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Quality Improvement

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Management and Leadership – A Guide for Clinical Professionals

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Abstract

Increasing patient demands and expectations, an ever expanding complexity of healthcare needs and dwindling resources mean that an understanding and incorporation of quality improvement into daily practice has become essential for all healthcare professionals. Clinicians, managers and information technology analytical professionals each have quite different areas of expertise and at times speak very different languages. These diverse groups must learn to work together, communicate effectively, analyse structures and processes, manage change and evaluate outcomes to bring about meaningful sustainable improvements in healthcare delivery.

In this chapter we discuss the introduction of quality improvement techniques into the modern healthcare setting, outline some basic quality improvement principles and terminology and introduce some tools that can be used by healthcare teams on their local quality improvement journey.

Quality is everybody’s responsibility

—W. Edwards Deming

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References

  1. James BC, Savitz LA (2011) How Intermountain trimmed health care costs through robust quality improvement efforts. Health Aff (Millwood) 30:1185–1191

    Article  Google Scholar 

  2. Scrivens E (1997) Putting continuous quality improvement into accreditation: improving approaches to quality assessment. Qual Health Care 6:212–218

    Google Scholar 

  3. Improvement IoH (2014). http://www.ihi.org/about/pages/default.aspx. Accessed 19 July 2014

  4. Jones FG (1990) Continuous quality improvement (CQI): solution to QA shortcomings? J S C Med Assoc 86:593–596

    CAS  PubMed  Google Scholar 

  5. Berwick DM (1989) Continuous improvement as an ideal in health care. N Engl J Med 320:53–56

    Article  CAS  PubMed  Google Scholar 

  6. Medicine Io (2001) Crossing the quality chasm: a new health system for the 21st Century America CoQoHi (ed). National Academy Press, Washington DC

    Google Scholar 

  7. Berwick DM, Godfrey A, Roessner J (1990) Curing health care: new strategies for quality improvement. Jossey-Bass, San Francisco

    Google Scholar 

  8. Berwick D (1990) Escape fire: designs for the future of health care. Jossey-Bass, Hoboken

    Google Scholar 

  9. Berwick DM (1996) Harvesting knowledge from improvement. JAMA 275:877–878

    Article  CAS  PubMed  Google Scholar 

  10. Benneyan JC, Lloyd RC, Plsek PE. Statistical process control as a tool for research and healthcare improvement. Qual Saf Health Care 12:458–464

    Google Scholar 

  11. Miyake D (2010) Balanced scorecard measurement and control charting theory. Boston. http://www.ascendantsmg.com/blog/index.cfm/2010/11/20/Balanced-Scorecard-Measurement–Control-Charting-Theory. Accessed 30 June 2014

  12. Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D et al (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321:694–696

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Nelson EC, Mohr JJ, Batalden PB, Plume SK (1996) Improving health care, Part 1: the clinical value compass. Jt Comm J Qual Improv 22:243–258

    CAS  PubMed  Google Scholar 

  14. Nadzam DM, Nelson M (1997) The benefits of continuous performance measurement. Nurs Clin North Am 32:543–559

    CAS  PubMed  Google Scholar 

  15. Gruber S (2012) Is it a metric or a Key Performance Indicator(KPI)? Healthcare Analytics [serial on the Internet]. 2014. http://healthcareanalytics.info/2012/02/is-it-a-metric-or-a-key-performance-indicator-kpi./#.Uw0LtWJ_uSp. Accessed 25 Feb 2014

  16. Sprague AE, Dunn SI, Fell DB, Harrold J, Walker MC, Kelly S et al (2013) Measuring quality in maternal-newborn care: developing a clinical dashboard. J Obstet Gynaecol Can 35:29–38

    PubMed  Google Scholar 

  17. Murphy BP, Armstrong K, Ryan CA, Jenkins JG (2010) Benchmarking care for very low birthweight infants in Ireland and Northern Ireland. Arch Dis Child Fetal Neonatal Ed 95:F30–35

    Google Scholar 

  18. Richardson D, Tarnow-Mordi WO, Lee SK (1999) Risk adjustment for quality improvement. Pediatrics 103:255–265

    CAS  PubMed  Google Scholar 

  19. (1993) The CRIB (clinical risk index for babies) score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. The International Neonatal Network. Lancet 342:193–198

    Google Scholar 

  20. Richardson DK, Corcoran JD, Escobar GJ, Lee SK (2001) SNAP-II and SNAPPE-II: simplified newborn illness severity and mortality risk scores. J Pediatr 138:92–100

    Article  CAS  PubMed  Google Scholar 

  21. De Felice C, Del Vecchio A, Latini G (2005) Evaluating illness severity for very low birth weight infants: CRIB or CRIB-II? J Matern Fetal Neonatal Med 17:257–260

    Google Scholar 

  22. Horbar JD (1999) The Vermont Oxford Network: evidence-based quality improvement for neonatology. Pediatrics 103:350–359

    CAS  PubMed  Google Scholar 

  23. Zupancic JAF, Richardson DK, Horbar JD, Carpenter JH, Lee SK, Escobar GJ et al (2007) Revalidation of the Score for Neonatal Acute Physiology in the Vermont Oxford Network. Pediatrics 119:e156–e163

