DU WK 5 The Organization Requires Creativity in Quality Improvement Discussion

Description

TOPIC: Ensuring Standard of Care: The QI Process: How to Improve Organizational
Processes and Performance with specific QI Processes (TQM or CQI); Selection and Use of Existing Instruments (Tools) for Individual System and Patient Measurement

WEEKLY OBJECTIVES:
1. Discuss the major aims for care improvement (safe, efficient, effective, timely, patient centered, equitable care)

Discuss differences between specific QI Processes (e.g. TQM and CQI)
Examine differences in quality measures such as effectiveness and safety measures
Differentiate the measurement of structure, process, and outcome variables
Describe accepted processes of data management for organizational quality improvement
Apply concepts of clinical practice to planning for an appropriate QI system of measurement for your clinical area
Understand the importance for the use of formal measurement tools in patient education and for establishing the criteria or levels of achievement necessary for independent patient or family functioning

WEEKLYASSIGNMENTS/ READING ASSIGNMENTS:

Tague chapter 1

Waltz, Chapters 12-19 (briefly read basic definitions and information explaining these processes)

Handouts/Articles:

Mainz: Defining and classifying clinical indicators for quality improvement Mainz Quality Indicators Articlel-1-1.pdf Download Mainz Quality Indicators Articlel-1-1.pdf
HRSA Quality Improvement White Paper Part I HRSA QualityImprovement-1.pdf Download HRSA QualityImprovement-1.pdf

Website Pages to Review:

AHRQ 6 Aims of Quality: https://www.ahrq.gov/professionals/quality-patient-safety/talkingquality/create/sixdomains.html (Links to an external site.)Links to an external site. (Links to an external site.)
Measures of Hospital Quality: (Read and review the following pages)

Videos:

1. View Quality Improvement in health Care Profound Knowledge-Systems-Mayo Clinic https://youtu.be/1CQgCGXUXD0 (Links to an external site.)Links to an external site.

2. The Cost of Quality: The cost of quality sounds easy to understand but, unfortunately, many misunderstand it. Cost of quality is defined and illustrated through the story of the iPhone 4. Click on the link below to access the video:*The Cost of Quality (Links to an external site.)

WEEKLY DISCUSSION BOARD:

Describe your understanding of the tool matrix in Tague chapter 1. What questions should you ask when trying to decide which quality improvement tool you should use in a project?
Summarize what you learned from viewing the Measures of Hospital Quality 3 web pages and from viewing the attached video.

hi, the name of the book for the DB is

The Quality Toolbox by Nancy Tague

hello, attach the following is one peer DB that needs a respond.

Describe your understanding of the tool matrix in Tague chapter 1. What questions should you ask when trying to decide which quality improvement tool you should use in a project?

Tague (2005) discusses using The Quality Toolbox, which we can apply to different situations for continuous improvement. Quality tools may include charts, diagrams, methods, and techniques that help with the quality improvement process. The Table 1.1 tool matrix provides an extensive list of generic tools that we can modify to fit our specific needs. Some of the unique variations for generic tools include two-dimensional charts, tree diagrams, matrix diagrams, and flowcharts. When deciding which quality improvement tool to use in a project, we can first ask, “What do we want to do with this tool?” For example, tools help guide us with process analysis, creating ideas, data collection, and cause analysis.

The fishbone diagram is an excellent tool to analyze various causes of problems by narrowing down ideas through logical reasoning, data collection, and analysis. Tague (2005) explains how some tools help expand your thinking while others help with focus. One tool that can either expand your focus or thinking is a flowchart. A flowchart includes a deployment and macro flowchart, process mapping, workflow diagram, and a top-down flowchart. Tague (2005) describes graphs as a general name for a generic tool. There are hundreds of different graphs that provide a faster and easier understanding of numerical data.

2. Summarize what you learned from viewing the Measures of Hospital Quality 3 web pages and from viewing the attached video.

In the video, the system of profound knowledge includes an appreciation of a system, knowledge of variation, theory of knowledge, and theory of knowledge (Mayo Clinic, 2012). The complex processes in a system where common sense does not necessarily improve a system. A system’s processes and boundaries determine how far it can extend. In healthcare, the complex system includes the patients and their suppliers. The system also consists of large boundaries. Competition within a system is bad, while cooperation can be beneficial. When identifying a system, we need to identify the aim and whether it makes sense.

The Institute of Medicine (IOM) developed a framework that addresses six aims for the health care system. The six domains of health care quality are safe, effective, patient-centered, timely, efficient, and equitable (Agency for Healthcare Research and Quality, 2018). When obtaining data and information, we can use the five measure sets endorsed by the National Quality Forum: AHRQ Quality Indicators, National Hospital Quality Measures, CAHPS Hospital Survey, ORYX, and The Leapfrog Group’s Measures (Agency for Healthcare Research and Quality, 2019). The CAHPS Hospital survey was widely used in the previous hospital I worked at. HCAHPS addresses important aspects of the hospital, including responsiveness of hospital staff, communication with doctors and nurses, discharge information, communication about medications, and hospital cleanliness and quietness (Agency for Healthcare Research and Quality, 2019). The HCAHPS scores were important because they helped us better understand patient experience and provided us with the patient’s view of the care that was provided. The HCAHPS survey and results help give patients a voice and help identify strengths and weaknesses within an organization.

