Healthcare Quality Environment and Healthcare Quality Professionals

Healthcare Quality Environment and Healthcare Quality Professionals

By Mazenz

Continuous  Quality  Improvement  Process (CQI)Kotzen..?Continuous  study  and improvement  of  the healthcare processes .Top  corporate  and  organizational  commitment  of  mission,  money, management,  material,  and  an  organizational  culture  that  daily  talks  and  acts  like  quality.
The Concept  of  CustomerCustomer is one who receives goods or services.
Identify the needs, expectations, and preferences of all who are affected by the healthcare services we provide.
External customers?Internal customers?

 

The Responsibility of the Healthcare Quality ProfessionalArticulate to all administrative and governing body leaders:How QM philosophy, with the processes of performance measurement, analysis, and improvement; and the development of an effective Healthcare Quality Strategy, are necessary and compatible with the organization’s financial health, and, making the Strategic Plan achievable.
“boxed it in” and confined it to meeting accreditation standardsValue of quality that is linked to reduced risk, reduced costs, and better patient outcomes.
What ?Understand, Teach,  Guide the development and Implementation Strategy and processes, How?Effective use of data and information, Why?Make wise improvements and effect positive change.

Integrating Quality FunctionsSystems thinking ….. the most important aspects.
“Interdisciplinary collaboration is commonly described using the terms problem-focused process, sharing, and working together. The elements that must be in place before interdisciplinary collaboration can be successful are interprofessional education, role awareness, interpersonal relationship skills, deliberate action and support. Consequences of interdisciplinary collaboration are beneficial for the patient, the organization, and the healthcare provider” (Petri, 2010, p. 73).
Balance care decisions, Incorporating quality, cost, and risk issues;To reduce duplication of effort, Share appropriate information, and increase efficiency; to increase and improve communication and continuity of patient care and services; and to improve accountability through effective use of data.Integration also applies to the information systems, including a common database, tracking over time, profiling, and reporting

The success of the key responsibilities of Quality ProfessionalQuality management professionals Do not need to be masters of all of them, but there should be some knowledge about the various roles and functions so as to enable collaboration.The degree of integration of data/information, the coordination of improvement effort, and timely effective communication

Important Roles and Quality FunctionsQuality Management (QM)Measurement, analysis, interpretation, and reporting of Patient outcomes , care delivery process and Patient safety.Clinical performance monitoring, Complications; Appropriateness of procedures; Adherence to :practice guidelines, protocols, or clinical pathsOrganizational systems assessment:Operational processes; quality controls; written policies, procedures, and protocols.

Important Roles and Quality Functions
Organization performance improvement processTraining, Team support, Measurement and analysis support,Documentation, Evaluation, andReporting

Important Roles and Quality Functions
Patient Safety ManagementPlanning, Program implementation,Measurement, etcPatient outcomes and care delivery process

 

Important Roles and Quality Functions
Utilization Management (Case Management, or Medical Management)Review medical necessity and appropriatenessResource allocation: timeliness, appropriateness, efficiency,and costRole of Case Management/Discharge Planning in some organizations
Case Management/Discharge Planning (CM/DP)(Transitions of Care or Care Coordination)Screening and assessmentAppropriate resource/support allocationCare coordination and aftercare planning

 

 

Risk Management (RM)Clinical occurrences and claimsEnvironmental, e.g., safety and preventive maintenanceMitigation of the effects of negative outcomes on both theorganization and the patient
Infection Control (IC)Surveillance, identification, isolation• Patterns and trends• Guidelines, policies, and procedures• Education and training

 

Practitioner credentialing,privileging, and competency appraisalAll independent practitioners, specific requirements privileging, and depending on the setting.Medical Staff  at time of appointment and reappointment. To a more limited degree, all employees/contract staff whoprovide direct patient care, through skills/competencyevaluation.

