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Assessing Process and Audit Measures. Armstrong Institute for Patient Safety and Quality Jill A. Marsteller, PhD, MPP Sept. 27, 2012. Learning Objectives. You will be able to: Explain why measuring process is critical to success Describe process measures planned for collection

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assessing process and audit measures

Assessing Process and Audit Measures

Armstrong Institute for Patient Safety and Quality

Jill A. Marsteller, PhD, MPP

Sept. 27, 2012

learning objectives
Learning Objectives
  • You will be able to:
    • Explain why measuring process is critical to success
    • Describe process measures planned for collection
    • Detail the planned collection process
donabedian model

Process

Outcome

Structure

Donabedian Model

How we organize care

The results we achieve

What we do during care delivery

E.g., presence of policies or committees

E.g., how often are evidence-based interventions performed

E.g., how/ how many patients are harmed

approaches to measuring process
Approaches to measuring process
  • Measures of perception
    • Accessible
    • Subject to bias
  • Regular process measures collection (audits)
    • More objective
    • Burdensome
  • Less frequent auditing
    • Less burdensome
    • Less reliable
process measures you already collect
Process measures you already collect
  • SCIP/STS
    • Abx selection
    • Abx timing
    • Abx stop w/in 48 hours
    • Glucose measure
    • Hair removal
new measures audit topics
New Measures/ Audit Topics
  • CLABSI:
    • Insertion (OR, ICU)
    • Maintenance (ICU, Floor)
  • CUSP:
    • Daily goals; AM Briefing; LFD (ICU, Floor, universal)
    • Briefing/debriefing ; Huddle; LFD (OR)
  • VAP process measures:
    • E.g., HOB elevation
    • E.g., sedation vacation
  • SSI:
    • Skin prep (type, appropriateness)
    • Antibiotic redosing
audit data how to
Audit data: “How To”
  • The timeline will tell you what to audit for the coming month
  • Collect data once a week and report at end of month
  • Methods: Observations; counts with measure/ count total eligible; answer Qs
  • When you enter web tool, it will tell you what audit data is due this month
  • Web-based data entry forms
examples
Examples
  • Daily Goal Audit—Once weekly count the number of patients that had a Daily Goals sheet filled for them during interdisciplinary rounds; also count total number of patients. Report: DG patients and total
  • LFD Audit—Count number of defects worked on in last quarter; number resolved; number posted; number evaluated for effects
  • AM Briefing /Huddle/ OR Briefing/ Debriefing Audit—observe XX opportunities for briefings; Report: number of briefings conducted and number of opportunities
how process measurement helps you
How process measurement helps you
  • Compliance is key to providing evidence-based practice
  • EBP allows you to meet your outcomes goals
  • Process measures provide a “map” to what’s working well and what’s not
  • Regular feedback on performance essential to performance and buy-in (transparency)
  • Use your data to inform, motivate, communicate laterally and upward
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Armstrong Institute for Patient Safety and Quality

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Armstrong Institute for Patient Safety and Quality

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Armstrong Institute for Patient Safety and Quality

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Armstrong Institute for Patient Safety and Quality

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Armstrong Institute for Patient Safety and Quality

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Armstrong Institute for Patient Safety and Quality

action items
Action Items
  • Try out our new site!
  • Set up new members
  • Begin data entry for:
    • Rates
    • TCT
    • Audits

Contact us at csts@jhmi.edu for support.

Training for Surveys, VAP Daily Process Forms, Reports, and additional features are upcoming.