz with two essay questions  Case Study 5 Assignment

What are the components of Donabedian’s quality matrix, and how do they compare to industrial models of process and process quality?

 Aspects of Care  Structure  Process  Outcome  Quality Dimensions - Access - Technical Management - Management of Interpersonal Relationships - Continuity of Care

StructureProcessOutcome Accessibility Technical Management Management of Interpersonal Relationships Continuity Figure 3-1 Donabedian’s Matrix for the classification of quality measures (McLaughlin and Kalunzy, 2006, p 68)

StructureProcessOutcome Accessibility Integrated delivery model Coordinated scheduling and referral management Timely access and treatment Technical Management Infection control team Improved hand washing techniques Decreased infection rates Management of Interpersonal Relationships Use of survey data to improve care HCAHPSOverall rating of care Continuity Arrangement for follow up care Timely communication of information Decreased readmissions Figure 3-1 Donabedian’s Matrix for the classification of quality measures (McLaughlin and Kalunzy, 2006, p 68)

 Project Selection (Unit 3)  Annotated Bibliography (Unit 4)  Process Tools Application (Unit 4)  Detailed Project Outline (Unit 5)  Progress Report (Unit 7)  Final Project (Unit 9)

 PLAN  DO  CHECK  ACT

 What could be the most important accomplishment of the team?  What changes do we desire?  What data is available?  Are new observations needed?  If yes, plan or change a test.  Decide how you will use the observations

 Analyze an existing process to find opportunity  Define processes and identify sources of variation using tools such as: Cause and effect diagram Histogram Pareto chart Check sheet Control chart Bar graph Scatter diagram

medication ordered is medication in unit stock? request from pharmacy dispensed by pharmacy administered to patient documented in patient’s record no yes observe patient status Figure 4-6 Flow Chart of Medication Administration Process

 First we flowchart the steps from order to results  Enter into the computer/order entry system What is the process in all of the respective areas?  Draw the specimen What is the time frame from order to draw?  Delivery of the specimen to the lab What methods are used, how long does it take?  Receipt of specimen in the Lab Where is it delivered?  Analytical stage Are processes standard? Equipment adequate?  Results Where are they going, and is there anyone there to receive them?

Manual systems Problem: Adverse Drug Event Policies People Plant & Equipment Procedures similar packaging for different drugs Lack of knowledge Wrong drug selected for patient condition dosage contraindications frequency of administration Policies not followed Unable to read order due to illegible writing 5 Rights of medication administration patient drug dose route time Reliance on memory distractions in work environment Equipment malfunction lack of training Unfamiliar with patient population lack of adverse event reporting Figure 4-9 Cause- and- Effect Diagram - Medication Errors