 

Continuing medical/clinical educationOrientation to the components of a comprehensive qualitymanagement program and the interrelationships of cost quality, and risk issuesKnowledge of, and conformance with, performance standards,policies, procedures, and documentation standardsKnowledge of, and conformance with, professionally acceptedstandards of patient care and practice guidelines

 

Professionals performing any of the first four components (QM,UM, RM, and IC)Data collection, summarization, and aggregationInformation analysis, display, and presentationInformation interpretation, sharing, and useOngoing communications within the organizationEffectiveness oversight
The healthcare quality professional shoulda) Practice the profession with honesty and integrity.b) Have enough knowledge about relevant laws and legislations.c) Promote the right of privacy for all patients.d) all of the above.

All of the following actions would aid in adopting a “Quality culture” inside any healthcare organization .EXCEPT               a) Delegation and empowerment of staff.  b) The (Quality professional) is assigned to lead such cultural transformation.c) Increased communication.d) Top management commitment and involvement

Standards of care based to the knowledge & experience of recognized experts & healthcare research are known as:A) benchmark dataB) generic screenC) pre-established criteriaD) evidence based guidelines

When facility make development of clinical indicator criteria, Healthcare quality professional should:
A-Selecting indicators that are approved by accrediting organizationB- Selecting indicators that are approved by PayersC-develop criteria that reflect processes & outcomesD-develop criteria that reflect department policies
Thank You

Basic Concepts Of HealthCare Quality

Basic Concepts Of HealthCare Quality

By Mazenz

The Quality/Performance Management processPlanned, systematic, organization wide (or network wide) approach to the monitoring, analysis, and improvement of organizational performance.
The costs and risks of care.Quality-cost-risk dilemma.

 

Healthcare Should be coordinated, case­ managed, measured, analyzed, and continually improved by one systematic process.The key concept is “value-added”.Value depends on the results not the inputs, and this customer.

Value is defined by the quality of care or service plus the outcome,divided by the cost.Value  = QUALITY OF CARE/SERVICE + OUTCOME                                    CostCost refers to the total costs of the full cycle of care, not the cost of individual services.

 

“value-based healthcare system”?The goal is transparency:All stakeholders must agree on compatible definitions and measures of “value.” “Value-based” . Everyone-in all healthcare organizations-committed to,and actively involved in, continuous improvement of the quality of patient care

 

Quality Management Principles

The Basic Principles1-Productive work is accomplished through processes…2-Sound customer-supplier relationships are absolutely necessary for sound quality management.3-The main source of quality defects is problem in the process.4-Poor quality is costly.

 

 

 

5-Understanding the variability of In healthcare,processes is a key to improving quality.6-Quality control should focus on the most vital processes .7-The modern approach to quality is thoroughly grounded in scientific and statistical thinking.8-Total employee involvement is critical9-New organizational structures can help achieve quality improvement.

 

 

10-Quality management employs three basic, closely interrelated activities: Quality planning, Quality control, andQuality improvement

ISO Principles of Quality Management System1-Customer focus.2-Leadership.3-Involvement of people.4-Process approach.5-Continuous improvement.6-Factual approach to decision making .7-Mutually beneficial supplier relationships8-System approach to management
Services Vs ProductsProduct:measured,counted,tangible,noticeable,little variationService:Cannot be measured,less concrete,intangible, high variationHealthcare is a serviceHealthcare quality requires a balanced, integrated approach to measurement, analysis, and improvement that appreciates these unique service characteristics.

Total Quality ManagementBroad management philosophy, espousing quality and leadership commitment that provides the energy and the rationale for implementation of the process of Continuous Quality Improvement (CQI) within the organization wide Quality Strategy. Organization wide management philosophy.Enhances and benefits the organization and all people.Continuously improve the quality of all products, services, and information.

 

 

TQM philosophy resultsIncreased customer satisfaction.Increased productivity.Increased profits.Increased market share.Decreased costs.
TQM philosophy results
Encompass the entire organization with an increased top-down and bottom­ up emphasis on quality, with top managers demonstrating leadership for the constant improvement of quality care, being responsive rather than directive.Focus on systems rather than individuals

CPHQ Mcqs

One fundamental difference between monitoring product quality and service quality is based upon the fact that

