Topic: Reducing Procurement Lead Time ( Tools and Frameworks for Quality)

Order Description obj: 1. Critically analyse quality frameworks to identify evidence-based best practice and knowledge that can be applied to the health or social care setting. 2. Critically apply the concepts of Structure, Process and Outcome (SPO) in examining a quality or patient safety improvement initiative in a service. 3. Carry out a quality improvement process using PDSA cycles and associated quality improvement tools. 4. Plan how you would monitor and evaluate a quality improvement initiative using “real time” and “before and after” data. Good evidence of care: Opportunities for improvement: • explaining well to the Dr • Dr explaining the whole history and diet restrictions • good care by paramedic • careless on the phone • interruptions in ER • 3 hrs waiting • not listening to the patient • no respect verbally and physically • reading from the screen and no patient education • not listening to the needs of the family • bathroom on her own • disgruntled consultant • consent form procedure • increasing oxygen without looking at screen reading • no teamwork Categorization of key patient quality and safety issues: Safety Efficient & effective service Patient-centeredness Timeliness of services Positive • • Warden comprehensive communication • Family doctor comprehensive communication • Paramedic comprehensive communication • Paramedic involved the family • • Negative • No documentation of patient’s case • No bed rails in ER • Not checking her file before giving drink • Letting patient go to the toilet alone • No site of surgery or IV drop • No checklist • Incorrect info on consent form • Surgeon went ahead although patient is not prepared • Staff nurse’s low quality of delivering the message with no patient education • Staff nurse misusing the policies • Inattentive surgeons • Interruptions in ER • No patient rights respect and no privacy • Disgruntled staff • No patient education • Drinking and chatting over her head • Family Dr to go to her home • Nurse to check on patient in ER • Ignored for the first 3 hours ? Identify the problem and gaps ? Risk management ? Time wasted ? lean ? Improve communication e.g. GP should get feedback from SHO on phone or logged details on system (reporting policy) ? Consent form process was inappropriate ? was there a policy? Why was it not followed? ? “Measures promote behavior” ? issues had to be resolved in ER within 4 hours ? Root-cause analysis ? Faulty structure (water on floor) ? Faulty Process (old patient went to toilet alone) ? Faulty Outcome (patient fell and required surgery) ? Is there a policy? E.g. identification, reporting, consent form, documentation, surgery preparation