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Nursing 104, Exam 3, Unit 12 QUESTIONS AND ANSWERS

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Nursing 104, Exam 3, Unit 12 Patient-Centered Care def. Correct Answer: • "Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions" • Nurses, physicians, and other health professionals partner with patients and families to ensure that health care decisions respect patients' wants, needs, and preferences Patient Centered Care as a philosophy of care Correct Answer: -Not a nursing care delivery model but a philosophy of care -Should be incorporated as an essential component of any nursing care delivery model Patient Centered Care Examples Correct Answer: -Developing care plans/discharge plans -Providing education to make informed decisions -Establishing "family advisory councils" to engage decision making -Incorporating user friendly technology to support patient education Institute of Medicine (IOM) Correct Answer: • To Err Is Human: Building a Safer Health System [2000report] ~ 98,000 patients die each year from preventable medical errors -poor quality of care is a major problem in the United States -updated estimate validated these original IOM statistics • Contributing factors -Overuse of expensive invasive technology -Underuse of inexpensive care services -Error-prone implementation of care that could harm patients and waste money Institute of Medicine [IOM] Correct Answer: • Crossing the Quality Chasm: A New Health System for the 21st Century • "The U.S. health care delivery system does not provide consistent, high quality medical care to all people. Americans should be able to count on receiving care that meets their needs and is based on the best scientific knowledge—yet this frequently is not the case. Health care harms too frequently and routinely fails to deliver its potential benefits. Indeed, between the health care that we now have and the health care that we could have lies not just a gap, but a chasm" (p. 1). IOM Crossing the Quality Chasm: A New Health System for the 21st Century Correct Answer: • 30% of Americans failed to receive recommended care in 2010 • On average, patients are subjected to at least one medication error each day with high costs to patients, families, health care professionals, hospitals, and insurance companies -Unprecedented advancement of science and technology, -Growing complexity of health care, -Changing public health care needs, and a -Poorly organized and uncoordinated health care delivery system Institute of Medicine [IOM] Quality Chasm Report: Correct Answer: The quality chasm report details six guiding aims for improvement That should be adopted by every individual in health care -Guiding aims for improvement -STEEEP STEEEP Correct Answer: Safe Timely Effective Efficient Equitable Patient-centered Safe Correct Answer: Preventing injuries Timely Correct Answer: Reducing waits and delays Effective Correct Answer: Services to those who benefit Efficient Correct Answer: Preventing waste Equitable Correct Answer: Providing unvaried care based on personal characteristics Patient-centered Correct Answer: Individual patients needs, values, preferences 10 Rules Guiding Improvement Initiatives Correct Answer: 1. Care is based on continuous healing relationships. 2. Care is customized according to patient needs and values. 3. The patient is the source of control. 4. Knowledge is shared and information flows freely. 5. Decision making is evidence based. 6. Safety is a system priority. 7. Transparency is necessary. 8. Needs are anticipated. 9. Waste is continually decreased. 10.Cooperation among clinicians is a priority. Quality Improvement (QI) Correct Answer: -Assessment and improvement of work processes while focusing on what customers need and want. -Framework for taking action to systematically make changes that lead to measurable improvements in health care services for pts, staff, and organizations; quality is determined by the needs, expectations, and desired health outcomes of individuals and populations. QI buzzwords: Correct Answer: -Total Quality Management (TQM) -Continuous Quality Improvement (CQI) -Continuous Process Improvement -Statistical Process Control -Performance Improvement (PI) Cornerstones of Quality Management Correct Answer: -Quality -Scientific approach -"All one team" Quality Correct Answer: customer defines quality Scientific approach Correct Answer: -Organizational support for all employees to develop knowledge and skills in the science of QI "All one team" Correct Answer: Belief in the people who are working to serve the customer Regulatory Organizations Correct Answer: -Centers for Medicare and Medicaid Services (CMS) *U.S. Medicare program *Requires quality management in "Conditions of Participation" -State licensing authorities require quality management activities and set quality standards Accreditation (voluntary) Correct Answer: The Joint Commission (TJC) The Joint Commission (TJC) Correct Answer: • Health care organizations voluntarily seek TJC accreditation to demonstrate that they have achieved a "gold seal of approval" in quality and safety standards • TJC one of the first accreditation agencies to embrace QI principles as an accreditation requirement in hospitals • Organizations accredited by TJC receive deemed status to automatically meet foundational approval from CMS • Accredits more than 20,500 health care organizations • Address the organizations level of performance in key areas -Patient safety -Patient rights -Patient treatment -Infection control

