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Quality and Safety Flashcards

(47 cards)

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1
Q

What are the WHO domains of quality healthcare?

A
  • Safe
  • Effective
  • Timely
  • Integrated
  • People-centred
  • Efficient
  • Equitable
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2
Q

What is the Australian Health Performance Framework?

A

Supports system-wide reporting on Australia’s health and health care performance, to:

  • Support assessment and evaluation of value and sustainability, and
  • Inform identification of priorities for improvement and development
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3
Q

What are the three tiers of the AHPF?

A
  • Tier 1: social determinants
  • Tier 2: health system performance
  • Tier 3: health status and outcomes

EQUITY throughout

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4
Q

What are the components of Tier 2 of the AHPF?

A

CAArEESS

  • Continuity of care
  • Accessibility
  • Appropriateness
  • Effectiveness
  • Efficiency
  • Sustainability
  • Safety
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5
Q

What is the Aboriginal and Torres Strait Islander HPF?

A

Similar to the AHPF but informed / co-developed with coalition of peak Aboriginal / Torres Strait Islander organisations.

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6
Q

How is the Aboriginal / Torres Strait Islander HPF different to the AHPF?

A

Similar except for the tier 2 quality components:

CCAAREES

Continuous
Capable
Accessible
Appropriate
Responsive
Effective
Efficient
Sustainable

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7
Q

What are the components of cultural safety in healthcare for Indigenous Australians (monitoring framework)?

A

Three components:

  • Access - same level of care
  • Culturally respectful service - provider behaviour, attitudes, and culture respects and understands Indigenous culture
  • Patient experiences - do patients feel like cultural idendity is respected?
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8
Q

What are the broad categories of the social determinants?

A

Four domains:

  • Individual biomedical factors
  • Health behaviours
  • Socioeconomic status
  • Environment
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9
Q

What are the biomedical factors of the SDoH?

A

Genetic-level susceptibility to disease e.g. BP, cholesterol, body weight

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10
Q

What are the behavioural factors of the SDoH?

A

Attitudes, beliefs, knowledge and behaviour e.g. patterns of smoking, alcohol, eating, physical activity

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11
Q

What are the socioeconomic factors of the SDoH?

A

Education, employment, income, housing, social isolation

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12
Q

What are the environmental factors of the SDoH?

A

Physical, chemical and biological factors e.g. water, food, air and soil quality

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13
Q

In the AHPF, what are the indicators for the determinants of health?

Biomedical, behavioural, SE, environmental factors

A

Biomedical - obesity / overweight
Behavioural - alcohol / smoking / physical activity / fruit and veg consumption / needle-sharing
Socioeconomic - low income, education level
Environmental

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14
Q

In the AHPF, what are the indicators for Tier 2?

CAArEESS

A

Continuity of care - readmissions
Accessibility - GP bulk billing, ED and surgical wait times
Appropriateness -
Effectiveness - immunisation rates, antenatal care, cancer screening, cancer rates, preventable hospitalisation, avoidable deaths
Efficiency - cost per weight separation, net growth in health workforce
Sustainability -
Safety - adverse events, SABI, sentinel events

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15
Q

What are the sub-domains of tier 3 in the AHPF?

A

Four sub-domains:

  • Health conditions
  • Human function - activity limitations, restrictions to participation
  • Wellbeing - physical, mental, social
  • Death - mortality rates, life expectancy
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16
Q

In the AHPF, what are the indicators for Tier 3: health status?

Health conditions, human function, wellbeing, deaths

A

Health conditions - ACS, diabetes, CKD, cancer, STIs/BBVs, injury/poisoning, LBW babies
Health function - severe / profound core activity limitation
Wellbeing - psychological distress, self-assessed health status
Deaths - infants/young child, LE, major causes of death, suicide

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17
Q

What are the levels of care through the patient journey?

A
  • Prevention (primordial, SDoH, primary)
  • Community and family-based care (primary prevention)
  • Primary care (secondary prevention)
  • Secondary and tertiary care (tertiary prevention)
  • End of life care
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18
Q

What are the 5As of the Levesque model of healthcare access (supply)?