    Article  PubMed  Google Scholar 

  24. Gagliardi L, Bellu R (2007) Score for Neonatal Acute Physiology (SNAP) or Vermont Oxford risk-adjustment model for very low birth weight infants? Pediatrics 119:1246–1247; (author reply 7

    Google Scholar 

  25. Horbar JD, Plsek PE, Leahy K (2003) NIC/Q 2000: establishing habits for improvement in neonatal intensive care units. Pediatrics 111:e397–e410

    PubMed  Google Scholar 

  26. Ellsbury DL, Ursprung R (2010) A primer on quality improvement methodology in neonatology. Clin Perinatol 37:87–99

    Article  PubMed  Google Scholar 

  27. Horbar JD, Rogowski J, Plsek PE, Delmore P, Edwards WH, Hocker J et al (2001) Collaborative quality improvement for neonatal intensive care. NIC/Q Project Investigators of the Vermont Oxford Network. Pediatrics 107:14–22

    Article  CAS  PubMed  Google Scholar 

  28. Huskins WC (2012) Quality improvement interventions to prevent healthcare-associated infections in neonates and children. Curr Opin Pediatr 24:103–112

    Article  PubMed  Google Scholar 

  29. Kilbride HW, Wirtschafter DD, Powers RJ, Sheehan MB (2003) Implementation of evidence-based potentially better practices to decrease nosocomial infections. Pediatrics 111:e519–e533

    Article  PubMed  Google Scholar 

  30. Wirtschafter DD, Powers RJ, Pettit JS, Lee HC, Boscardin WJ, Ahmad Subeh M et al (2011) Nosocomial infection reduction in VLBW infants with a statewide quality-improvement model. Pediatrics 127:419–426

    Article  PubMed Central  PubMed  Google Scholar 

  31. Wirtschafter DD, Pettit J, Kurtin P, Dalsey M, Chance K, Morrow HW et al (2010) A statewide quality improvement collaborative to reduce neonatal central line-associated blood stream infections. J Perinatol 30:170–181

    Article  CAS  PubMed  Google Scholar 

  32. Payne NR, Barry J, Berg W, Brasel DE, Hagen EA, Matthews D et al (2012) Sustained reduction in neonatal nosocomial infections through quality improvement efforts. Pediatrics 129:e165–e173

    Article  PubMed  Google Scholar 

  33. Gill AW, Keil AD, Jones C, Aydon L, Biggs S (2011) Tracking neonatal nosocomial infection: the continuous quality improvement cycle. J Hosp Infect 78:20–25

    Article  CAS  PubMed  Google Scholar 

  34. Bizzarro MJ, Sabo B, Noonan M, Bonfiglio MP, Northrup V, Diefenbach K (2010) A quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit. Infect Control Hosp Epidemiol 31:241–248

    Article  PubMed  Google Scholar 

  35. Narine L, Persaud DD. (2003) Gaining and maintaining commitment to large-scale change in healthcare organizations. Health Serv Manage Res 16:179–187

    Article  CAS  PubMed  Google Scholar 

  36. Strome TL (2013) Healthcare analytics for quality and performance improvement. Wiley, Hoboken

    Book  Google Scholar 

  37. Spitzer AR, Ellsbury DL, Handler D, Clark RH (2010) The pediatrix babysteps data warehouse and the pediatrix qualitysteps improvement project system–tools for “meaningful use” in continuous quality improvement. Clin Perinatol 37:49–70

    Article  PubMed  Google Scholar 

  38. Spencer A, Modi N (2013) National neonatal data to support specialist care and improve infant outcomes. Arch Dis Child Fetal Neonatal Ed 98:F175–F180

    Google Scholar 

  39. Services USDoHH HRSA clinical quality and performance measures supplemental technical assistance (2011). http://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/index.html. Accessed 27 March 2014

  40. Colleges AoMR (May 2009) Medical leadership competency framework. . http://www.leadershipacademy.nhs.uk/discover/leadership-framework/. Accessed 25 February 2014

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Author information

Authors and Affiliations

  1. Cork University Maternity Hospital, HSE South, Wilton, Cork, Ireland

    Dr. Brendan Paul Murphy MD, FRCPI, FRCPCH, MRCP, DCH, Dip. Health Care Management

  2. Department of Paediatrics and Child Health, University College Cork, Cork, Ireland

    Dr. Brendan Paul Murphy MD, FRCPI, FRCPCH, MRCP, DCH, Dip. Health Care Management

Authors
  1. Dr. Brendan Paul Murphy MD, FRCPI, FRCPCH, MRCP, DCH, Dip. Health Care Management
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Correspondence to Brendan Paul Murphy MD, FRCPI, FRCPCH, MRCP, DCH, Dip. Health Care Management .

Editor information

Editors and Affiliations

  1. Department of Neonatal Paediatrics, KEM Hospital for Women, Perth, West Australia, Australia

    Sanjay Patole

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Murphy, B. (2015). Quality Improvement. In: Patole, S. (eds) Management and Leadership – A Guide for Clinical Professionals. Springer, Cham. https://doi.org/10.1007/978-3-319-11526-9_6

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  • DOI: https://doi.org/10.1007/978-3-319-11526-9_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-11525-2

  • Online ISBN: 978-3-319-11526-9

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