262310
Description
Flashcards by Michael Riben, updated more than 1 year ago
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Created by Michael Riben
about 11 years ago
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| Question | Answer |
| list stakeholders at national level in healthcare quality | CMS, NQF, NCQA, ONC, Joint Commission, and LEapfrog |
| what has CMS published around quality initiatives? | Published quality measures called CQM's that define appropriate use of EHR technology, Submitting CQM is required for MU 1 and 2, derived from NQF |
| what is the NQF? | collects and standardizes quality measures in a tool called the quality position system (QPS) |
| what does each NQF-endorsed quality measure have? | An NQF number, a defined steward, and update/revision cycle. |
| What is the NCQA? | National Committee for Quality Assurance |
| what does NCQA publish? | HEDIS - health effectiveness data and information set |
| what are purpose of HEDIS measures? | allow consumers to benchmak health plans, required by CMS medicare advantage subcontractors like HMO's |
| WHat is the ONC? | Office of the National Coordinator for Healthcare IT established by legislative order in 2004 and HITECH act in 2009 mandated the office |
| what does ONC do? | Oversees activities to promote HIT and HIE, established EHR certification and HIE standards |
| What are the 4 leaps of the Leapfrog group? | CPOE, Evidence-based hospital referral (complex cases referred to high volume/high quality centers), ICU physician staffing with intensivists, and Leapfrog Safe Practice Score based on NQF endorsed practice |
| what does Joint Commission do? | Accredits us healthcare organization, Established the national patient safety goals |
| what does Joint Commission do? | Accredits us healthcare organization, Established the national patient safety goals |
| what are the 6 healthcare quality dimensions as defined by IOM? | Safe, Effective/reliable care, Patient centered care, Efficient, Timely, and Equitbale |
| what is the Swiss cheese model of error ? | latent and active failures are holes in cheese; processes, safeguards, and workflow are the layers Errors occur if the latent/active failures in different layers line up |
| what is a effective error proofing concept for surgical saftey? | WHO surgical safety checklist |
| what is Failure Mode/Effect Analysis (FMEA)? | 4 step process: created process diagram, describe what happens at each step if failure occures, rate teh failure on standardized scale, calculate the risk priority number |
| what is the RPN and how do you calculate? | RPN=SeverityX LikelihoodX inability to detect = SxOxD severity 1 (none)-5 (fatal) Likelihood to occur 1(rare)-5(comm) inability to detect (1(easy ) -5 (diff) |
| what are the 3 main indicators of healthcare quality? | Structural, Process, and outcomes |
| what are structural indicators of quality? | # of specialist, # of clinical guidelines implemented etc.. |
| what are process indicators of healthcare quality ? | how many diabetics are screened for proteinuria, proportion of children with otitis media who get correct antibiotics |
| what are outcome measure of healthcare quality? | effects of care : HbA1C for diabetics, Lipid profiles or end measures: -->Quality of life, stroke pt functional status, patient statisfaction etc. |
| what is demming method of quality improvement? | Plan-do-study-act |
| what is the toyota production system? | focus of removing all activity that has no value and contributes to waste |
| what did Walter shewhart create? | Control charts |
| what are the upper and lower confidence limits in control charts? | UCL and LCL calculated from standard error (Sdev/sqroot(n)) = 3 std deviations from the center |
| How many standard deviations from center are warning limits on a control chart? | 2 |
| what is a common cause fluctuation control chart? | UCL and LCL contains 99.73% of random fluctuation and has no unnatural patterns |
| what is a special cause fluctuation ? | any fluctuation outside the UCL and LCL |
| What are the Special Cause (rules) | more later |
| What is a FlowChart | graphical representation of process step by step that models the workflow and cognitive steps with inputs, decisions and outputs |
| what is a cause/effect /ishikawa/fishbone diagram? | root cause analysis techniques with asking the 5 whys where the head is the outcome and the domains are the bones |
| What is a pareto chart? | identifys the most valuable targets for the improvement |
| what is the Five "why"s technique | Method to ask why over and over until the root cause is identified |
| what is PDSA? | key to improvement is cycles of plan,do, study, act and repeat |
| what is six sigma | ideal of having process in control within six-sigma or 3.4 defects/million , i.e. 99.999 error free |
| what are the steps of Six Sigma | define--> Measure--> Analyze--> improve--> control |
| what three non-value added activities is targeted with LEan (toyota production) system? | Muda - uselessness Mura -irregularity/unevenness Muri - unreasonable |
| list seven types o fmuda? | Overproduction, inventory, repairs,motion, processing, waiting, transport |
| list seven types o fmuda? | Overproduction, inventory, repairs,motion, processing, waiting, transport |
| what is value stream mapping ? | graphic depiction of inputs , throughputs, and outputs to identify improvement opportunities |
| what is kaizen? | standard operations, compare measurement, engage frontline staff, |
| what is a kanban card? | visual indicators of something empty |
| what is andon? | visual indicator of production status/alerts - indicating something needs assistence or status |
| what is Poka-yoke | mistake avoidance in design or process, ie.. color coding of medical gases in hospital rooms, notch in sim card so it only goes in one way |
| what is Poka-yoke | mistake avoidance in design or process, ie.. color coding of medical gases in hospital rooms, notch in sim card so it only goes in one way |
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