ADMIN/NON MEDICINE
QUALITY IMPROVEMENT
PromptDefine Quality Assurance
ResponseA system to establish standards of care and monitor how well these standards are met
PromptClinical Indicators
ResponseMeasures of clinical outcome that help to point potential problems and allow comparative data
PromptBenchmarking
ResponseComparing performance with others to act as a marker and goal for improvement.
Commonly used quality measures
Waiting time vs ATS category
DNW rates
Flow measures (4hr targets)
Time to analgesia
M+M reviews
XR follow up
Commonly used quality measures
Waiting time vs ATS category
DNW rates
Flow measures (4hr targets)
Time to analgesia
M+M reviews
XR follow up
PromptOutline steps in quality improvement
ResponseDefine the problem
Determine what can be done to improve
Implement intervention
Evaluate impact of intervention
Repeat evaluation
Determine what can be done to improve
Implement intervention
Evaluate impact of intervention
Repeat evaluation
PromptList audits which ACEM recommend the department do
ResponseRegular clinical audits of (Lots. List shortened)
High volume/high risk conditions
Time to critical interventions
Triage
Time to analgesia
Unplanned returns
Audits of procedural complications
Audit of medical imaging
Appropriate, turnaround times, results checking
Audit of medication errors
Monthly M+M meetings
High volume/high risk conditions
Time to critical interventions
Triage
Time to analgesia
Unplanned returns
Audits of procedural complications
Audit of medical imaging
Appropriate, turnaround times, results checking
Audit of medication errors
Monthly M+M meetings
PromptWhat are the Domains of Quality recommended by ACEM
ResponseClinical care patient pathway
Administration
Professionalism
Education and training
Research
Administration
Professionalism
Education and training
Research
PromptList contributors to delays to treatment
(Delay to thrombolysis in stroke as an example)
(Delay to thrombolysis in stroke as an example)
ResponseTriage – incorrect/lack of awareness
Medical staff knowledge deficits
Lacok of protocol (eg liaising with stroke team)
Poor access to imaging/CT
Poor access to radiology for urgent reporting
Medical staff knowledge deficits
Lacok of protocol (eg liaising with stroke team)
Poor access to imaging/CT
Poor access to radiology for urgent reporting
PromptSolutions to the above problems
ResponseEducation of triage staff about stroke = Cat 2
Education of medical staff about thrombolysis
Liaise with stroke team for pathway/protocol
Liaise with radiology for expedited reporting
ED consultant to prioritise which scans done when
Education of medical staff about thrombolysis
Liaise with stroke team for pathway/protocol
Liaise with radiology for expedited reporting
ED consultant to prioritise which scans done when
PromptContributors to low quality
ResponseSystem factors
- Lack of training
- Lack of equipment
- Lack of guideline/policy
- Procedures/processes not followed
Do – Test potential solutions
Check – Study the results
Act – Implement the best solution
Then repeat