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CPHQ Key Definitions

CPHQ Study Definitions

TermDefinition
85/15 Theory Deming claimed that ~ 85% of problems detected are process related, whereas only 15% are traceable to workers
Pareto Principle 80% of the problems come from 20% of the causes
A3 Lean/Six Sigma Tool used to chronicle an improvement opportunity; storyboard using oversized (A3) paper
Affinity Diagram Tool that organizes numerous ideas based on their natural relationships within the groupings
Balanced Scorecard Approach that reports key metrics representing all aspects of the business; provides snapshot of how the organization is performing on strategic goals
Balanced Scorecard Metrics (1) People-> turnover, certifications (2) Service -> pt. satisfaction (3) Quality/Safety -> HAIs (4) Growth/Strategic Goals -> volumes (5) financial/operational -> operating margins
Bar Chart Tool to visually demonstrate comparisons among categories. It is a visual tool only and improvement decisions should NOT be made using this tool.
Benchmarking Comparison against a reference point. Ideally the reference point is a demonstrated best practice.
Cause and Effect Diagram Used to display, explore, and analyze all the potential causes related to a problem to discover the root causes of variation
Ishikawa Diagram Fishbone or Cause and Effect Diagram
Chi-Square Test of statistical significance that assesses the difference in PROPORTIONS among two or more variables
Construct Validity Degree to which a measurement instrument correctly assesses the trait it was designed to measure
Construct Validity Example Severity adjustment scales are tools for measuring staffing needs
Content Validity Degree to which a measurement instrument adequately represents the universe of content; also known as face validity
Control Chart Tool that focuses attention on detecting and monitoring process variation over time; provides guidance for ongoing control of a process
Correlation Extent to which variables relate
Poka Yoke Use of process or design features to prevent error (mistake proofing)
Tree Diagram Method that maps out the full range of paths/tasks involved in a process/problem; resembles an org chart
t-test Used to analyze the difference between two MEANS to determine if the difference between them is significant
Value Stream Mapping Map of the process in which only value-added steps are retained and waste is removed (Lean tool)
Propensity Score Matching A multivariate approach to pairing up people with the same characteristics in the intervention and control groups to eliminate potential impact of variation between the groups that are not equal
Yokoten Sharing learning laterally across an organization (horizontal deployment)
Steering Committee Formed to advise and guide the development and implementation of a major program, project, or initiative
Autocratic Leadership Leader is directive and controlling; leaders make decisions on their own without consulting subordinates
Participative Leadership Leader seeks input from employees and serves as facilitator
Transactional Leadership Leadership that involves an 'exchange process' where performance (compliance) is achieved through the process of giving rewards and punishment
Transformational Leadership Leader inspires others to 'change' expectations and motivations to work toward a common goal; empowers followers
Laissez-faire Leadership Leadership that gives authority to employees; subordinates allowed to work as they choose with minimal/no interference; least satisfying and LEAST EFFECTIVE management style
Democratic Leadership Employees involved in making decisions; get employee input; works best when the leader wants fresh ideas; leader holds final responsibility
Coaching Leadership Leadership that involves teaching and supervising followers; followers are helped to improve their skills
Coercive Leadership Leaders just tell employees what to do ...and how to do it; works best in crisis situations
Brainstorming Quick method to generate lots of ideas
Champion Person who translates the companies vision, mission, goals, and metrics to create an organizational deployment plan; ID's individual projects and resources; removes roadblocks
Checklist A standardized way to ensure completion of critical tasks for a process or activity; gives users the opportunity to pause and consider their actions before proceeding to the next step
