quality measurements tools for nursing.pptx

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1. quality measurement tools Under supervision Dr. Rehab Mohamed Rashed Assist. Prof. of nursing administration Faculty of Nursing Benha University كلية معتمدة

2. Prepared by Mervat Tharwat Hussein 2023-2024   2 nd semester doctorate degree كلية معتمدة

3. Objectives: At the end of the theme, you should be able to : • define of quality, quality measurement and 7QC tools • List importance of quality measurement tools • Explain types of measurements • Discuss basic tools of Quality for Process Improvement • Apply the role of nurse manager for quality measurement

4. Introduction : Quality measurement tools vital component of an effective performance management system. Also, it helps organizations to identify, analyze and assess qualitative and quantitative data that is relevant to their business, these tools can identify procedure, ideas, statistics, cause and effect concerns.

5. Definition of quality: quality is the ability of a product or service to meet a customer's expectations for that product or service. quality is doing the right thing the first time. Quality is defined as "the totality of characteristics of an entity that bear on its ability to satisfy stated or implied needs

6. Definition of quality measurement: It is a process of set standards for measuring the performance of healthcare providers to care for patients and populations. Quality measures can identify important aspects of care like safety, effectiveness, timeliness, fairness and typically focus on structures or processes of care

7. Definition of 7QC tools: 7 QC tools are basic quality control tools which help in resolving quality issues: - Data collection analysis - Root cause identification - Identifying solution through data stratification - Controlling the improved data

8. Importance of quality measurement tools: - 1. Assess performance of staff. 2. Assessment of customer needs. 3. Improve processes of work. 4. Enhance the Market process. 5. Increase productivity 6. Identify staff duties and work flow analysis. 7. Identify positive and negative forces affecting business. 8. Using as competition advantage. 9. Find out the creative idea

9. Types of Measurements: 1. Measurements of structures (input) include the characteristics of physicians and hospitals. They could include number and qualifications of the physicians, the ownership of a hospital, availability of equipment, staffing levels, etc.

10. 2. Measurements of processes are the components of the encounter between a healthcare professional and a patient, for example, the medication administered, laboratory test done, radiological examination performed or the surgical procedure completed. A clinical process measure assesses performance based on adherence to established clinical standards.

11. 3. Measurements of outcomes(output) include outcome data and costs incurred by producing a specified healthcare output. Outcome data refer to the patient’s subsequent health status (e.g., improvement in mobility) and include observed outcomes, e.g., death, morbidity, and patient perceived outcomes such as satisfaction and quality of life .

12. Basic tools of Quality for Process Improvement Histograms Cause and Effect Diagrams (Fishbones) Control Charts Flow Charts Pareto charts Scatter diagrams check sheet

13. 1- Cheek sheet Description:  A check sheet also known as tally sheet, is a form for systematic data gathering and registering to get a clear view the facts. It is used to keep track of how often something occurs .

14. Advantages of check sheets: • Easy to be applied. Check sheets allow teams to systematically record and compile data from historical sources (or observations as they happen), to more easily detect and display patterns and trends. • Easy to understand Creates easy-to-understand data from a simple, efficient process that can be applied to any key performance areas and Forces agreement on the definition of each condition or event (participants must look for and record the same thing) • Provide clear view the facts. Builds, with each observation, a clearer picture of the facts, as opposed to the opinions of each team member and Makes patterns in the data quickly become obvious Disadvantages of check sheets: • Don’t show the difference between variables.

15. For example List problem First year Second year Third year Total Shortage of staff 6 7 6 19 Turn over 2 3 1 6 Conflict 3 2 3 8 Absentissm 6 8 10 24 Improper communication 3 3 4 10 Total 20 23 24 67

16. 2-Histograms Histogram is a bar chart (graphical representation of discrete groups or categories of data, shown in such a way that clear comparisons can be easily made). Description:  A frequency distribution shows how often each different value in a set of data.  A histogram is the most commonly used graph to show frequency distributions.

17. Uses of histogram: -  When the data are numerical.  When you want to see the shape of the data’s distribution.  When analysing whether a process can meet the customer’s requirements.

18. Advantages of Histogram • Summarize large data sets graphically. • Compare measurements to specification. • Communicate information to the team. • Assist in decision making. • Easily to understand.

19. Disadvantages of Histogram • Only for numerical data. Example After using check sheet to determine frequency of each problem, then using histogram to represent data was collected, and using it distribution of data and compare among different problems .