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Nursing 104, Exam 3, Unit 12
Patient-Centered Care def. Correct Answer: • "Providing care that is respectful of and responsive to
individual patient preferences, needs, and values and ensuring that patient values guide all clinical
decisions"
• Nurses, physicians, and other health professionals partner with patients and families to ensure that
health care decisions respect patients' wants, needs, and preferences

Patient Centered Care as a philosophy of care Correct Answer: -Not a nursing care delivery model but a
philosophy of care
-Should be incorporated as an essential component of any nursing care delivery model

Patient Centered Care Examples Correct Answer: -Developing care plans/discharge plans
-Providing education to make informed decisions
-Establishing "family advisory councils" to engage decision making
-Incorporating user friendly technology to support patient education

Institute of Medicine (IOM) Correct Answer: • To Err Is Human: Building a Safer Health System
[2000report]
~ 98,000 patients die each year from preventable medical errors
-poor quality of care is a major problem in the United States
-updated estimate validated these original IOM statistics
• Contributing factors
-Overuse of expensive invasive technology
-Underuse of inexpensive care services
-Error-prone implementation of care that could
harm patients and waste money

Institute of Medicine [IOM] Correct Answer: • Crossing the Quality Chasm: A New Health System for the
21st Century
• "The U.S. health care delivery system does not provide consistent, high quality medical care to all
people. Americans should be able to count on receiving care that meets their needs and is based on the
best scientific knowledge—yet this frequently is not the case. Health care harms too frequently and
routinely fails to deliver its potential benefits. Indeed, between the health care that we now have and
the health care that we could have lies not just a gap, but a chasm" (p. 1).

IOM Crossing the Quality Chasm: A New Health System for the 21st Century Correct Answer: • 30% of
Americans failed to receive recommended care in 2010
• On average, patients are subjected to at least one medication error each day with high costs to
patients, families, health care professionals, hospitals, and insurance companies
-Unprecedented advancement of science and technology,
-Growing complexity of health care,
-Changing public health care needs, and a
-Poorly organized and uncoordinated health care delivery system

, Institute of Medicine [IOM] Quality Chasm Report: Correct Answer: The quality chasm report details six
guiding aims for improvement That should be adopted by every individual in health care
-Guiding aims for improvement
-STEEEP

STEEEP Correct Answer: Safe
Timely
Effective
Efficient
Equitable
Patient-centered

Safe Correct Answer: Preventing injuries

Timely Correct Answer: Reducing waits and delays

Effective Correct Answer: Services to those who benefit

Efficient Correct Answer: Preventing waste

Equitable Correct Answer: Providing unvaried care based on personal characteristics

Patient-centered Correct Answer: Individual patients needs, values, preferences

10 Rules Guiding Improvement Initiatives Correct Answer: 1. Care is based on continuous healing
relationships.
2. Care is customized according to patient needs and values.
3. The patient is the source of control.
4. Knowledge is shared and information flows freely.
5. Decision making is evidence based.
6. Safety is a system priority.
7. Transparency is necessary.
8. Needs are anticipated.
9. Waste is continually decreased.
10.Cooperation among clinicians is a priority.

Quality Improvement (QI) Correct Answer: -Assessment and improvement of work processes while
focusing on what customers need and want.
-Framework for taking action to systematically make changes that lead to measurable improvements in
health care services for pts, staff, and organizations; quality is determined by the needs, expectations,
and desired health outcomes of individuals and populations.

QI buzzwords: Correct Answer: -Total Quality Management (TQM)
-Continuous Quality Improvement (CQI)
-Continuous Process Improvement
-Statistical Process Control
-Performance Improvement (PI)

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