CPHQ Exam 1 (Answered) Verified Solution

CPHQ Exam 1 (Answered) Verified Solution Six Sigma Improvement Model Define, Measure, Analyze, Improve, Control Six Sigma A business process for improving quality, reducing costs, and increasing customer satisfaction and a process whereby firms work to limit product defects to 3.4 per million or fewer LEAN approach (quality improvement technique) Focused on what's valuable to customers, pt, payers, providers, regulatory bodies with an emphasis on investigating new ways to get things done and making changes in a short period of time. Reengineering Redesigning a company's processes to make them more efficient. A focus on cross-functional capabilities led to the dissolution of departmental silos. Often became associated with downsizing and layoffs and employee morale declined and productivity suffered. Rapid cycle improvement (RCI) An improvement model that makes repeated incremental improvements to optimize performance Breakthrough Series A collaborative approach to QPI developed by the IHI to bring about rapid cycle improvements. Collaborations allow organizations to learn from each other's successes and failures. Incorporates the PDSA cycles and the concept of spread. Patient safety approach six key areas structure, environment, equipment/technologies, processes, people, and leadership/culture Patient-centered care "Nothing about me without me" best describes the concept of patient-centered care. Care that is respectful of and responsive to individual patient preferences, needs, and values. TeamSTEPPS stands for Team Strategies and Tools to Enhance Performance and Patient Safety TeamSTEPPS (an AHRQ strategy to promote patient safety) A teamwork system designed to increase patient safety developed by the DoD and AHRQ TeamSTEPPS Designed to improve communication and teamwork skills among healthcare professionals. IOM Imperatives, Priorities and Competencies Patient safety and harm, changing the healthcare delivery system, and policy and healthcare quality Underuse Not providing a health service that might have been medically beneficial Overuse The potential for harm from the provision of a service that exceeds the possible benefit Misuse Incorrect diagnoses, medical errors, and other sources of avoidable complications IOM 6 characteristics 2c2 Safe, effective, patient-centered, timely, efficient, equitable SEPTEE Safe Avoid injuries to patients resulting from care that is intended to help them Effective Care based on scientific knowledge demonstrating who will likely benefit and restrain from providing care when it is not likely to benefit patients Patient-centered Care should be respectful and responsive to patient preferences, needs and values; further, patient values should guide all clinical decisions Timely Elimination of wait times and harmful delays Efficient Care provided in ways that avoid waste of equipment, supplies, ideas and energy Equitable Care should not vary in quality because of patients' personal characteristics such as gender, ethnicity, geographic location and socioeconomic status Standards of Practice Descriptions of the responsibilities for which healthcare providers are accountable National Quality Forum (NQF) Organization that's set standards are used to measure publicly reported Healthcare quality Leapfrog Group standards CPOE system, evidence-based hospital referral, ICU physician staffing, Leapfrog safe practices Personal health information The patient's own information that pertains to his or her health. HIPAA Health Insurance Portability and Accountability Act of 1996 Release of information A written consent is required for an organization to release patient information to anyone outside the organization. Utilization management QI tool of an MCO & a method to control cost through prospective & retrospective review of services Utilization management includes (4) 1) Preadmission certification; 2) Preauthorization; 3) Concurrent review; 4) DC planning Evidence-based practice (EBP) The practice of medicine that utilizes guidance-based information gleaned from research studies. The "conscientious and judicious use of current best evidence in making decisions about the care of individual patients". Decision support system