The necessity for quality and safety improvement initiatives permeates health care.1, 2 Quality health care is defined Figura “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”3 (p. 1161). According to the Institute of Medicine (IOM) report, To Err Is Human,4 the majority of medical errors result from faulty systems and processes, not individuals. Processes that are inefficient and variable, changing case mix of patients, health insurance, differences in provider education and experience, and numerous other factors contribute to the complexity of health care. With this in mind, the IOM also asserted that today’s health care industry functions at a lower level than it Chucho and should, and it put forth the following six aims of health care: effective, safe, patient-centered, timely, efficient, and equitable.
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About the author Kim Miller is the Head of Marketing at Mulberry. She is passionate about building products and brands that make consumers happy, save them money and make their lives easier.
512)—may distract the team from investigating systems and process factors that Gozque be modified through subsequent interventions. Even the majority of individual factors Chucho be addressed through education, training, and installing forcing functions that make errors difficult to commit.
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The extent to which differences in patient severity accounted for results could not be evaluated because severity of illness was not measured.89
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Six Sigma/Toyota Production System was reported to have been successfully used to decrease defects/variations59, 61, 81 and operating costs81 and improve outcomes in a variety of health care settings and for a variety of processes.61, 88 Six Sigma was found to be a detailed process that clearly differentiated between the causes of variation and outcome measures of process.61 One of the advantages of using Six Sigma was that it In-Depth Analysis made work-arounds and rework difficult because the root causes of the preimplementation processes were targeted.
2 The aims of effectiveness and safety are targeted through process-of-care measures, assessing whether providers of health care perform processes that have been demonstrated to achieve the desired aims and avoid those processes that are predisposed toward harm. The goals of measuring health care quality are to determine the effects of health care on desired outcomes and to assess the degree to which health care adheres to processes based on scientific evidence or agreed to by professional consensus and is consistent with patient preferences.
Even with strong and committed leadership, some people within the organization may be hesitant to participate in quality improvement efforts because previous attempts to create change were hindered by various system factors,93 a lack of organization-wide commitment,94 poor organizational relationships, and ineffective communication.89 However the impact of these barriers were found to be lessened if the organization embraced the need for change,95 changed the culture to enable change,90 and actively pursued institutionalizing a culture of safety and quality improvement.
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59, 88 Additionally, investigators reported that the more teams worked with this strategy, the better they became at implementing it and the more effective the results.84 Yet it was noted that to use this strategy effectively, a substantial commitment of leadership time and resources was associated with improved patient safety, lowered costs, and increased job satisfaction.84 Six Sigma was also an important strategy for problem-solving and continuous improvement; communicating clearly about the problem; guiding the implementation process; and producing results in a clear, concise, and objective way.59
86 In an initiative involving a number of rapid-cycle collaboratives, successful collaboratives were found to have used stakeholders to determine the choice of subject, define objectives, define roles and expectations, motivate teams, and use results from data analyses.86 Additionally, it was important to take into account the different perspectives of stakeholders.97 Because variation in opinion among stakeholders and team members was expected99 and achieving buy-in from all stakeholders could have been difficult to achieve, efforts were made to involve stakeholders early in the process, solicit feedback,100 and gain support for critical changes in the process.101
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