سال انتشار: ۱۳۸۶

محل انتشار: دومین همایش سراسری طب اورژانس

تعداد صفحات: ۲

نویسنده(ها):

MORAD ALI AHANGARAN –

چکیده:

The cost of care resumed an upward course . these costs, along withincreased patient awareness, intersert . knowledge , and access to information have now, more than at the right time, at the right place, by the right provider the qualityof theircare.
Continous quality improvement (CQI) applications, have been particularly relevant to the ED giventhe process foucss focus of quality improvement and the fact that the emergency departmentisa process – rich environment
PHILOSOPHIC AND PRACTICAL TENETS OF CONTUOUS
1) COUSTOMER FOCUS
The central focus of CQI philosophy is on through and statistical understanding of customersas an essential element to implementing a successful healthcaresystems . in simplest terms a customer is any personexcedding the customer’sexpectations
2) STATISTICAL APPLICATION OF KNOWLEDGE OF VARIATION
Just as DNA is considered the "buildjng block" of life , statical process
control (SPC) should be considered the bilding block of CQI .Reduction of variation through statistical means is an cssential compnnent of CQI and derives directly from scicnse of SPC . The movement toward more dearly defined clinical path ways (protocols) in ED will reduce variation which represenrs part of the success of CQI principles.
3)FOCUS ON PROCESS
As Demingfirst noled , 85% of bad outcomes arise from the process itself,Whereasonly 15% arise from faulty performance by the individual provider, Given this fact , CQI attempts to imprelve processes and systems rather than Focus on individual performance ,as was the the primary purposeof traditionalmanagement and quality assesment ( QA ) programs .
4) EMPHESIS ON DESIGN AND, REDESIGN
In traditional QA, quality improvement is attempied by routing out " bad
apple " rather than by improving processes and systems . The design and
redesign concept in CQI focus on analyzing the system in such a way that " average performance "improves rather than placting omphesis primarily put liers withbad outcome.
5) LEAUEKSHIP REDEFINED AND EMPOVERMENT OF THE
WORKEKS
THE STRUCTURE OF CONTINUOUS QCJALlYIMPROVEMENT
-THE BERWICK TRIAD :
The Berwick triad consists of a strategy , a culture ,and a groupof technique (augmented by specific tools) that constitute the foundation of quality improvement The techniques of quality improvement include the tradilionul aspects of qualiry planning .quality control, quality Improvement to whichhave been added morerecently developed concepts of process management andbenchmarking . The first step, tools blishiques of qualityproveto be the I most difficult in the early 5 tages of implernencing a CQI program Juran trilogy.
Oncc theproject is identified, toole and techniques of qualityimprovement can be applied, including traditional oncs of qualily planning. Quality control,and quality improvement (collectively known as theJuran trilogy) aswell as the enhancements of processanagement and benchmarking.