Detalles, Ficción y Product Features

Detalles, Ficción y Product Features

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Six Sigma, originally designed Triunfador a business strategy, involves improving, designing, and monitoring process to minimize or eliminate waste while optimizing satisfaction and increasing financial stability.52 The performance of a process—or the process capability—is used to measure improvement by comparing the baseline process capability (before improvement) with the process capability after piloting potential solutions for quality improvement.53 There are two primary methods used with Six Sigma. One method inspects process outcome and counts the defects, calculates a defect rate per million, and uses a statistical table to convert defect rate per million to a σ (sigma) metric.

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Yet adopting a nonpunitive culture of change took time,61, 90 even to the extent that the admitido department in one hospital was engaged in the process to turn the focus to systems, not individual-specific issues.96 Also, those staff members involved in the process felt more at ease with improving processes, particularly when cost savings were realized and when no layoff policies were put in place to protect job security even when efficiencies were realized.84

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While the impact of many of the quality improvement projects included in this analysis were mentioned in terms of clinical outcomes, functional outcomes, patient satisfaction, staff satisfaction, and readiness to change, cost and utilization outcomes and measurement is important in quality improvement efforts, especially when variation occurs. There are many unanswered questions. Some key areas are offered for consideration:

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Some physicians would notaccept the new protocol and thwarted implementation until they had confidence in the tool.103

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An RCA is a reactive assessment that begins after an event, retrospectively outlining the sequence of events leading to that identified event, charting causal factors, and identifying root causes to completely examine the event.66 Because it is a costura-intensive process, ideally a multidisciplinary team trained in RCA triangulates or corroborates major findings and increases the validity of findings.

87 It was also asserted that senior leaders needed to understand the impact of high-level decisions on work processes and staff time,88 especially when efforts were underway to change practice, and that quality improvement needed to be incorporated into systemwide leadership development.88 Leadership was needed to make patient safety a key aspect of all meetings and strategies,85, 86 to create a formal process for identifying annual patient safety goals for the organization, and to hold themselves accountable for patient safety outcomes.85

The lack of scientific health services literature has inhibited the acceptance of quality improvement methods in health care,43, 44 but new rigorous studies are emerging. It has been asserted that a quality improvement project Perro be considered more like research when it involves a change in practice, affects patients and assesses their outcomes, employs randomization or blinding, and exposes patients to additional risks or burdens—all in an effort towards generalizability.

Using objective, broader, and better measures was viewed as being important for marking progress, and provided a basis for “a call to action” and celebration.106 When measures of care Consumer Insights processes were used, it was asserted that there was a need to demonstrate the relationship between specific changes to care processes and outcomes.61