In this presentation, Learning team B will discuss common problems encountered in the hospital, ways in which decisions are made dealing with risk and quality management issues. We will provide a scenario and give our advice on how to decrease the transmission of hospital acquired infections.
Then we will discuss challenges the team faced while completing this assignment. Encountered problems with Hospital Decision Making (Felicia) Acquired Information for Decision Making (Felicia) Common Decision Making Tools (Felicia) Challenges that may be encountered in risk and quality management (Mom) Waiting until the last minute and then not having enough time to make an informed decision is not only a risk in any organization; it is a quality issue also. When individuals are rushed they tend to make mistakes or overlook important information that may be needed to make decisions. If one misses important information the quality of service may be affected. Not using a well thought out method to when decision making may lead to the wrong action or measure being taken.
For example, if a nurse has a patient with a pressure ulcer and the nurse has no guideline or routine that is enforced for this type of pressure ulcer then the treatment that the nurse gives may not be the best for the patient. When one makes a decision one must use the information available to make the best possible decision for the best outcome. If the information available is not accurate then the wrong decision could be made. This is not only a risk but it may decrease the quality of the organization as well.
Strategies that should be adapted to improve ongoing performance (Sonya) One can measure the quality of health care by observing its structure, processes, and outcomes. Structure measures assess the accessibility, availability, and quality of resources, such as health insurance, bed capacity of a hospital, and number of nurses with advanced training. Process measures assess the delivery of health care services by clinicians and providers, such as using guidelines for care of diabetic patients. Outcome measures indicate the final result of health care and can be influenced by environmental and behavioral factors.
Examples include mortality, patient satisfaction, and improved health status. Decision making process tools (Mar) FMEA- A step-by-step approach for identifying all possible failures in a product or service. Best used to take actions to eliminate or reduce failures. Flow Chart- A picture of separate steps of a process in sequential order. This is used to study a process for improvement. To communicate to others how a process is done. Cause–and-effect diagram- A tool that helps identify, sort, and display possible causes of a specific problem or quality characteristic.
It graphically illustrates the relationship between a given outcome and all factors that influence the outcome. Helps determine the root causes of a problem or quality characteristic using a structured approach. Increases knowledge of the process by helping everyone to learn more about the factors at work and how they relate. Check sheet- A structured, prepared form for collecting and analyzing data. A generic tool that can be adapted for a wide variety of purposes. When collecting data on the frequency or patterns of events, problems, defects, defect location, defect causes, etc.
Control chart- A graph used to study how processes change over time. When determining whether your quality improvement project should aim to prevent specific problems or to make fundamental changes to the process. Histogram: Most commonly used graph to show frequency distributions. Frequency distributions show how often each different value in a set data occurs. When analyzing whether a process can meet the customers requirements. When seeing whether a process change has occurred from one time period to another. When you wish to communicate the distribution of data quickly and easily to others.
Pareto chart: A bar graph. The lengths of the bars represent frequency or cost (time or money) and are arranged with longest bars on the left and shortest on the right. The chart visually depicts which situations are more significant. When there are many problems or causes and you want to focus on the most significant. Analyzing broad causes by looking at their specific components. Run chart: Display process performance over time. Detect special causes of variations. * Scatter diagram: Graphs pairs of numerical data with one variable on each axis, to look for a relationship between them.
If the variables are correlated, the points will fall along a line or curve. The better the correlation the tighter the points will hug the line. When numerical data is paired. When your dependent variable may have multiple values for each value of your independent variable. When trying to figure out whether two variables are related. Scenario (Sonya) ABC organization has noticed an increase in patients who have acquired infections while receiving care and service. In fact, there seems to be so many different types of infections that the organization does not know where to start.
With your guidance, the organization will be able to identify infections and the number of infections per category throughout the facility to determine the vital few and focus their efforts on the few areas that will bring about the greatest return on investment of time and effort. The organization needs to identify which infections affect the most patients. Information needed (mom) This is a check sheet that shows what information is needed to identify the types of infections that are being acquired in the hospital.
One the infection is identified then one must find the prevalence of the infection. Who is being infected, how are they being infected, how to treat the infection and so on and so forth. This check sheet will let the hospital know all the information needed to decrease the rate of infections. Why the process (MAR) The check sheet is one of the tools of choice because it enables the hospital to find out which patients are affected, when and where the infection may be coming from and other information needed to stop the spread of infection.
A cause-and-effect diagram was chosen because it shows the cause of infections so that we can come up with a plan and enforce current plans to decrease the likely hood that the infection will occur. The Pareto Chart gives the hospital a way to tract the infection and how much the infections will cost the hospital. Decision (Mom) The reason that we have chosen each process is because these processes give the hospital a way to identify the types of infection and the ways in which the infections are being transported to the patients.
They will identify which units are having the most infection rates so that we will know who needs reinforcement with infection control. This will track what infections are occurring so that infection control policies can be updated in a timely fashion to help minimize infection occurrence. Changes (MAR) Changes of the results that we are finding include but are not limited to the decrease of nosocomial infections. They will make the staff more aware of infection control. This will also give the hospital ample opportunity to retrain staff that are not up to par or are noncompliant with infection control policies.
Explanation (Mom) Quality of service is a major issue in health care. The plans that are in place are meant to identify infections. Identify units that are most affected. The patients are our main priority. This will tell us what type of patients are more likely to get the infection. We want to decrease the number of infections that occur by reinforcing the infection control policies. This will increase patient safety and patient satisfaction which will save the hospital money in the long run.
Challenges (Mar) The challenges that our team faced while completing the assignment were time restraints. We all have different schedules and time availability. We have learned to adapt so that the assignment is completed in a timely fashion. We also realized that we need to communicate precisely what each of our parts in assignment should be. The most important thing that we found challenging was interpreting what exactly the assignment requirements were. We will be sure to make sure we ask questions if we need clarification in the future.
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