Question

"Implementing Continuous Quality Improvement in Healthcare" Case Study 16

Which of the core competencies for health professions are most relevant for this case? Why?

Answer 1

Ans) For health professionals, there is a set of core competencies that can advance adherence to the rules of a redesigned health care system as envisioned in the Quality Chasm report: provide patient-centered care, work in interdisciplinary teams, employ evidence-based practice, apply quality improvement, and utilize informatics.
The extent to which current health professionals are implementing these competency areas does not meet the health care needs of the American public.

- Example:

Mrs. Johnson’s health care needs were met in several ways.

First, health professionals provided patient-centered care as they shared information on the decision-making process and the management of diabetes with the patient. It was evident that Mrs. Johnson valued her education and family. In the interdisciplinary team meeting, she voiced her frustration regarding the amount of time it was taking her to learn how to self-manage her diabetes while attempting to meet her responsibilities as wife, mother, and graduate student. She was fearful that she would have to quite graduate school. The interdisciplinary team members reviewed Mrs. Johnson's short-term self-management goals with her and emphasized her successes. In addition, they discussed options that would allow her to meet her varied responsibilities. By the end of the interdisciplinary team meeting, Mrs. Johnson felt confident that she was making progress in the self-management of her condition. In addition, she and her husband decided that instead of quitting graduate school, she should decrease her course load to one class per semester until she felt comfortable with juggling the self-management of her diabetes and her other responsibilities.

Second, the health professionals worked in an interdisciplinary team in approaching Mrs. Johnson’s care. She was referred to a number of health care providers who offered education and support according to the recommended standards of care. The team members, including Mrs. Johnson and her husband, met to communicate and coordinate the treatment plan.

Third, the health care professionals employed evidenced-based practice. Health professionals frequently expect newly diagnosed diabetics to change multiple behaviors to decrease their risk of complications. Patients often fail at self-management because they are overwhelmed by the number of changes. In accordance with the current literature, the diabetes educator and dietician each had Mrs. Johnson choose one basic self-management goal. They provided her with the information and tools necessary to be successful, and then on her follow-up visits, they reviewed her progress.

Fourth, the team applied quality improvement in the provision of care through use of the diabetes registry. Key outcome measures were tracked for individual patients, a subpopulation, or the general registry population. At Mrs. Johnson’s next appointment, health care providers will print out a record that displays data and graphs of visits and care provided for the past 6 months. Doing so allows providers and patients to note trends. In addition, care reminders can be printed out and given to health care providers to remind them of needed services, or a letter can be sent to the patient as a reminder for care.

Finally, health care providers utilized informatics as a way to communicate and manage Mrs. Johnson’s diabetes care. All the health care providers used PDAs to input data into the diabetes registry so they had continual access to updated information. Mrs. Johnson was able to obtain results of her EKG and laboratory tests from an automatic recorded information system. If she had questions related to diabetes and self-management, she had email access to her health care team. In addition, she was encouraged to seek out current diabetes information on the Web while obtaining support from others with diabetes through a chat room.