Quality Management of Healthcare
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1 Management of Healthcare Shell Conference This Session Introduction Urgency Improvement Management 1
2 Hello! Industrial and Systems Engineer MS in Health Systems Engineering Past Work: Hospital Based Improvement Healthcare IT Consulting Areas of Focus Measurement Continuous Improvement Safety Culture 3 Synensis 4 2
3 Parking Lot 5 Today 6 3
4 Experience with Improvement Please rate your level of knowledge and experience in healthcare quality improvement Little experience Some experience 30% 7% Lots of experience 63% 7 Who is at the center of healthcare delivery? The Patient 8 4
5 This Session Introduction Urgency Improvement Management Do we have a problem? How much harm occurs? 10 5
6 11 United States IOM report in ,000 deaths per year 2013 report in Journal of Patient Safety 220, ,000 deaths per year Third leading killer in US (Leapfrog) Behind Cancer and Heart Disease Medical harm occurring is estimated to be over 40,000 each and EVERY day (IHI) wrong site surgeries per week Annual Cost of Harm = $17.1 Billion USD 12 6
7 Harm in Nigeria 13 Harm in Africa The incidence of clinical negligence and medical error in African countries including South Africa is unknown as there are no accurate statistics. This has a huge impact on healthcare services delivery. Professor Chima Managing clinical negligence and medical error in South African hospitals: Implications for the National Health Insurance Scheme 14 7
8 Root Cause 7/14/2014 What is causing this harm? Human Factors Communication Leadership Assessment Information Management Physical Environment Care Planning Continuum of Care Medication Use Operative Care 2013 Root Causes of Sentinel Events (Reviewed by Joint Commission) 9% 9% 12% 11% 17% 16% 57% 63% 62% 72% N = 887 0% 10% 20% 30% 40% 50% 60% 70% 80% % of Reviewed Sentinel Events *Source: The Joint Commission, Office of Monitoring, Sentinel Event Data Root Causes by Event Type We have a problem. Poor 16 8
9 Change 17 This Session Introduction Urgency Improvement Management 9
10 19 Other Industries 10
11 Definitions from Group Delivering healthcare service in an environment where care and safety of your patients and the workers in the facility is taken as priority. There should clear protocols and procedures. Safe, effective and cost optimized health care delivery 22 11
12 Components Safe Timely Effective Efficient Equitable Patient-centered Source: Institute of Medicine Components Safe: Treatment helps patients and does not harm them in any way. Source: Institute of Medicine 12
13 Components Timely: Patients get care at a time they need it most and when it will do them the most good. Source: Institute of Medicine Components Effective: The right kind of care is provided that is based on sound scientific knowledge and research that treatments have positive benefits and outcomes. Source: Institute of Medicine 13
14 Components Efficient: Treatment does not result in waste of any kind (i.e., time, money, other resources) and is provided in the right manner. Source: Institute of Medicine Components Equitable: Care does not vary in quality, irrespective of financial status, culture, ethnicity, level of education, social status, etc. Source: Institute of Medicine 14
15 Components Patient-centered: Care provided is focused solely on the patient, and is responsive to individual preferences, needs and values. Source: Institute of Medicine Where do I/we start? GAP Safe Timely Effective Efficient Equitable Patient-centered Where am I? Where are we? Where do I/we want to be? 15
16 Envisioning Exercise At your table: 1) Discuss and record the current quality of care in Nigeria. Use the STEEEP framework to articulate your thoughts. 2) Discuss and record the improvements in the quality of care are that are needed in Nigeria. 3) Choose a representative to report out to the group. 31 Definition of Risk Human Error + Deviation from Standards = the possibility of suffering harm or loss; danger. 16
17 Management Planning Improvement Management Control Assurance 33 Who is responsible for care? Leaders Teams Systems Patients 17
18 This Session Introduction Urgency Improvement Management The PDCA Cycle of Improvement Take Next Steps to Improve Adopt Adjust Abandon Act Plan Design/Redesign Process What, Who, How When, Where Evaluate Results Analyze data results Obtain lessons learned Brainstorm improvements Check Do Implement Process Pilot process, if possible Collect data Source: Institute of Medicine (IOM) 18
19 Sustainable Improvement Will standards and a quality management framework be enough to create sustainable improvement? 37 19
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