20. 2- Cause and Effect Diagrams (Fishbone)  The Fishbone Diagram has many names like “Problem Analysis Tool”, “Cause effect identification tool” , ishikawa diagram and “Root cause Analysis Tool”. Description:  The Fishbone Diagram is an analysis tool that provides a systematic way of looking at effects and the causes that create or contribute to those effects.  The design of the diagram looks much like the skeleton of a fish. Therefore, it is often referred to as the fishbone diagram.

21. Uses of Fishbone diagram. To analyze cause and effect relationships. To facilitate the search for solutions of related problems. To standardize existing and proposed operations. To educate and train personnel in decision-making and corrective action. To study why a process is not performing efficiently or producing the desired results

22. Advantages of fishbone diagrams • Identifies cause and effect relationships in problems. • Allows for prioritizing the relevant causes. • Providing a convenient and easily understood way of thinking of and listing possible causes of the problem that is being faced. • Easily to understand.

23. Disadvantages of fishbone diagrams: A very large space for working out the diagram is needed for complex problems with many branching bones and "why"-bones. The complex interrelationships of multiple factors are difficult to show on a fishbone.

24. Examples After showing the managerial problems on histogram, can arrange the problem and determine the highest priority (absenteeism). After determining the highest priority to solve, should collect the data and analysis by using fishbone (head represent problem, body +causes) and tail solutions

25. 3- Pareto charts Description  Pareto Analysis is a statistical technique that is used for the selection of a limited number of tasks that produce significant overall effect. It uses the Pareto Principle (also known as the 80/20 rule) the idea that a large majority of problems (80%) are produced by a few key causes (20%). This is also known as the vital few and the unimportant many.

26. Uses of Pareto Chart  When analyzing data about the frequency of problems or causes in a process.  When there are many problems or causes and you want to focus on the most significant . Advantages of Pareto chart: Companies operate efficiently when employees identify the root causes of problems. Breaks big problem in to smaller pieces. Identifies most significant factors. Shows where to focus efforts. Allow better use of limited resources.

27. Disadvantages of Pareto chart:  Requires that individuals list changes that are needed or organizational problems. Example After analysis cause, should show and represent on pareto chart To start solution by 20% can solve 80%

28. 4- Flow charts Description A flowchart is a picture of the separate steps of a process in sequential order . Flowcharts can be useful in identifying where errors are likely to be found in the system.

29. Uses of Flowchart To develop understanding of how a process is done. To study a process for improvement. To document a process. When planning a project. Assist in definition and analysis of each step in a process by illustrating it in a clear and comprehensive manner. Identify areas where workflow may be blocked, or diverted, and where workflow is fluid. Identify where steps need to be added or removed to improve efficiency and create standardized workflow.

30. Advantages of Flowchart: Convenient method of communication. Important tool for planning and designing a new system. Clearly indicates the role-played at each level. Serves the purpose of documentation for a system. Provides an overview of the system and also demonstrate the relationship between various steps. Promote logical accuracy. Disadvantages of Flowchart Waste of time and slow down process of software development. Quite costly to produce and difficult to use and manage.

31.   5- Control charts Description: A control chart is a graph that displays data taken over time and the variations of this data. The chart consists of three horizontal lines that remain constant over time: a center, a lower control limit (LCL), and on upper control limit (UCL). The center is usually set at the normal design value.

32. Uses of Control Charts: The purpose of a control chart is to identify when the process has gone out of statistical control, thus signaling the need for some corrective action to be taken . Ad vantages of control charts: Used for monitoring the outputs of a particular process. Have widespread applications in service and manufacturing environments.

33. D isadvantages of control charts: Special Training Small organizations with limited training resources and limited experience with quality-assurance techniques will likely have difficulty implementing Example used the control chart to determine measure and monitor, evaluation level of controlling on the problem to solve comparing with results. upper or central or lower .

34. Scatter diagrams Description: Is a tool for determining the potential correlation between two different sets of variables Use a Scatter Diagram When you have paired numerical data. When trying to determine whether the two variables are related.

35. Advantages of scatter diagram: Show link or relationship between two variables trend-line can be plotted to show correlation. Disadvantages of scatter diagram:- Do not show if a relationship is significant. Can only be used to link two variables

36. The role of nurse manager in quality measurement:- Set the direction for Quality measurement by creating a strong patient focus. Create clear statements Demonstrate continuous commitment Identifies clear goals Includes systematic cycles Actively support the team; Encourages continuous improvement of services. Identify internal experts or external consultants with experience Develop staff member’s skills