#MEQAPI – Tweetchat Oct-4 2018 3:00ET Manterrupting

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

The phenomenon of one person interrupting the speech of another is fairly commonplace, but in high-risk situations is a cause for greater concern. There are striking asymmetries in who interrupts whom, and how often. Men interrupt others more than women do, and men interrupt women far more than that.

While much has been said of the causes, it is perhaps useful to consider the quality cost of interruption, and the cost of the asymmetry of interruption.

These can be seen in five areas:

  1. Patient and Staff Safety
  2. Quality & Efficiency
  3. Innovation & Problem-Solving
  4. Organizational Velocity
  5. Staff Burnout

Interruptions cause reduced message integrity and informational survival, resulting in higher error rates and increased unmet needs. In simpler terms, when someone’s message is interrupted, there is a high probability that the meaning of what they were conveying will be degraded or lost, and there is an increased likelihood of the message not being acted on or understood. In a healthcare setting this can have fatal outcomes.

Interrupted speech results in higher rates of error, and lower quality execution of work, with more things being missed and greater execution gaps.

Interruptions depress creativity, increase guarded thinking, and increase the amount of knowledge hoarding and knowledge hiding. This results in reduced innovation, and less effective problem solving

As a result of the combination of all those above, the organization spends more time and effort per achieved work outcome, and has less velocity in achieving strategic goals.

Perhaps the largest impact is in the effect that ubiquitous and frequent interruption has on people. It reduces a sense of organizational attachment, increases stress, and drives up the probability of burnout. People who are frequently interrupted are less committed to organizational goals, less likely to share ideas, and less likely to participate.

High interruption rates are a risk factor for low achievement, high cost, and high turnover.

We will discuss the various dimensions of interrupting using a structured approach.

Manterrupting

Topics

  1. Policy: What laws, policies, rules, regulations, etc. increase or decrease the frequency and degree to which men interrupt women at work?
  2. Equipment: How do equipment and devices increase or decrease the frequency and degree to which men interrupt women at work? Everything from speaker phones to messaging systems.
  3. Measurement: How do quality, safety, and performance metrics increase or decrease the frequency and degree to which men interrupt women at work?
  4. Environment: What environmental factors increase or decrease the frequency and degree to which men interrupt women at work?Everything from the room where care is provided, facility location, privacy, etc.
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc increase or decrease the frequency and degree to which men interrupt women at work?
  6. Materials: What effect does the “medical stuff” patients need increase or decrease the frequency and degree to which men interrupt women at work? – the medications, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

Advertisements

#MEQAPI – Tweetchat Sep-27 2018 3:00ET Compliance Shaming

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

There is an unfortunate holdover from the old days of medical paternalism that continues to bear a rancid fruit of mistrust and anger among patients and physicians – the label of “non-compliance”.

Here is how Stephen Brunton, editor in chief at the journal of clinical; diabetes puts it:

Medicine has a history of paternalistic and top-down approaches to patient care; patients had to follow our instructions, and if they did not, we labeled them “noncompliant.” (How dare they ignore our erudite advice?) More recently, as we have become more enlightened in our recognition that input from our patients needs to at least be considered, we began using a term many of us thought of as more politically correct: “adherence.” However, this term also suggests a power differential, and although we may believe it to be less offensive, it, too, misses the mark. We have simply slapped a new label (“nonadherent”) over the old “noncompliant” label, but we are still blaming and shaming our patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391811/

The term “non-compliant patient” conjures up images of an intransigent know-it-all patient who “thinks they know better than the doctor”, and who digs in their heel for no other reason than to be bull-headed and contrary. However,  more typical reasons that patients do not follow doctors’ orders are social determinants of health such as lack of money, lack of accessibility, and impracticality in the context of the lived environment. Physicians often do not know how much prescribed medications cost, nor what practical difficulties the patient may experience in their lived environment.

When a patient must choose between the brand-name medication and buying food, or when getting the prescription filled will require two buses and a stiff walk, they may simply not be able to stay in compliance with doctor’s orders. Likewise, an instruction to use an ice pack and have bed rest may be good advice, but impractical when missing a day’s work means risking the rent or losing a job, and the nearest ice machine is a bus trip away.

Part of escaping the blame and frustration cycle is to make sure that care plans are developed with patient participation, and will therefore be more closely aligned to the patient’s goals, priorities, and capabilities. Quality, let’s not forget, is a function of how well the outcomes meet patient’s goals.