Clinical Risk Management Process of assessing potentially preventable defects in care and acting to mitigate those risks in a comprehensive multi-stakeholder way that emphasizes systems thinking
Common Cause Variation Fluctuation caused by unknown factors resulting in a steady but random distribution of output around the average of the data
Special Cause Variation In statistical process control, a variation in performance that falls outside the control limits or when an obvious nonrandom pattern occurs in a process; REQUIRES INVESTIGATION
Control Chart Tool that monitors process variation over time; displays common & special cause variation
Deeming Authority Granted by CMS to accrediting organizations to determine, on CMS's behalf, whether an organization evaluated by the accrediting organization is following corresponding Medicare regulations
Deming Famous quality guru who went to Japan in the 1950s; known for PDSA & Statistical Process Control (SPC)
SPC Statistical Process Control
Delphi Method Combination of brainstorming, multivoting, and nominal group techniques; technique used when group members are not in one location; frequently conducted by mail or email
Effective Producing expected results
Equitable Care All individuals have access to affordable, high-quality, culturally and linguistically appropriate care in a timely manner
Failure Mode and Effects Analysis (FMEA) Preventive approach to identify failures and opportunities for error
Flowchart or Process Map Graphical display of a process outlining the steps of the process
Focused Professional Practice Evaluation (FPPE) Privilege-specific competency evaluation of a practitioner that is undertaken for all newly requested privileges and/or whenever a question arises regarding a practitioner's ability to provide safe, high-quality patient care
Force Field Analysis PI technique to map the nature and relative strength of individual factors leading to, and opposing, the success of an improvement process
High Reliability Operating in complex, high-risk environments for extended periods w/o significant failures, accidents, or avoidable errors
Histogram Tool used to illustrate the variability or distribution of data. It presents the measurement scale of values along its x-axis (broken into equal-sized intervals) and the frequency scale (as count or percent) along the y-axis.
Hoshin Planning Japanese term for policy deployment; ensures the vision set forth by top management is translated into planning objectives
Human Factors Knowledge of human capabilities and limitations in the design products, processes, systems, and work environment, which affect health and safety. i.e. attitudes, motivation, training, cognitive functioning can influence the likelihood of a medical error.
Inter-rater Reliability Degree to which 2 raters, operating independently, assign the same ratings
Just Culture Awareness by everyone throughout the organization about the inevitability of medical errors; but all errors and unintended events are reported, even when the events may not cause patient injury
Kaizen Systematic approach to improve efficiency and quality; focuses on removing process waste and maximizing value to the customer.
Lean Enterprise The major focus is to eliminate waste in the following areas: production, waiting time, inappropriate processing, inventory, transporting, and defects
Mean Sum of all scores or values divided by the total number of scores
Median 50th percentile; number that divides a set of numerically ordered data into a lower and an upper half
Misuse Occurs when patients received appropriate medical services provided poorly
Mode most frequent value(s) in a set of numbers
Morbidity Disease related
Mortality Death related
Overuse Repeated use of therapy when additional applications have not proven to be medically necessary or therapeutically beneficial
Underuse Situation in which patients do not receive beneficial health services
Regression Analysis Statistical procedure to predict outcomes based on the identification of individual variables and how they interact with the process being measured
Multiple Regression Analysis Exercise that estimates the effects of 2 or more INDEPENDENT variables (x) on a DEPENDENT measure (y)
Nonprobability sampling Method that provides no way of estimating the probability that each element will be included in the sample. The results CANNOT be generalized to the available population. Non random sampling.
Nominal Group Technique Group decision-making process for generating many ideas in which each member initially works by him/herself. Brainwriting.
