HLSC122 Lecture Notes - Lecture 9: Health Professional, Unwarranted Variation, Transactional Leadership
2 Jun 2018
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Definition of continuous quality improvement
● Continuous quality improvement (CQI) is a system that seeks to improve the
provision of services with an emphasis on process and ongoing review and change
● Change can come about due to changes in evidence for practice, new research and
release of Clinical Practice Guidelines (CPGs)
● All staff in healthcare are part of CQI
● An important part of CQI is quality and safety improvement (QSI)
Evidence based practice (EBP) and quality and safety improvement (QSI) complement
each other
Linking EBP with QSI
● Clinical registries
● Quality improvement collaborations
● Health service accreditation
EBP and QSI
Identify area of clinical practice where there is potential for suboptimal care
● High volume, high cost, high uncertainty, high risk condition
Formulate desirable standards to care
● Find or synthesise clinical guidelines and consensus expert opinion
● Formulate standards of care tailored to local context
Determine measures of improvement in care
● Develop clinical indicators of performance measures based on care standards
● Design systems for collecting, analysing and reporting indicators
● Measure baseline performance and pilot-test the measures
Identify quality improvement strategies
● Appraise literature and collective experience regarding successful strategies
● Consider how strategies may or may not lead to desired behaviours
● Ascertain local barriers to implementation
● Select, adapt and profile the anticipated strategies
● Walk the process to identify potential defects in each step of implementation
Implement and diffuse the quality improvement strategies
● Engage and educate; explain why the change is important
● Execute; actively implement the strategies
Evaluate the changes achieved and modify the strategies
● Assess change in performance measures; look for unintended effects and
unforeseen barriers
● Modify the strategies and repeat the cycle of implementation and evaluation
Organisational strategies for supporting EBP
● Active commitment and support from senior managers
● Use of evidence to inform care delivery
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● Alignment of evidence based practice with quality and safety improvements
Alignment of EBP with QSI
● Foster system wide recognition that EBP and QSI are symbiotic
● Establish evidence based quality and safety teams
● Provide necessary resources for establishing Q&S measurement and feedback
systems
● Support the creation of clinical registries
● Maintain up-to-date inventory
● Participate in collaborations
● Seek organisational accreditation
Australian Commission on Safety and Quality in Health Care
ASCQHS:
● Monitor safety and quality standards
● Work with health professionals to identify best practice in clinical care
Goal (2012)
“People receive appropriate, evidence based care.”
Initial priorities are for:
● Acute coronary syndrome
● Transient ischemic attack
● Early care of stroke patients
ASCQHS:
● Safety of care
● Appropriateness of care
● Partnering with consumers
National Safety and Quality Framework
● Using up to date knowledge and evidence to guide decisions about care
● Safety and quality data are collected, analysed and feedback for improvement
● Taking action to improve patient’s experiences
ASCQHS - Quality Care Management
Clinical Care Standards aim to
● Support the delivery of appropriate care
● Reduce unwarranted variation in care,
● Aid shared decision making between patients, carers and clinicians
The development of the Clinical Care Standards is a priority area for the Commission
How evidence impacts CQI
● Evidence can drive change in healthcare
● Evidence can be used to challenge beliefs and practices that need to change as
more, or better quality, evidence is produced
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Continuous quality improvement (cqi) is a system that seeks to improve the provision of services with an emphasis on process and ongoing review and change. Change can come about due to changes in evidence for practice, new research and release of clinical practice guidelines (cpgs) All staff in healthcare are part of cqi. An important part of cqi is quality and safety improvement (qsi) Evidence based practice (ebp) and quality and safety improvement (qsi) complement each other. Identify area of clinical practice where there is potential for suboptimal care. High volume, high cost, high uncertainty, high risk condition. Find or synthesise clinical guidelines and consensus expert opinion. Formulate standards of care tailored to local context. Develop clinical indicators of performance measures based on care standards. Design systems for collecting, analysing and reporting indicators. Measure baseline performance and pilot-test the measures. Appraise literature and collective experience regarding successful strategies. Consider how strategies may or may not lead to desired behaviours.
