PSQRD Framework Smartforms application

Instructions: Read about the Schipper and colleagues study of the Smartforms application (discussed in chapter 24).
1. Discuss how the PSQRD framework might have been better used during this project’s planning phase to identify strategies that promote the adoption and use of the technology.

2. How might this framework have led to more significantly improved patient outcomes?

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Definitions of “quality of care” and “patient safety”

Framework for patient safety and quality research design

Suggestions for further improvement

Definitions

Quality of care

Is the extent that health services increase the likelihood for the desired health in a population.

Definitions (Cont.)

Six aims from the Institute of Medicine (IOM) state that healthcare should be:

Safe

Effective

Patient-centered

Timely

Efficient

Equitable

Definitions (Cont.)

Patient safety

Is the freedom from accidental injury as a result of medical care or medical errors. An error is defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim.

National Initiatives Driving Adoption and Use of Health Information Technology

Federal Health Information Technology Strategic Plan: 2011–2015

Is a focus on the redesign of clinical processes and adoption and Meaningful Use of health information technology (IT).

National Efforts Related to Quality Data Standards

Working on mapping- or linking-specific quality concepts that are to be recommended terminologies

What is semantic interoperability?

Evaluating Quality and Patient Safety

Conceptual framework for patient safety and quality

Medication safety

Chronic illness screening and management

Nursing-sensitive quality outcomes: Patient falls and pressure ulcers

Framework for Patient Safety and Quality Research Design

Figure 20-1 from text

Conceptual Framework for Patient Safety and Quality

Supports the understanding of the health IT intervention that is most likely to have an effect within the organizational causal chain of quality and safety events.

Provides a means to better explain why an health IT intervention was successful (or not).

Quality and Safety Continuum

Figure 20-2 from text

Medication Safety

Health IT initiatives that have improved medication safety include:

Computerized physician (provider) order entry (CPOE) system

Clinical decision support (CDS) system

Electronic medication administration record (eMAR)

Barcode medication administration (BCMA) system

Chronic Illness Screening and Management

Structural incentives for use of health IT to improve clinical processes include:

Screening for breast cancer

Screening for depression

Pay-for-performance measures