Chapter #23 - Quality Control in Creating a Culture All of Patient Safety
Quality Health Care/Quality Control Process-
o The criterion or standard is determined
o Information is collected to determine whether the standard has been met
o Educational or corrective action is taken if the criterion has not been met
Set standards
Collect data to check if standards are met
Take action if standards are not met
Standards; Benchmark - definitions/purpose-
o Standards-
Predetermined baseline condition or level of excellence that constitutes a
model to be followed and practiced
Each organization and profession must set standards and objectives to
guide individual practitioners in performing safe and effective
The ANA has played a key role in developing standards for the profession
Baselines for excellent care (ANA standards)
o Benchmark-
The process of measuring products, practices, or services against best-
performing organizations
Organizations can determine how and why their organization differs from
these exemplars
Then use the exemplars as role models for standard development and
performance improvement
, Comparing your care to the best practices
Audits - Outcome, Process, & Structure-
o Outcome-
Determine what results, if any, followed from specific nursing
interventions for patients
What happened because of care?
o Process-
Measure the process of care or how the care was carried out
How was care given?
o Structure-
Monitor the structure or setting in which patient care occurs
Where did care happen?
Quality Improvement Model - Total Quality Management (TQM)-
o Over the past several decades, the American health-care system has moved from a
quality assurance (QA) model to one focused on quality improvement (QI)
o The difference between the two concepts is that QA models target currently
existing quality
o QI models target ongoing and continually improving quality
o Two models that emphasize the ongoing nature of QI include Total Quality
Management (TQM) and the Toyota Production System (TPS)
Based on the premise that the individual is the focal element on which
production and service depend
Focus is on doing the right things, the right way, the first time, and
problem-prevention planning, not inspective and reactive problem solving
TQM is the empowerment of employees by providing positive feedback
and reinforcing attitudes and behaviors to support quality and productivity
Focus on continuous improvement (TQM)
Empower employees to improve care processes
The Joint Commission; Sentinel Event examples;/ Sentinel Event Reporting; Core
Measures;/ National Patient Safety Goals-
o Joint Commission-
An independent, not-for-profit organizations that accredits> 22,000 health
care organizations and programs in the US
Has historically had a tremendous impact on planning for quality control
in acute care hospitals
First to mandate that all hospitals have a QA program in place by 1981
o Sentinel Event Reporting-
JC maintains one of the nations most comprehensive databases of sentinel
(serious adverse) events by health care professionals and their underlying
causes
Quality Health Care/Quality Control Process-
o The criterion or standard is determined
o Information is collected to determine whether the standard has been met
o Educational or corrective action is taken if the criterion has not been met
Set standards
Collect data to check if standards are met
Take action if standards are not met
Standards; Benchmark - definitions/purpose-
o Standards-
Predetermined baseline condition or level of excellence that constitutes a
model to be followed and practiced
Each organization and profession must set standards and objectives to
guide individual practitioners in performing safe and effective
The ANA has played a key role in developing standards for the profession
Baselines for excellent care (ANA standards)
o Benchmark-
The process of measuring products, practices, or services against best-
performing organizations
Organizations can determine how and why their organization differs from
these exemplars
Then use the exemplars as role models for standard development and
performance improvement
, Comparing your care to the best practices
Audits - Outcome, Process, & Structure-
o Outcome-
Determine what results, if any, followed from specific nursing
interventions for patients
What happened because of care?
o Process-
Measure the process of care or how the care was carried out
How was care given?
o Structure-
Monitor the structure or setting in which patient care occurs
Where did care happen?
Quality Improvement Model - Total Quality Management (TQM)-
o Over the past several decades, the American health-care system has moved from a
quality assurance (QA) model to one focused on quality improvement (QI)
o The difference between the two concepts is that QA models target currently
existing quality
o QI models target ongoing and continually improving quality
o Two models that emphasize the ongoing nature of QI include Total Quality
Management (TQM) and the Toyota Production System (TPS)
Based on the premise that the individual is the focal element on which
production and service depend
Focus is on doing the right things, the right way, the first time, and
problem-prevention planning, not inspective and reactive problem solving
TQM is the empowerment of employees by providing positive feedback
and reinforcing attitudes and behaviors to support quality and productivity
Focus on continuous improvement (TQM)
Empower employees to improve care processes
The Joint Commission; Sentinel Event examples;/ Sentinel Event Reporting; Core
Measures;/ National Patient Safety Goals-
o Joint Commission-
An independent, not-for-profit organizations that accredits> 22,000 health
care organizations and programs in the US
Has historically had a tremendous impact on planning for quality control
in acute care hospitals
First to mandate that all hospitals have a QA program in place by 1981
o Sentinel Event Reporting-
JC maintains one of the nations most comprehensive databases of sentinel
(serious adverse) events by health care professionals and their underlying
causes
