Welcome to HS Tami Ford, M.A. Unit 6

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Chapter 7: Quality Health Care Management “Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of quality patient care; it refers to data that can demonstrate and represent in an objective sense the delivery of quality patient care” (McWay, 2008, p. 141).

Stages: Data Quality Errors Found in a patient health record: ◦ “…when data are entered into the record (the documentation process) ◦ when data are retrieved from the record (the abstracting process) ◦ when data are manipulated (the coding process) ◦ When data are processed (the indexing and registry processes) ◦ And when data are used (the interpreting process) (McWay, 2008, p. 143).

Agency for Healthcare Research & Quality (AHRQ) Formerly known as the Agency for Health Care Policy & Research (AHCPR) AHRQ “…is a scientific research agency located within the Public Health Service (PHS) of the U.S. Department of Health and Human Services” (McWay, 2008, p. 145).

Goals of AHRQ “Improve patient safety by reducing medical errors Increase health information sharing between providers, labs, pharmacies, and patients” Help patients transition between health care settings Reduce duplicative and unnecessary testing Increase our knowledge and understanding of the clinical, safety, quality, financial, and organizational values and benefits of HIT” (McWay, 2008, 145) (From Table 7-2)

Aims for Health Care Improvement “Safe Effective Patient-Centered Timely Efficient Equitable” (McWay, 2008, p. 146) (From Table 7-3)

Brainstorming “…refers to an idea-generating tool in which ideas are offered on a particular topic, in an unrestrained manner, by all members of a group within a short period of time” (McWay, 2008, p. 148).

Benchmarking “…refers to the structured process of comparing outcomes or work practices generated by one group or organization against those of an acknowledged superior performer as a means of improving performance” (McWay, 2008, p. 148).

Idea Generating Tools Performance Improvement Project ◦ Brainstorming ◦ Benchmarking ◦ Affinity diagrams ◦ Nominal group technique ◦ Gantt charts ◦ Program Evaluation & Review Technique (PERT) (McWay, 2008).

Histogram Is one of several methods to display data. “…similar to a bar graph, containing both the x-and y- axes, with the exception that it can display data proportionally” (McWay, 2008, p. 149). “Histograms are chosen over bar graphs when trying to identify problems or changes in a system or process, or where large amounts of continuous data are difficult to interpret in lists or other nongraphic forms” (McWay, 2008, p. 149).

Performance Improvement & Risk Management “Performance improvement is a clinical function that focuses on how to improve patient care” (McWay, 2008, p. 156). “Risk management is a nonclinical function that focuses on how to reduce medical, financial, and legal risk to an organization” (McWay, 2008, p. 158). “…both performance improvement and risk management rely upon data that are collected, stored, and retrieved by automated methods” (McWay, 2008, p. 156).

Accreditation ORYX Initiative of the Joint Commission (JC) ◦ “…the most influential performance improvement method of recent years” (McWay, 2008, p. 157).

ORYX “To assess its internal performance under ORYX, a health care organization would collect and aggregate its own data to measure patient outcomes. For example, an organization could aggregate data collected from similar patients and analyze them to determine whether certain treatment options are more effective than others…Date used for comparisons concerning the ORYX initiative are available to the public through the JC website (under “Quality Check”) (McWay, 2008, p. 157).

“Accreditation Watch” “A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or other risks…” (McWay, 2008, p. 159). “Facilities are encouraged but not required to report sentinel events to the JC within 45 days of the event…Failure to do so within the specified time frame could result in placing the organization on Accreditation Watch status until the response is received and the protocol approved” (McWay, 2008, p. 159).

Utilization Review Process See Figure 7-12 for the 5 steps (p. 161). “Preadmission review is performed prior to admission to the facility and operates to determine if the admission or procedure/treatment plan is medically necessary and appropriate for the setting…If preadmission review is not conducted, admission review is performed at the time of admission or as soon as possible thereafter…” (McWay, 2008, p. 161). Reference: McWay, D.C. (2008). Today's health information management: An integrated approach. Clifton Park, NY: Delmar Cengage Learning.

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