Ongoing Professional Practice Evaluation (OPPE) Documented summary of ongoing data collected for assessing a practitioner's clinical competency and professional behavior
Simple Random Sampling Pulling a name of out a hat containing all possible names
Systematic Sampling Picking every 3rd name from a list of possible names, after randomly selecting the first name
Stratified Random Sampling Sampling by subpopulation -> sex, ethnicity, disease, living in a certain part of the country
Cluster sampling sampling method whereby if studying medical students, may only have a list of medical schools in the area, no student names; so sample randomly derived from the list of medical schools
Convenience Sampling Sampling whereby subjects are included based on whoever is easily available...perhaps the 1st 30 patients walking into the ED
Snowball Sampling Sampling whereby subjects suggest other subjects for inclusion...often friends invite friends
Expert Sampling Type of purposive sampling that involves selecting experts in each area because of their access to the information relevant to the study
Purposive or Judgement Sampling Sampling using a group of nurses to represent a cross-section of women (as determined by researchers subjective opinion)
Quota Sampling Sampling whereby the researcher pre-specifies characteristics of the sample to increase its representativeness
Continuous Data (definition) Any variable measured on a scale that can be infinitely divided
Continuous Data (examples) Height, weight, temp., CBGs
Discrete/Attribute/Categorical/Count Data (definition) All types of data that are NOT continuous (so cannot be infinitely divided)
Count Data (definition) Data that is counted/tallied
Count Data (examples) counts of errors, # of people
Binary Data (definition) Data that can have only one of 2 values
Binary Data (examples) yes/no; pass/fail; male/female
Nominal Data (definition) Data are names or labels where ORDER DOESN'T MATTER
Nominal Data (examples) Dept. A, Dept. B, Dept. C; ethnic groups; types of transport -> boat, plane, train
Ordinal Data (definition) Characteristics are put into categories and rank ordered (order matters)
Ordinal Data (examples) Likert Scale (Agree, neutral, disagree); Nursing Staff rank (RN Level 1, RN Level 2, RN Level 3); salsa taste test (mild, hot, very hot, smokin')
Paradigm Shift A time/situation where the usual and accepted way of doing or thinking about something changes completely
Numerator Upper portion of a fraction (top number) used to calculate a rate, proportion, or ratio
Denominator Bottom portion of a fraction (bottom number) used to calculate a rate, proportion, or ratio
Peer Review An episode of care review is conducted to improve the quality of patient care or the use of healthcare resources.
Peer Generally defined as a healthcare professional with comparable education, training, experience, licensure, or similar clinical privileges or scope of practice.
Structure measure (definition) Measure that assesses features of a healthcare organization or clinician relevant to its capacity for healthcare delivery (resource availability)
Structure measure (examples) quantity of imaging equipment, # of computers, nurse-patient ratio, # of chemo certified RNs
Process measure (definition) Measure that focuses on a sequence of actions or steps that should be followed to provide high-quality evidence-based care
Process measure (examples) # of patients Dx with imaging technology, % of MDs using a specified order set, % of Septic patients receiving the correct Abx
Outcome Measure (definition) Measure that assesses the results of healthcare that are experienced by patients
Outcome Measure (examples) higher percentage of early Dx, due to use of imaging technology; results of care (for ex. satisfaction, length and quality of life, turnover rates); mortality rates; complication rates; infection rates; patient satisfaction rates
Propensity Score Matching A multivariate approach to pairing up people with the same characteristics in the intervention and control groups to eliminate potential impact of variation between the groups that are not equal; effective approach to 'equating' groups
Reliability Coefficient Numerical index … measured using the range of 0 to (+1) of a test's reliability. The closer the reliability coefficient is to 1, the more reliable the tool. In general reliability coefficients of ≥ 0.70 are considered acceptable.
Pearson Correlation Coefficient (r) Numerical index … measured using the rang of (-1) to (+1) that reflects the strength and the direction of the relationship. The closer the correlation coefficient is to (-1) or to (+1) the stronger the relationship.
r = (-1); … r is the Pearson Correlation Coefficient numerical index indicating a perfect negative relationship
r = 0; … r is the Pearson Correlation Coefficient numerical index indicating no relationship
r = (+1); … r is the Pearson Correlation Coefficient numerical index indicating a perfect positive relationship
Scatter Diagram A visual (graphical) representation of the relationship of the numerical index represented by the Pearson Correlation Coefficient (r)
Sentinel Event Any patient safety event that reaches the patient and causes death, permanent harm, or severe temporary harm and intervention required to sustain life
Serious Reportable Adverse Events 'Never Events' … CMS withholds payment to hospitals if any of these events occur in an acute care facility
Stakeholder All groups that might be affected by an organization's actions and successes
Created by: smccall