  • a service is easier to measure and verify in advance
  • a service is not perishable
  • a service is more heterogeneous than an object
  • there are more service delays than product delays
  • CPHQ Mcqs
  • Which of the following is most important to the successful implementation of quality improvement activities?
  • Financial commitment and written quality management plan
  • Leadership commitment and organization wide collaboration
  • Leadership commitment and financial commitment
  • Information management system and department collaboration

CPHQ Mcqs
According to QI process theory and quality/performance improvement standards, it is best to select a quality improvement project that:

  • is the chief executive officer’s ongoing quality or cost concern.
  • is limited in scope and time to provide quick feedback.
  • has the greatest potential to improve patient outcome.
  • has the greatest potential to save the organization money

CPHQ Mcqs
The primary goal of quality/performance improvement is to improve

  • Patient Care processes.
  • Patient Safety.
  • Patient Outcomes.
  • Patient Satisfaction.

What is CPHQ ?

CPHQ INTRODUCTION WORKSHOP
By Mazenz

WHAT IS CPHQ?
Certified Professional in Healthcare Quality®(CPHQ) certification :-
Strategic and operational roles in management and leadership
Information management, including design and data collection, measurement and analytics, and communication
Performance/quality measurement and improvement, including planning, implementation and evaluation, and training
Strategic and operational tasks in patient safety

 

WHAT IS CPHQ?
The CPHQ is the only accredited certification in the profession of healthcare quality
Accredited by the National Commission for Certifying Agencies of the Institute for Credentialing Excellence in Washington, D.C.
To become certified, each quality professional must pass the CPHQ examination
The examination is available in computer-based format at assessment centers in the United States and multiple international locations
The credential is valid from the time you receive your certificate through a 2-year period, which begins on January 1 of the year following the date you pass the examination`

CPHQ EXAM
Multiple-choice examination consisting of 140 questions.
125 are used in computing the score.
An additional 15 pre test questions. You will be asked to answer these questions; however, they will not be included in the scored examination result.
26% recall, 57% application, and 17% analysis.
Recall questions test the candidate’s knowledge of specific facts and concepts.
Application questions require the candidate to interpret or apply information to a situation.
Analysis questions test the candidate’s ability to evaluate, problem solve, or integrate a variety of information and judgment into a meaningful whole.

WWW.CPHQ.ORG
How I study ?
Q Solutions: Essential Resource for the Healthcare Quality Professional, 3rd Edition
The Healthcare Quality Handbook: A Professional Resource and Study Guide, Janet Brown.
CPHQ Review Course
CPHQ Practice Exam

 

CERTIFIED PROFESSIONAL IN HEALTHCARE QUALITY® EXAMINATION SPECIFICATIONS
Quality Leadership and Structure
Leadership
Structure
Information Management
Design and Data Collection
Measurement and Analysis

 

CERTIFI ED PROFESSIONAL IN HEALTHCARE QUALITY® EXAMINATION SPECIFICATIONS
Performance Measurement and Process Improvement
A. Planning
B. Implementation and Evaluation
C. Education and Training
D. Communication

4. Patient Safety
A. Assessment and Planning
B. Implementation and Evaluation

WHAT WE WILL DO HERE ?
30 Minutes Per Week.
Discuss topics in practical way with hints for MCQ questions .
Implement the concept of quality in our work.
MCQ examples for EXAM
Save time and effort.

 

 

“The definition of insanity is continuing to do the same thing over and over again and expecting a different result”

Albert Einstein

 

Quality is Defined as Dictionary :-

Noun : Degree or grade of excellence. Adjective : Having a high degree of excellence.

Webster’s new World College and American Heritage Dictionaries
Quality is:-
Doing the right thing right first time and every time.

With Standers
Standers are created when experts are able to understand what the right things are an how the right things are best achieved based on Research and Clinical Evidence.

Standers serve as guidelines for excellence .

OTHER DEFINITIONS
The Centers for Medicare and Medicaid service (CMS) defines healthcare quality as “The right care for every person every time”

The Juran institute:-
Free from Deficiencies:
Nosocomial infection, excessive waiting time, lost lab results etc.
Service features :
Pleasant waiting room, computerized health records, follow-up care etc.

The Institute Of Medicine collected and analyzed over 100 definitions of quality of care and came for this definition :-
The quality of care 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.