References

Agency for Healthcare Research and Quality. (2018). Six Domains of Health Care Quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html

Agency for Healthcare Research and Quality. (2019). Major Hospital Quality Measurement Sets. https://www.ahrq.gov/talkingquality/measures/setting/hospitals/measurement-sets.html

Mayo Clinic. (2012). Quality Improvement in Health Care: Profound Knowledge – Systems. [Video]. Youtube. https://www.youtube.com/watch?v=1CQgCGXUXD0

Tague, N. R. (2005). The Quality Toolbox (2nd ed.). ASQ Quality Press, Milwaukee,
Wisconsin

This is the second peer DB.
please mark which responds belong to which DB if possible. I apologize for sending them this way, I don’t have a computer and I’m doing it with my phone.

Describe your understanding of the tool matrix in Tague chapter 1. What questions should you ask when trying to decide which quality improvement tool you should use in a project?

The tool matrix in Tague’s chapter one is a useful resource for helping researchers see available tools to advance their project. These tools are similar to tools in a toolbox for a carpenter. As mentioned by Tague (2005), if a carpenter wants to cut a piece of wood, he doesn’t reach for a screwdriver. The same concept is relevant for researchers. The first question researchers should ask is, “What do I want to measure?” This will help determine what tools a researcher can choose from. Then they can go into their toolbox and choose the most appropriate tool to measure the specific parameter. Tague’s tool matrix is divided into categories based on what part of the project one is needing to evaluate. The different tool categories are 1) Project planning and implementing tools, 2) Idea creation tools, 3) Process analysis tools, 4) Data collection and analysis tools, 5) Cause analysis tools, and 6) Evaluation and decision-making tools.

Each tool in the tool matrix has six categories. A description of the tool will tell the reader what the tool is used for and the category to which the tool belongs. Another section describes when to use the tool. Some tools are very valuable at the beginning of a project while other tools are effective at the end. The next section is the procedure section, which guides the researcher in a step-by-step manner on how to use the tool. Another section is the example section, in which the use of the tool is explained through a fictional application. I found this section to be very helpful. The fifth section is the variation section. Some tools have different possible uses and this section provides step-by-step procedures for the use of a tool. The last section is the consideration section, where tips and tricks on how to use a tool are discussed, as well as warnings on how to avoid problems. Tague’s Tool Matrix is a great resource for someone beginning a research project!

Summarize what you learned from viewing the Measures of Hospital Quality 3 web pages and from viewing the attached video W. Edwards Deming was a statistician that advocated for leaders to have what he called “profound knowledge” (Mayo Clinic, n.d). He believed that profound knowledge was foundational to quality improvement in healthcare. Profound knowledge includes four main topics: an appreciation of a system, knowledge of variation, theory of knowledge, and knowledge of psychology (Mayo Clinic, n.d.). No matter what system we are discussing, all systems have an aim and one or more processes at getting at that aim. The difference is how each system reaches its aim. Most health care systems aim for quality healthcare, especially because of the reimbursement pay-per-performance system set up by Medicare. The Agency for Healthcare Research and Quality (2018) discusses six domains for providing quality health care. Quality health care is safe, effective, patient-centered, timely, efficient, and equitable. Each health care system will have a different process for reaching these aims. When working within a system, it is important to see the whole picture, assess each domain, and determine how a change may impact everyone in the system (Mayo Clinic, n.d.). The National Quality Forum has endorsed five different quality measurement sets to compare reliable data in health care systems. These are AHRQ Quality Indicators, National Hospital Quality Measures, CAHPS Hospital Survey, ORYX, and The Leapfrog Group’s Measures (The Agency for Healthcare Research and Quality, 2019). Obtaining reliable information on outcomes can help nurse leaders identify areas requiring improvement and implement evidence-based interventions targeting the problem. Interestingly, a change that may seem like it is common sense in one department may actually harm the system as a whole (Mayo Clinic, n.d.). The key within a system is to cooperate with each other and to find the changes that will make a positive impact on the whole system.

References:

Agency for Healthcare Research and Quality. (2018). Six domains for health care quality. https://www.ahrq.gov/talkingquality/measures/six-d…

Agency for Healthcare Research and Quality. (2019). Major hospital quality measurment sets.https://www.ahrq.gov/talkingquality/measures/setti…

Mayo Clinic. (n.d). Quality improvement in health care: Profound knowledge systems. [Video]. Youtube.

Tague, N. (2005). The Quality Toolbox, (2nded.). ASQ Quality Press, Milwaukee, Wisconsin. ISBN 13: 978-0873896399

Reply:

Thanks for your post. Agreed that within organizations, there are many teams who seek to achieve quality from various perspectives. Often times , the goal to achieve quality measures can conflict or compete against one another. This can have a negative impact on team dynamics/relationships. Having a common aim can reduce conflict and competition among the team .

As a DNP leader, how would you apply that concept of a common aim in work relationships that you have witnessed in the healthcare environment? Specifically, when these work relationships are not as collaborative or cooperative as they should be?

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