A

Ac Af Ap Ap Av

  • Approachability
  • Acceptability
  • Availability / accommodation
  • Affordability
  • Appropriateness

A cfppv

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19
Q

What are the 5 domains of the Levesque model of healthcare (demand)

Study These Flashcards
A

SPPER

Seek
Perceive
Pay
Reach
Engage

20
Q

Levesque model: explain acceptability

Study These Flashcards
A

Comfortable

Professional values, norms, culture

21
Q

Levesque model: explain affordability

Study These Flashcards
A

Cost

Direct, indirect, opportunity costs

22
Q

Levesque model: explain approachability

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A

Interaction

Outreach, information, transparency, screening

23
Q

Levesque model: explain appropriateness

Study These Flashcards
A

Meets needs

Quality (technical, interpersonal), adequacy, coordination, continuity

24
Q

Levesque model: explain availability and accommodation

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A

**Location, time, format
**
Geography, opening hours, appointments

25
Levesque model: explain ability to seek
**Initiate seeking care ** Personal values, culture, gender, autonomy
26
Levesque model: explain ability to pay
**Afford** Income, assets, social capital, health insurance
27
Levesque model: explain ability to perceive
**Recognise need ** Health literacy, beliefs, trust, expectations
28
Levesque model: explain ability to engage
**Active participation ** Empowerment, information, adherence, caregiver support
29
Levesque model: explain ability to reach
**Physical access ** Living environment, transport, mobility, social support
30
What are Patient-Reported Experience Measures (PREMs)?
Patient perceptions of experiences with healthcare services. E.g. accessiblity, physical environment, clinician interaction
31
What are Patient-Reported Outcome Measures (PROMs)?
Patient perception of how health care affected their health and wellbeing e.g. questionnaires on self-reported change in health status
32
What are national and local data sources for PRMs?
* ABS - Patient Experience Survey (PES) * Consumer Assessment of Healthcare Providers and Systems (CAHPS)
33
What are the principles of patient safety and quality?
Right care, right place, right time and cost
34
What is the definition of patient safety?
Prevention of error and adverse events
35
What is the definition of quality of care?
Degree to which health services and care increase likelihood of desired health outcome and are consistent with current professional knowledge
36
What are the principles of safe and high-quality care (ASQ framework)?
* Patient centred * Evidence-based * Organised for safety
37
What are some data sources for indicators of safety / quality?
* ACSQHC * MyHospitals * Tas local reports
38
What is healthcare variation?
Differences in service delivery or outcomes compared to peers or gold standard.
39
What is a major data source for healthcare variation?
Australian Atlas of Healthcare Variation
40
What are some mechanisms for quality in healthcare? | I.e. by what means can we achieve better quality healthcare? ## Footnote X 3
* Clinical governance * Accreditation * Performance reporting
41
What is the ACSQHC?
Australian Commission on Safety and Quality in Health Care.
42
What standards does the ACSQHC produce?
* National Safety and Quality Health Service Standards (NSQHS) * National safety and Quality Primary and Community Healthcare Standards * Numerous clinical care standards e.g. sepsis, delirium, anaphylaxis
43
What are the 8 domains of safety / quality in the National Safety and Quality Health Service Standards?
1. Clinical governance 2. Comprehensive care 3. Recognising and responding to acute deterioration 4. Infection prevention and control 5. Blood management 6. Medication safety 7. Communicating for care 8. Partnering with consumers
44
What is the Aged Care Quality Commission? What standard does it regulate against?
Regulates and provides approvals to deliver aged care services. Monitors and assesses quality against Aged Care Quality Standards.
45
What is the definition of an incident? | Context: adverse events
An event that results in potential harm to the patient, or a complaint, loss or damage.
46
What is the definition of an adverse patient safety event?
An event that results in harm to a patient - disease, suffering, impairment, death.
47
What is the definition of a sentinel event?
An **wholly preventable** event that results in preventable serious harm to a patient e.g. surgery on wrong patient, wrong side, wrong procedure; ABO incompatible transfusion; medication error

Health Systems / Quality and Safety (2 decks)

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