ASPECTS OF QUALITY
Measurable
Appreciative
Perceptive

 

Measurable quality :-
Defined objectively as compliance or adherence to standers .

Clinical as Protocols and clinical guidelines.
Performance measures or indicators.

Appreciative quality :-
Is a comprehensive and appraisal of excellence beyond minimal standards and criteria .

None articulate judgment of skilled ,experienced practitioners and sensitive ,caring persons .

Perceptive quality :-
Is the degree of excellence that is perceived and judged by the recipient or the observer of care rather than the provider.

The ideal organizational wide healthcare quality strategy is effective in tracking Measurable quality.

Key Dimensions:-
Provide the Framework for the quality management activities in all healthcare setting.

1 ) Appropriate :-
Relevant to individual clinical needs.
Doing the right thing in accordance to purpose.

2) Available : –
Accessible and obtainable to meet individual needs .

3) Competence :-
The practitioners ability to produce both the health and satisfaction of customers.

4)Continuous : –
Delivery of needed healthcare unbroken succession.

5)Effectiveness: –
The degree to which desired outcome is reached.
Positive results of care delivery
Performance that equivalent to stated requirements .
6)Efficacy:-
Potential capacity or capability to produce the desired effect or outcome
The power of procedure.
By Dr Mazen Salama

7)Efficiency: –
The relationship between Outcomes and resources used to deliver care.
Relationship between inputs and outputs .

8)Prevention and early detection:-
Identification of risk factors to promote health and prevent diseases .

9)Respect and caring:-
The degree to which those providing services do so with sensitivity for the individuals needs, expectations and individuals differences.

10)Safety :-
The degree to which the healthcare intervention minimizes risks of adverse outcome for both patient and provider .

 

11) Timeliness: –
The degree to which care is provided to individual at the most beneficial or necessary time.

CPHQ QUESTION.
When a newly introduced drug is told to be able of producing positive results for certain clinical conditions, then this drug should be considered:
a. Effective.
b. Efficient.
c. Efficacious.
d. Appropriate.

 

CPHQ QUESTION
Appropriateness” of care refers to:
a. The degree to which the care is accessible and obtainable.
b. The degree to which needed care is provided to the patient at the most beneficial time.
c. The degree to which care provided is relevant to the patient’s clinical needs.
d. The coordination of needed healthcare services for a patient among all practitioner and across various settings.

 

Thank you

CPHQ MCQs 2

  1. One fundamental difference between monitoring product quality and service quality is based upon the fact that

  1. a service is easier to measure and verify in advance

  2. a service is not perishable

  3. a service is more heterogeneous than an object

  4. there are more service delays than product delays

  1. The perception of quality by a patient receiving care in an ambulatory healthcare center is influenced most by

  1. the physical environment.

  2. caring staff and physician.

  3. new technology.

  4. the physician’s technical competence.

  1. What is the most important relationship between structure, process, and outcome as types of indicators of quality?

  1. Interdependent: Structure directly affects both process and outcome.

  2. Causal: Structure leads to process and process leads to outcome.

  3. Relational: Useful for comparisons, but not causal

  4. There is no relationship; they are categories used to group indicators

  1. Which of the following best describes the successful outcome of the quality improvement process?

  1. Customer satisfaction

  2. Enhanced communication

  3. Employee empowerment

  4. Improved statistical data

  1. Monitoring phlebitis associated with IV insertions by nurses in the Surgical Intensive Care Unit addresses which focus?

  1. Outcome of care

  2. Process of care

  3. Structure of care

  4. Administrative procedure

  1. “Common causes” of problems in processes refer to

  1. one-time situations.

  2. temporary situations.

  3. acute situations.

  4. chronic situations

  1. Under the quality improvement paradigm, which statement is incorrect?

  1. The focus is on the competency of individual practitioners.

  2. The focus is on the efficacy and effectiveness of processes.

  3. The focus is on the patient.

  4. The focus is on organization performance.

  1. Organizational “culture” most often refers to

  1. the ethnicity of the organization’s employees and licensed independent practitioners

  2. assumptions about people and how work gets done

  3. the efforts to reach out to the diverse groups in the community.

