How can we recognize Continuos Quality Improvement in theUniversity Children’s Hospital?

Elena Antoñanzas Baztan; Nurse Manager, Complejo Hospitalario de Navarra

Sonia Font Bosch, Accident and Emergency Nurse, Denia’s Hospital Evija Paceja, National Latvian co-ordinator 20

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Latvia

Latvia Riga

Area (km2) 64.589 307,17

Population(hab)

2.003.000 696. 618

Density(hab/km2)

34,3 2,848

GDP (PP) 11,620 $ --------

Health % of GDP

6 --------

CHILDREN’S HOSPITAL 1899. 21.SEPTEMBER

Number of beds 475

2053 employees: • 540 nurses• 210 assitent nurses• 512 physicians

200, 000 outpatients25, 000 inpatients

How Can we recognize continuos qualityimprovement in the University Children´sHospital?1. Systematic Data Guided Activities

2. Aiming to Change Routine Work Processes

3. Creating a Culture of Quality Improvement

4. Specific Predefined Aims

5. Using Evidence Relevant to the Problem

6. Designing with Local Conditions in Mind

7. Iterative Development and Testing

8. Multidisciplincary Teams from Target Organizations

9. Data Feedback to Implementers

10. Specific Named Improvement Methods

11. Set of Specific Changes

* International Journal for Quality in Health Care 2012; Volume 26, Numeber I: pp. 6 -15 Advance Access Publication: 4 December 2013

1. Is the use of aims and measures an

example of a data-guided activity?

• Reduce the incidence of hospitalization for a duration of up to 24 hours get availability by activating the day hospital work.

• Reduce the incidence of re-hospitalization within 72h after discharge is Quality Score for more detailed assessment of complications.

• Patient-satisfaction index for healthcare in-the introduction of clinical guidelines and recommendations.“Patient is the center of the whole process."

2. Is CQI changing routine practices or

introducing new processes?

3. Is it necessary to create a culture

of quality improvement ?

4. It is important to predefined aims during the

implementation of process?

5. To have a chance of success must be based on

strong evidence?

6. What are the implications when an

intervention is developed elsewhere and implemented locally using CQI?

7. Should implementation of improvements

without iterative testing be considered CQI?

8. Can CQI sometimes be carried out by just one

discipline?

Marking hazard situations, week points of system, prioritize next working groups, improvements, SOP (Emergency, rapid response for inpatients, clients, reporting of critical results, medication of high risks drugs, etc.)

Cooperation with internal auditors – valuable information both ways (reports on PS events related to i/v catheters and ongoing audit on peripheral i/v SOP – better understanding what to improve

9. Is continuous feedback an important aspect of

the ethical conduct of research? Is it important to report in publications?

10. Is it important standardized procedures?

Changes in processes, procedures (for example- triage nurse evaluates and sign Ambulance referral, etc.)

11. Does ‘set of specific changes’ imply pre-

determined changes?

How specific changes in one department imply changes in all hospital…..

Photo: Medicine Museum of Riga

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