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Flashcards in Test 1 Deck (33):
1

Who was Florence Nightingale

She decreased crowding and improved sanitation in British military hospitals, founder of modern nursing

2

Who was Earnest Codman?

Boston surgeon with a knack for studying medical outcomes

3

What is underuse?

Neglecting to give patients necessary medical care under best practices

4

What is overuse?

Giving drugs or treatment without medical justification

5

What is misuse?

Essentially medical errors

6

How does Donabedian define quality health care?

Health care that is delivered through the right structure, using the right processes, and produces good outcomes. (structure, processes, outcomes)

7

IOM Six aims for improvement:

Safety (no harm to the patient).
Effectiveness (no underuse or overuse)
Patient-centered
Timeliness (avoid unintended waiting that doesn't benefit the patient)
Efficiency
Equity

8

Quadruple aim

Experience, Pop health, and reduce cost, improve work life of providers

9

What should scorecards include?

Measures of healthcare performance, financial performance, customer assessment, internal assessment, innovation

10

What does HCAHPS stand for?

Hospital Consumer Assessment of Healthcare Providers and Systems

11

Safety =

Freedom from accidental injury

12

Error =

use of an incorrect plan, or failure to execute as needed

13

Adverse event

Cause of injury to a patient

14

Injury

Damage to patient caused by medical care

15

Can errors, adverse events caused by errors, and adverse events no caused by errors be preventable?

Yep!

16

Active error

Unsafe acts by people interacting with patients: slips and mistakes

17

Latent error

Design faults or faults in the established procedures

18

What is the bad apple approach?

Eliminate the bottom 2.5% of your providers constantly

19

How did process improvement change the typical bad apple approach?

individual performance was no longer the sole determinant of overall performance, big focus on system errors

20

What is the model for improvement?

PDSA

21

What makes a good aim statement?

Quant target, timeline, specific aspect of care

22

Well crafted measure?

Good definition, specifies quantity and unit of measure, population, no ambiguity

23

Criticisms of RCA

Focused on uncovering single fundamental reason for error, hindsight bias, organizational politics bias, weak recommendations, rarely follow up to concerns

24

Lean is also known as

TPS

25

Kaizen

continuous improvement

26

Muda

waste

27

7 wastes

Overproduction
Waiting
Unnecessary transportation
Overprocessing
Unneeded inventory
Unnecessary movement
Defects

28

Key tool of lean:

value stream maps

29

DMAIC

Define
Measure
Analyze
Improve
Control

30

Focus of: PDSA, Lea, Six-Sigma

Improve particular process, eliminate waste, decrease variation

31

What is TeamSTEPPS

Team training based on Crew Resource Management (CRM), improve safety for short-duration teams in high-risk, high-stress situations

32

TeamSTEPPS behavioral routines:

Huddles, debriefs, SBAR communication, handoff checklist sequences

33

Simulation is most often used to train

anesthesiologists