  4. the scheduled social and cultural events within the organization.

  1. The leadership style that is said to motivate employees, and that optimizes the introduction of change, is

  1. autocratic.

  2. consultative.

  3. participatory.

  4. democratic

  1. In participative management the manager

  1. relinquishes decision-making responsibility to the staff.

  2. retains the final decision-making responsibility.

  3. presents a final decision to the staff

  4. permits staff participation only with noncritical issues

  1. Which of the following is most important to the successful implementation of quality improvement activities?

  1. Financial commitment and written quality management plan

  2. Leadership commitment and organizationwide collaboration

  3. Leadership commitment and financial commitment

  4. Information management system and department collaboration

  1. The best way to facilitate leadership education about the role of ethics in the organization is to understand that

  1. each leader’s personal value system drives decision making.

  2. the organization’s written Code of Ethics drives decision making.

  3. the organization can have both good and bad ethics.

  4. accountability for organizational ethics is primarily internal, not public.

  1. In any quality management approach, how can you best evaluate the effectiveness of action taken?

  1. Use the same performance measures to remonitor the process.

  2. Formulate a new special study to monitor the action.

  3. Interview the staff involved in implementing the action plan.

  4. Do nothing. Effectiveness is expected with well-planned action

  1. According to QI process theory and quality/performance improvement standards, it is best to select a quality improvement project that

  1. is the chief executive officer’s ongoing quality or cost concern.

  2. is limited in scope and time to provide quick feedback.

  3. has the greatest potential to improve patient outcome.

  4. has the greatest potential to save the organization money

  1. All quality improvement approaches or models include the following mechanisms except

  1. developing strategic goals.

  2. prioritizing problems/projects.

  3. collecting and analyzing data

  4. taking action to improve

  1. The main goal of measurement in performance improvement is to

  1. provide specifications for processes needing redesign.

  2. keep track of process and practitioner variances.

  3. collect accurate data reflecting actual performance

  4. establish benchmarks for the improvement process

  1. The integrated delivery system is undergoing a major reengineering effort, with corporate goals to complete projects timely and within budget. Of the following, the most appropriate approach or model is

  1. Failure Mode and Effects Analysis (FM EA).

  2. rapid cycle.

  3. FOCUS-PDCA.

  4. Balanced Scorecard

  1. The primary goal of quality/performance improvement is to improve

  1. patient pare processes.

  2. patient safety.

  3. patient outcomes.

  4. patient satisfaction

  1. Failure mode and effects analysis (FM EA) is what type of review or improvement tool?

  1. Concurrent

  2. Focused

  3. Prospective

  4. Retrospective

  1. The basic philosophy of benchmarking is

  1. eliminating the competition

  2. finding best practice and incorporating it.

  3. getting all processes under statistical control

  4. eliminating process deficiencies.

QUESTIONS & ANSWER

1

c

2

b

3

b

4

a

5

a

6

d

7

a

8

b

9

c

10

b

11

b

12

a

13

a

14

c

15

a

16

c

17

b

18

c

19

c

20

b

CPHQ MCQs 1

Leadreship & Management

MCQ 1

1. Appropriateness” of care refers to:

a. The degree to which the care is accessible and obtainable.

b. The degree to which needed care is provided to the patient at the most beneficial time.

c. The degree to which care provided is relevant to the patient’s clinical needs.

d. The coordination of needed healthcare services for a patient among all practitioner and across various settings.

2. When a newly introduced drug is told to be able of producing positive results for certain clinical conditions, then this drug should be considered:

a. Effective.

b. Efficient.

c. Efficacious.

d. Appropriate.

3. When an employer contracts with a health plan or directly with a provider, this employer should be concerned about which of the following perspectives:

a. The cost of the care provided.

b. The quality of the care provided.

c. The outcomes of the care provided.

d. All of the above.

4. Which of the following healthcare reformers developed the structure, process, and outcomes” model?

a. Ernest Codman.

b. Florence Nightingale.

c. Avedis Donabedian.

d. Donald Berwick.

