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Copyright © 2006 Elsevier, Inc. All rights reserved
Chapter 22
Quality Patient Care
Copyright © 2006 Elsevier, Inc. All rights reserved
Quality Patient Care
Standards of quality health care management Standards of nursing care (ANA) Accrediting group standards (JCAHO) Clinical practice treatment guidelines
(AHRQ) Standards of practice (each health care
agency)
Copyright © 2006 Elsevier, Inc. All rights reserved
Quality Patient Care
JCAHO Publishes a Sentinel event alert monthly
An unexpected occurrence involving death or loss of limb or function
Sounds a warning of the need for immediate investigation and response
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History and Evolution of Quality in Health Care (cont’d)
Who is Deming? Edward Deming—father of quality
improvement Method to prevent defects evolved to a
method to track and improve quality
Quality is everyone’s responsibility
Copyright © 2006 Elsevier, Inc. All rights reserved
History and Evolution of Quality in Health Care (cont’d)
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Primary agency for hospital accreditation Must meet certain quality standards to
pass inspection Mandated continuous quality
improvement JCAHO mandates specific quality
outcome measures for all hospitals
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Just What Is the JCAHO?
Accrediting body for health care institutions that are Medicare and Medicaid funded
Address patient safety issues Require error reduction and design of
safe patient care processes
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Just What Is the JCAHO? What are patient safety goals?
Improve accuracy of patient identification Improve the effectiveness of communication
among caregivers Improve the safety of using medications Improve the safety of using infusion pumps Reduce the risk of health care–associated
infections Accurately and completely reconcile
medications across the continuum of care Reduce the risk of patient harm resulting
from falls
Copyright © 2006 Elsevier, Inc. All rights reserved
Monitoring Quality of Health Care
What is quality assurance? Used synonymously with quality
improvement Process or activities used to monitor,
evaluate, and control services providing some measure of quality to consumers
Key Indicators
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Monitoring Quality of Health Care (cont’d)
What are key indicators? JCAHO mandates certain key indicators
to monitor Advance directives, autopsy rates, AMAs
and elopement rates, blood product utilization rates, blood transfusion reaction rates, code blue rates, conscious sedation complication rates, fall rates, medication error rates, mortality rates, pain management effectiveness, restraint use, and surgical site infection rates
Copyright © 2006 Elsevier, Inc. All rights reserved
Quality Improvement Methods
Institutional values Commitment to CQI Empowerment of nurses Collect data systematically Working groups with sense of
collaboration