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Defining Quality

Defining Quality. 2013 Albuquerque Area Dental Chiefs/Prevention Coordinators Meeting June 05, 2013 Kristina Rogers, MMI, CPC John M. Shutze, MPH, CQIA. Learning Objectives. Define Quality Identify Approaches to Quality Identify Types of Measures for Quality. Defining Quality.

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Defining Quality

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  1. Defining Quality 2013 Albuquerque Area Dental Chiefs/Prevention Coordinators Meeting June 05, 2013 Kristina Rogers, MMI, CPC John M. Shutze, MPH, CQIA

  2. Learning Objectives • Define Quality • Identify Approaches to Quality • Identify Types of Measures for Quality

  3. Defining Quality Quality Philosophies & Definitions Approaches to Quality Picking Appropriate Quality Measures

  4. Activity • Draw An Image Of Quality • First Thing That Comes To Mind • 5 Minutes Total To Complete This Exercise

  5. 0 0 9 0 0 0 5 3 8 6 5 4 3 2 1 7 0 9 5 1 8 7 6 5 4 3 2 3 0 4 9 8 7 6 5 4 4 2 3 9 8 7 6 5 4 2 7 1 0 2 1 9 8 6 1 5 0 0 3 2 1 0 4 8 9 6 5 4 3 2 1 0 7 You Have Hours Minutes Seconds

  6. 0 0 9 0 0 0 4 3 8 6 5 4 3 2 1 7 0 9 5 1 8 7 6 5 4 3 2 3 0 4 9 8 7 6 5 4 3 2 3 9 8 7 6 5 4 2 7 1 0 2 1 9 8 6 1 5 0 0 3 2 1 0 4 8 9 6 5 4 3 2 1 0 7 You Have Hours Minutes Seconds

  7. 0 0 9 0 0 0 3 3 8 6 5 4 3 2 1 7 0 9 5 1 8 7 6 5 4 3 2 3 0 4 9 8 7 6 5 4 2 2 3 9 8 7 6 5 4 2 7 1 0 2 1 9 8 6 1 5 0 0 3 2 1 0 4 8 9 6 5 4 3 2 1 0 7 You Have Hours Minutes Seconds

  8. 0 0 9 0 0 0 2 3 8 6 5 4 3 2 1 7 0 9 5 1 8 7 6 5 4 3 2 3 0 4 9 8 7 6 5 4 1 2 3 9 8 7 6 5 4 2 7 1 0 2 1 9 8 6 1 5 0 0 3 2 1 0 4 8 9 6 5 4 3 2 1 0 7 You Have Hours Minutes Seconds

  9. 0 0 9 0 0 0 1 3 8 6 5 4 3 2 1 7 0 9 5 1 8 7 6 5 4 3 2 3 0 4 9 8 7 6 5 4 0 2 3 9 8 7 6 5 4 2 7 1 0 2 1 9 8 6 1 5 0 0 3 2 1 0 4 8 9 6 5 4 3 2 1 0 7 You Have Hours Minutes Seconds

  10. What Is Quality? Quality Philosophies Definitions of Quality

  11. Quality Philosophies Quality Guru View of Quality It’s Up To Management It’s Not Accidental Quality Vaccine • W.E. Deming • Joseph Juran • Philip Crosby

  12. Common Definitions

  13. I’ll Know It When I See It

  14. Fitness For Use

  15. Conformance to Requirements

  16. What Is Quality? • Know It When I See It • Fitness for Use • Conformance to Requirements • Meeting Customer Expectations • Exceeding Customer Expectations • Superiority to Competitors • Safe • Effective • Patient-Centered • Timely • Efficient • Equitable

  17. Approaches To Quality IHI/PDSA Lean Six Sigma Accreditation

  18. IHI/Model for Improvement

  19. PDSA Cycles • Increase Belief Change Will Result in Improvement • Small Tests = Small Risk • Rapid Cycle Testing = Quick Feedback • Multiple Cycles = Iterative Learning • List of Changes & Outcomes for an Improvement Process

  20. Lean Eliminating Waste & The Pursuit of Perfection

  21. What Is Lean? • Toyota Production System • Reduce Waste (muda) • Change for the Better (kaizen) • More Customer Value • Pursue Perfection

  22. Six Sigma Eliminating Errors & Improving The Bottom-Line

  23. What Is Six Sigma? • Motorola • Fact-Based, Data Driven • Defect Reduction/Prevention • Customer Centered • Bottom-Line Results • Project Based

  24. Accreditation Joint Commission Patient-Centered Medical Home

  25. Accreditation to Drive Quality • Systems Approach • Set of Standards • Provides Direction • Helps Build Capacity

  26. Summary of Approaches

  27. Approaches & Tools * Additional tools are available for each approach. The primary references used for this toolkit include the Institute for Healthcare Improvement (IHI) and the American Society for Quality (ASQ). Lean Sigma uses a combination of tools from both the lean and six sigma.

  28. Picking Quality Measures Uses of Measures Types of Measures Developing Measures

  29. Uses of Quality Measures Research Improvement Accountability Quality Measures

  30. Uses of Quality Measures

  31. Uses of Quality Measures

  32. Uses of Quality Measures

  33. Uses of Quality Measures

  34. Types of Measures Measure Type Focus Infrastructure & Capacity Delivery of Care Ultimate Goal Different Perspectives • Structural • Process • Outcome • Balancing

  35. A Good Measure Is… • Aligned With The Mission • Important to Customers • Actionable • Accessible to People

  36. More Tips… • Plot Data Over Time • Use Sampling • Make It Routine • Use Qualitative & Quantitative Data

  37. The Details

  38. Questions?

  39. References Associates in Process Improvement (August, 2007). The improvement handbook: models, methods & tools for improvement. Version for : IHI Improvement Advisor Development Program. Bauer, J.E., Duffy, G.L., Westcott, R.T. (2006). The quality improvement handbook (2nd ed.). Milwaukee, WI: American Society for Quality Bialek, R., Duffy, G.L., Moran, J.W. (2009). The public health quality improvement handbook. Milwaukee, WI: American Society for Quality. Duke, O. (Sept, 2008). Driven by metrics. Quality Progress. Milwaukee, WI: American Society for Quality. National Quality Measures Clearinghouse. Tutorials on quality measure. Available at: www.qualitymeasures.ahrq.gov/tutorial/index.aspx

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