Chapter 5: promoting accountability through measurements

1. Chapter 5: promoting accountability through measurements Jamie Duffy ETM 568/ Dr. Burtner

2. Presentation Summary • Acronyms • Levels of Accountability • Case Example: Self-Extubation • Getting the Doctors on Board • Analyzing Errors • Overview Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

3. Acronyms • ACS- American College of Surgeons • AHRQ- Agency for Healthcare Research and Quality • APACHE-Acute Physiology, Age and Chronis Health Evaluation • CEO- Chief Executive Officer • CMS- Centers for Medicare and Medicaid Services • ED- Emergency Department • ICU- Intensive Care Unit • JCAHO-Joint Commission on Accreditation of Healthcare Organizations • LOS-Length of Stay • NYS DOH- New York State Department of Health • OR- Operating Room • PDCA-Plan Do Check Act • PIGG- Performance Improvement Coordination Group Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

4. Levels of Accountability Figure 5.1. Levels of Accountability High level management Middle level management Low level management Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

5. Case Example: Self-Extubations • Decrease patient self-extubation in ICUs • PDCA methodology • Specific goals for improvement: • Standardize critical care quality indicators for monthly collection and analysis • Develop admission and discharge criteria for the ICU • Improve and monitor nursing competency • Formalize protocols • Leadership support was crucial Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

6. Getting the Doctors on Board • Mortality rating has an impact of doctor reputation. • Financially punished for never events. • Held to national standards of patient safety. Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

7. Analyzing Errors • Continuously measuring care allows for data to alerts leadership when a process is beginning to fail. • A root cause analysis is used to identify the causes of the event and processes can be implemented in place to improve. • Cause and effect (fishbone or Ishikawa) diagram illustrates how various factors impact a result. • Must mandate that the hospital present a corrective action plan to alert the problem. Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

8. Overview • Accountability is promoted when leadership can evaluate the delivery of care. • Physicians must be held to an objective standard. • It is important that even nonclinical staff must understand their role in the process of care. • The use of measurements must determine gaps in patient safety and then monitor improvements. Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz

9. THANK YOU! Measuring Health Care: Using Quality Data for Operational, Financil, and Clinical Improvement by Yosef D. Dlugacz