Summary The Health Care Quality Book
Summary quality and safety in health care
Chapter 1: science and knowledge foundation
Two notable contributions to the industry from the Journal of American Medical Association:
1. Assessment of the state of quality serious and widespread quality problems
2. Categorization of three defects:
a. Underuse: many scientifically sound practices are not used as often as they should be
b. Overuse: can be seen in areas such as imaging studies for diagnosis in acute asymptomatic low back pain or prescription of antibiotics when not indicated for infections.
c. Misuse: when the proper clinical care process is not executed appropriately, such as giving the wrong drug to a patients.
To Err Is Human: publication that shows the severity of the quality problems in a way that captured the attention of all key stakeholders for the first time this report spoke about the negative, not how it should be improved.
Crossing the quality chasm: provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effect and simple rules for redesign of health care.
Six dimensions of quality (Berwick):
Outcome measures and goals (IOM) = Institute of Medicine’s
Safe
Percentage of overall mortality rates/patients experiencing adverse events or harm
Effective: science and evidence should be applied and serve as the standard for delivery of care.
How well are evidence based practices followed? Percentage of time diabetic patients receive all recommended care at each doctor visit..
Efficient: Care and service should be cost effective, and waste should be removed.
Analyzing the costs of care by patient, organization, provider or community
Timely: no waits or delays in receiving care
Measured by waits and delays in receiving needed care, service, and test results.
Patient centered: system should revolve around the patient, respect its preferences and put the patient in control
Patient or family
Chapter 1: science and knowledge foundation
Two notable contributions to the industry from the Journal of American Medical Association:
1. Assessment of the state of quality serious and widespread quality problems
2. Categorization of three defects:
a. Underuse: many scientifically sound practices are not used as often as they should be
b. Overuse: can be seen in areas such as imaging studies for diagnosis in acute asymptomatic low back pain or prescription of antibiotics when not indicated for infections.
c. Misuse: when the proper clinical care process is not executed appropriately, such as giving the wrong drug to a patients.
To Err Is Human: publication that shows the severity of the quality problems in a way that captured the attention of all key stakeholders for the first time this report spoke about the negative, not how it should be improved.
Crossing the quality chasm: provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effect and simple rules for redesign of health care.
Six dimensions of quality (Berwick):
Outcome measures and goals (IOM) = Institute of Medicine’s
Safe
Percentage of overall mortality rates/patients experiencing adverse events or harm
Effective: science and evidence should be applied and serve as the standard for delivery of care.
How well are evidence based practices followed? Percentage of time diabetic patients receive all recommended care at each doctor visit..
Efficient: Care and service should be cost effective, and waste should be removed.
Analyzing the costs of care by patient, organization, provider or community
Timely: no waits or delays in receiving care
Measured by waits and delays in receiving needed care, service, and test results.
Patient centered: system should revolve around the patient, respect its preferences and put the patient in control
Patient or family