Quality Improvement in Healthcare: Connecting Research, Education, and Practice
Explore the vital link between research, education, and practice in quality improvement within healthcare. From identifying needs for improvement to the history of QI initiatives, understand how stakeholders collaborate for better patient outcomes and system performance. Discover resources like QSEN and Choosing Wisely that empower nurses and providers to continuously enhance healthcare quality and safety.
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Quality Improvement and the Quality Improvement and the Nurse Nurse
Identified Need for Improvement in Health Care Identified Need for Improvement in Health Care 30-45% of patients not receiving care according to scientific evidence 20-25% of care provided is not needed or potentially harmful Choosing Wisely funded by RWJF to promote conversations between providers and patients about care http://www.choosingwisely.org/our-mission/facts-and-figures/ 17 years to move research into practice (Schuster et al., 1998; Grol 2001) Have we improved?
How does Research and EBP connect to Quality Improvement and Safety? How does Research and EBP connect to Quality Improvement and Safety? https://www.youtube.com/watch?v=jq52ZjMzqyI
QSEN: Quality & Safety Education for Nurses QSEN: Quality & Safety Education for Nurses Community that provides comprehensive, competency- based resources to empower nurses with the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems in which they work. 6 Competencies that align with IOM Competencies required for all health care providers Focus: Improve care for patients through competent care
QI History QI History Origins in manufacturing 1980 s Deming Post WWII rebuilding industry Constancy of Purpose to improve Donabedian Structure: availability and quality of services Process: measures deliver of care Outcome: final result; mortality Healthcare initiative 1993 HMO Group conference on Total Quality Management Operations Focus
What is Quality Improvement in Health care? What is Quality Improvement in Health care? ..the combined and unceasing efforts of everyone healthcare professional, patients and their families, researcher, payers, planner and educators to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning) .. Batalden, P; Davidoff, F (2007)
QI Theory: Improvement Knowledge QI Theory: Improvement Knowledge 1) Knowledge of a system 2) Knowledge of variation 3) Knowledge of psychology 4) Theory of knowledge
Quality Improvement (QI) Look at waste and variation and eliminate it Identify where to make changes in the system Resource for Learning Tools and Strategies for Quality Improvement and Patient Safety - http://www.ncbi.nlm.nih.gov/books/NBK2682
Model for Improvement PDSA Plan idea for action Do make the change Study test it and collect data Act adjust actions PDSA (Plan, Do, Study, Act) What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in improvement?
Using Sequential Using Sequential PDSA Cycles to Build PDSA Cycles to Build Knowledge and Knowledge and Improve Care Improve Care
Essential Features For Quality Improvement Essential Features For Quality Improvement Systems thinker Data Leadership skills Theory of improvement Creativity Industry assessment
Quality Improvement Assignment Student Assignment using Model for Improvement Improve something about yourself Presentation of data: Describe Aim PDSA (Plan, make the change, test it, study it, adjust actions) Use of Tools (flow charts, check sheets, run charts, bar graphs) IHI Toolkit for Reporting Data PDSA (Plan, Do, Study, Act) What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in improvement?
References: Batalden, P. & Davidoff, F. (2007). What is quality improvement and how can it transform healthcare. Quality and Safety in Healthcare;16: 2-3 Grol, R. (2001). Improving the quality of medical care: Building bridges among professional pride, payer profit, and patient satisfaction. JAMA; 286(20):2578-85. Schuster,, M. A., McGlynn, E. A., & Brook, R. H. (1998). How good is the quality of health care in the United States? Milbank Quarterly;76(4):517-63, 509.
