quality management in emergency care
TRANSCRIPT
![Page 1: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/1.jpg)
Quality management in
Emergency Care Department
W.A .Keerthirathne(RN,BScN,PGDDE,Dip Teaching
& Sup,Dip in Edu,Mgt & Leadership,Dip in Psy) Special Grade Nursing Tutor PBCN
![Page 2: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/2.jpg)
is a nursing specialty in which nurses care for patients in the emergency or critical phase of their illness or injury.
![Page 3: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/3.jpg)
Emergency Nursing is a specialty in which nurses care for patients in the emergency or critical phase of their illness or injury and are adept at discerning life-threatening problems, prioritizing the urgency of care, rapidly and effectively carrying out resuscitative measures and other treatment, acting with a high degree of autonomy and ability to initiate needed measures without outside direction, educating the patient and his family with the information and emotional support needed to preserve themselves as they cope with a new reality. These activities may be carried out in a variety of settings and not necessarily in an "Emergency Room."
![Page 4: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/4.jpg)
Every other specialty of nursing, a patient arrives with a diagnosis by a physician and the
nurse must manage patient's care according to that diagnosis,
Emergency nurses work with patients diagnosis has not yet been made and the cause of the problem is not known.
Emergency nurses frequently contact patients in the emergency department before the patient sees a physician.
In this situation, the nurse must be skilled at rapid, accurate physical examination, early recognition of life-threatening illness or injury, the use of advanced monitoring and treatment equipment, and in some cases, the ordering of testing and medication according to "advance treatment guidelines" or "standing orders" set out by the hospital's emergency physician staff.
![Page 5: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/5.jpg)
. How is "Emergency Nursing" different from other nursing?
An Emergency Nurse is hold high degrees of knowledge and skills, with diagnostic and decision-making power to effectuate urgently needed activities in autonomous or in the closely-collaborative with other health professionals. An Emergency Nurse is capable of providing a broad spectrum of skills that in other settings would be delegated to other health care workers. Without disregarding the critical activities, Emergency Nurses commonly triage and treat less urgent problems, providing care and treatment of those injuries or illnesses, and providing the educational and psychosocial evaluations and support to return the patient successfully
![Page 6: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/6.jpg)
![Page 7: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/7.jpg)
High level of value or excellence How good or bad some thing
![Page 8: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/8.jpg)
The combine and unceasing effort of everyone
![Page 9: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/9.jpg)
The combine and continuous effort of every one ,health care professionals, patients and their families, payers ,researchers, educators and planners
to make changes that will leads to better patient outcome(health),
better system performance(care) and better professional
development(learning)
![Page 10: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/10.jpg)
Concept is complex Main goal is to change performance not to
discover new knowledge. To do their work, improve it. Change in care process and routine work in
health care All improvement require changers but not
every change is improvement. Do more carefully. Faster ,better, more effective and safer
![Page 11: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/11.jpg)
Patients in emergency care not always satisfied with the care
Nursing care describe as instrumental and non-holistic.
![Page 12: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/12.jpg)
Information Respect and empathy Pain relief Nutrition Waiting time General atmosphere Patent safety Cost effectiveness Evidenced based practice
![Page 13: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/13.jpg)
2. Determine solution
5. Monitor and analyse
7. Document and educate 3. Implement solution
6. review accordingly 4. Communicate the process
I Identify a problem
![Page 14: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/14.jpg)
Safety Timely Access Equitable Efficacy Efficient Patient Centered
![Page 15: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/15.jpg)
How can you improve a system to achieve better results in the 6 pillars of quality?
![Page 16: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/16.jpg)
You need a good understanding of the system
You need to understand where it is failing - Identify what is wrong Make sure it is the step that needs
fixingThen you can implement a change to
the “system”
![Page 17: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/17.jpg)
System = any assembly of procedures, resources and routines to carry out a specific activity
![Page 18: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/18.jpg)
To understand a system and identify what is wrong with it Map it out!
