QAPI Program Utilization_Manual

5. For each cause, ask “Why does this happen”? List the responses that apply to each cause directly below it. 6. Interpret findings. • Look for causes that occur repeatedly. • Determine how often causes occur. • Prioritize these items accordingly. • Specify the cause(s) for which the greatest impact can be realized. • Reach agreement among group members. • Seek to cure the cause, not the symptoms. 7. Decide upon the process, procedure, policy, etc. to address the cause(s) identified. 8. Educate all directly involved. Inform all others. 9. Implement. 10. Re-evaluate outcome or problem. Improved? Worsened? Remained same? Ask Why? Decide next course of action. » Patient Outcome of Knowledge and Compliance Measurement additional patient outcomes, i.e., supplemental outcomes of knowledge and compliance, helps give to the OASIS outcomes achieved. Example: Ascertaining what the patient knows to do to prevent an exacerbation and what the patient does the patient does to prevent it can be important keys to achieving improvement in the OASIS outcome of ACH rate. Aside from the natural progression of the patient’s condition, it’s critical to measure a patient’s knowledge of how to recognize and manage symptoms that signal him/her to action. Measuring this outcome gives perspective to the acute care hospitalization rate achieved. If the outcome of a population of patients shows that the rate of ACH is high, and the knowledge outcome is low, the agency then has a place from which to begin a meaningful investigation. Lack of knowledge could be a contributing factor to the ACH rate. If a knowledge outcome is not measured, then we don’t knowledge or not that can affect the ACH rate. To incorporate the use of knowledge and compliance outcomes, the agency must have a consistent process by which to measure and aggregate the outcome results. Our agency can develop their own or purchase outcome-based documentation systems that include these outcomes. Either method should have outcomes written in such a way that the user understand what is being measured, how to measure it, and when to measure it. Examples: Goals that the nurse measures as outcomes met, not met, or not applicable: 1. Patient/caregiver knows how to independently test own blood glucose by discharge. (The agency has a specific procedure that outlines the “have-to-know”steps the patient must take in order to test own blood glucose independently.) 2. Patient/caregiver is independent with managing wound by visit 9. (The agency has an outline of wound management that the nurse must address with the patient and caregivers (s). It includes priority items of assessing the wound for infection, cleansing the wound, and waste disposal). Another method of outcome measurement is provided bay the University of Iowa, in a published document entitled, Iowa Outcomes Project: Nursing Outcomes Classification (Johnson, Maas, and Moorehead, 2000). Outcomes are measured on a continuum rather than as discrete met or not met goals. Example: Extent of understanding conveyed about Diabetes Mellitus and its control. 1. Indicator # 182914: Demonstration of the correct procedure for blood glucose testing. 103