5. Which of the following tools can be used to identify (Customer Needs)?

a) Focus groups.

b) Brainstorming.

c) Surveys and interviews.

d) a and c only.

e) a, b and c.

6. When the health care delivered should not vary in Quality because of patient’s personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status; then this health care is

a) Safe.

b) Efficient.

c) Patient centered.

e) Equitable. .

7. The healthcare quality professional should

a) Practice the profession with honesty and integrity.

b) Have enough knowledge about relevant laws and legislations.

c) Promote the right of privacy for all patients.

d) all of the above.

8. Which of the following situations best describes the term “Misuse” of Resources at healthcare facilities?

a) Patients receive appropriate medical services that are provided poorly, exposing them to added risks of preventable complications.

b) Patients undergo treatment or procedures from which they do not benefit.

c) Patients do not receive beneficial health services.

d) None of the above.

9. Which of the fol1owing items is not considered as an “outcome”?

a) Mortality. .

b) Management of Complications

c) Patient/family satisfaction.

d) ” Activities of daily living” status.

10. All of the following actions would aid in adopting a “Quality culture” inside any healthcare organization .EXCEPT

a) Delegation and empowerment of staff.

b) The (Quality professional) is assigned to lead such cultural transformation.

c) Increased communication.

d) Top management commitment and involvement

11. All of the following are ways through which any organization leadership can enhance the spread of “quality culture” within the organization

EXCEPT

a) Develop mission and vision statements.

b) Develop quality initiatives.

c) Adopt flexible management styles.

d) Assign quality professionals to lead the process of cultural transformation.

12. What is the right sequence for the elements of Donabedian’s model?

a) Process – Structure – Outcome

b) Outcome – Process – Structure

c) Structure – Process – Outcome

d) Process – Outcome – Structure

13. All of the following are key components that guide the (Strategic Organizational Direction), except:

a) Mission.

b) Vision.

c) Procedures.

d) Values.

14. Which of the following is not correct about (Strategic planning)?

a) May need annual development of “operational plans”.

b) Should be based on objective environmental assessment.

c) Neither long-term nor short-term objectives should be developed until the organization completes the strategic planning process.

d) Can be prepared for a single department within the organization.

15. Which of the following statements is not correct concerning (Goals and Objectives)?

a) Goals are more specific than Objectives.

b) A single Goal may have many Objectives.

c) Objective should be challenging yet achievable.

d) A Goal statement should mention the excepted time for achieving the goal.

16. All of the following criteria are considered by the hospital leaders when selecting a (Strategic Quality Initiative), except:

a) Has organization-wide impact

b) Is linked to one or more strategic goals.

c) Should addresses clinical issues only.

d) Should focus on the improvement of systems and processes.

17. The CEO of hospital (X) sake an area for improvement, he asked each member of the senior management group to propose him a list of potential improvement opportunities in the next meeting; what is the most reliable source from which the managers can get their ideas?

a} Assessment of internal and external customer needs.

b) Assessment of needs of external customers only.

c) Comparative information pertinent to competitors.

d) The work experience each manager has.

18. All of the following about the using (Metrics) or (Measurement methods) in an organization is correct, except:

a) They have no role in linking the organizational processes to the achievement of the corporate plan.

b) They are the diagnostics which show progress in meeting corporate goals and objectives. ·

c) They may take various forms according to the process to be measured and the type of data to be collected.

d) Clear understanding of the organizational mission and vision, would ultimately facilitate the development of the appropriate metrics.

19. All of the following statements concerning the “Goals” and the “Objectives” are correct, except:

a) Objectives are more specific than goals.

b) A single goal may have many objectives.

c) Objectives can be measured with qualitative and quantitative criteria

e) Objectives are developed before goals.

20. Risk management in an organization is most effective when it is:

  1. Responsible for sentinel event root cause analysis

  2. Incorporated into safety management

  3. Integrated with organizationalwide performance Improvement

  4. The responsibility of the clinical performance improvement teams.

Answers:

1- c

2- c

3- d

4- c

5- e

6- e

7- d

8- a

9- b

10- b

11- d

12- c

13- c

14- d

15- a

16- c

17- a

18- a

19- e

20- c