![Page 19: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/19.jpg)
Use a flow chart/diagram
Use different perspectives (a doctor’s perspective is different to a nurse’s or a porter’s to a patient’s perspective)
![Page 20: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/20.jpg)
![Page 21: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/21.jpg)
1. The Aim: What are we trying to accomplish? (How good do we want to get and by when?)
2. The Measures: How will we know a change is an improvement?
3. The Changes: What change can we make that will result in improvement?
![Page 22: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/22.jpg)
What are we trying to accomplish?
How will we know that a change is an improvement?
What change can we make that will result in improvement?
MODEL FOR IMPROVEMENT
STUDY
ACT PLAN
DO
![Page 23: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/23.jpg)
Plan a change Do the change Study the results Act on the results
STUDY
ACT PLAN
DO
![Page 24: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/24.jpg)
Eight fundamental priority rights to improve quality of emergency department
![Page 25: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/25.jpg)
Health care staff who are appropriately trained and qualified to deliver emergency care, with the early involvement of senior doctors with specific expertise in E M where life-threatening/changing illness (physical or mental) or injury is suspected.
![Page 26: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/26.jpg)
1. Properly equipped (for example with monitoring equipment and supplies)
2. Appropriate compliance with hygiene3. Infection control measures reduce the incidence of
hospital acquired infection for the anticipated number of patients and all commonly presenting conditions, as well as less common but predictable emergencies.
![Page 27: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/27.jpg)
3.Adequate space to provide the necessary patient care in an environment that is secure and promotes patient privacy and dignity;
4. Acutely ill and injured patients should not be routinely cared for in hallways or non-equipped overflow spaces.
![Page 28: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/28.jpg)
At all levels of ED function, from managerial/administrative levels to the frontline, the importance of critical thinking in decision making should be recognized and emphasized.
![Page 29: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/29.jpg)
To ensure early recognition of those patients requiring immediate attention and prompt time critical interventions, and the timely assessment, investigation and management of those with emergency conditions
![Page 30: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/30.jpg)
Patient-centred care with an emphasis on relieving suffering, good communication and the overall experience of patients and those accompanying and/or caring for them.
![Page 31: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/31.jpg)
Optimal outcomes from treatment within the ED for all patients presenting with emergency healthcare needs.
![Page 32: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/32.jpg)
Which enables the patient to access timely and appropriate emergency care, and which continues to support them after they have left the ED. There should be strong links to the community including education and prevention, alongside the promotion of public health.
![Page 33: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/33.jpg)
From community and hospital-based healthcare teams, and managers of the ED, who should ensure that the above arrangements are sustainable. There should be established and agreed mechanisms to monitor standards and compliance, with action taken if an ED falls short.
![Page 34: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/34.jpg)
Appropriate access and utilization of, diagnostic support services (e.g. plain radiography, ultrasound, CT scanning and laboratory services) by EM doctors when needed for the immediate diagnosis of life threatening conditions
Expertise in critical care in collaboration with colleagues from anaesthesia and intensive care
Early access to specialist inpatient and outpatient services to assure appropriate on-going evaluation and treatment of patients with emergency care needs
![Page 35: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/35.jpg)
Appropriate duration of stay in the ED to maximise patient care and comfort, and to optimise clinical outcomes
Additional services to enhance the quality and safety of emergency care. Such as short-stay/observation facilities, alternative patient pathways, social and mental health services or associated outpatient activity.
However excellent ED care is the constant development of innovative and enhanced services to support the delivery of quality and safety.
![Page 36: Quality management in emergency care](https://reader034.vdocuments.mx/reader034/viewer/2022042716/55a37fca1a28ab7f598b457c/html5/thumbnails/36.jpg)
Safe - Avoiding harm to patients . Effective -Providing services based on
scientific knowledge to all who could benefit, and refraining from providing services/care to those not likely to benefit.
Patient-centred -Providing care that is respectful of and responsive to individual patient preferences, needs, and values .
Timely -Reducing waits and sometimes harmful delays .
Efficient -Avoid waste (personnel, ressources, finance).
Equitable -Providing care that does not vary in quality because of personal characteristics .