We will discuss the various dimensions of compliance shaming

Compliance Shaming

Topics

  1. Policy: What laws, policies, rules, regulations, etc. enhance or degrade patient ability or willingness to adhere to  a care plan?
  2. Equipment: How do equipment and devices enhance or degrade patient ability or willingness to adhere to  a care plan? Everything from transport to gowns with no back.
  3. Measurement: How do quality, safety, and performance metrics enhance or degrade patient ability or willingness to adhere to  a care plan?
  4. Environment: What environmental factors enhance or degrade patient ability or willingness to adhere to  a care plan? Everything from the room where care is provided, facility location, privacy, etc.
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc enhance or degrade patient ability or willingness to adhere to  a care plan?
  6. Materials: What effect does the “medical stuff” patients need enhance or degrade patient ability or willingness to adhere to  a care plan? – the medications, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

#MEQAPI – Tweetchat Sep-13 2018 3:00ET Shared Decision Making

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

One of the rallying cries around patient empowerment and increased patient self-management, is the concept of shared decision-making. Shared decision-making is also a central component of pateint-centered care – after all, how can a situation be “patient-centered” if the patient has no say in the goals, priorities, and approaches taken in the care plan?

HealthIT.gov argues that there are seven beneficial outcomes to shared decision-making, and that patients are more likely to:

  1. learn about their health and understand their
    health conditions
  2. recognize that a decision needs to be made
    and are informed about the options
  3. understand the pros and cons of
    different options
  4. have the information and tools needed
    to evaluate their options
  5. are better prepared to talk with their health
    care provider
  6. collaborate with their health care team
    to make a decision right for them
  7. are more likely to follow through on
    their decision

We will discuss the various dimensions of shared decision-making

Shared Decision Making

Topics

  1. Policy: What laws, policies, rules, regulations, etc. enhance or degrade patient participation in shared decision-making?
  2. Equipment: How do equipment and devices enhance or degrade patient participation in shared decision-making? Everything from transport to gowns with no back.
  3. Measurement: How do quality, safety, and performance metrics enhance or degrade patient participation in shared decision-making?
  4. Environment: What environmental factors enhance or degrade patient participation in shared decision-making? Everything from the room where care is provided, facility location, privacy, etc.
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc enhance or degrade patient participation in shared decision-making?
  6. Materials: What effect does the “medical stuff” patients need enhance or degrade patient participation in shared decision-making? – the medications, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

#MEQAPI – Tweetchat Aug 23-2018 3:00ET Central Line Embolism

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

Central lines are a valuable tool in medical care where rapid access to the bloodstream is required. Central lines allow clinicians to administer infusions with less risk, monitor blood flow, etc. However, central lines run the risk of introducing infection, or, perhaps worse, allow air to enter the bloodstream, potentially resulting in death. Air emboli can be due to removal of central lines with the patient seated upright instead of lying down.

Some quality improvement efforts have tried to reduce this risk. For example Dr. Rob Hackett has proposed something as simple as a warning label that might alert the clinician at the critical moment

DlDFxtwXcAEidnT

We will discuss the various dimensions of preventing fatal central line air emboli

Central Line

Topics

  1. Policy: What laws, policies, rules, regulations, etc. improve or worsen the quality and safety of Central Line placement, maintenance, or removal?
  2. Equipment: How do equipment and devices improve or worsen the quality and safety of Central Line placement, maintenance, or removal? Everything from transport, to gurneys, beds, scanners, infusion sets, etc.
  3. Measurement: How do quality, safety, and performance metrics improve or worsen the quality and safety of Central Line placement, maintenance, or removal? Are we measuring the right things?
  4. Environment: What environmental factors improve or worsen the quality and safety of Central Line placement, maintenance, or removal? Everything from the room where it is carried out, facility location, transport, etc.
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc improve or worsen the quality and safety of Central Line placement, maintenance, or removal?
  6. Materials: What affect does the “medical stuff” patients need improve or worsen the quality and safety of Central Line placement, maintenance, or removal? – the medications, contrast media, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

#MEQAPI – Tweetchat Aug 9-2018 3:00ET Radiology

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

Radiology is one of the essential healthcare services that are usually invisible, but critical when needed. Although miniaturized equipment is making radiology more mobile, most radiology is done at central locations where there is room, firm foundations, and adequate three-phase industrial power for the gargantuan machines it often uses. An MRI machine can generate a 7 Tesla magnetic field, and needs liquid helium to cool the superconducting magnets. An MRI can use 20KW of electricity when operating.

The intense magnetic fields can result in injury or death for the unwary, for example, a case in 2001 in which a child was killed by a flying oxygen cylinder, or a man in 2008 who was fatally injured when  the oxygen bottle he was carrying was pulled into an MRI machine.  Radiology also has risks of x-ray exposure, and sensitivity to contrast dyes, but patient injuries are very rare due to the high level of care in quality and safety.

However, for patients, the journey through radiology can be confusing, alarming, or exhausting, and can start with the travel and parking associated with getting to a facility that offers the required radiological services, to the claustrophobia of an MRI, to the hot flushes from an injectable contrast material, to the ignominy of a Barium enema.

Since many patients only venture into the radiology department on rare occasions, the unfamiliarity can be daunting.

We will chat about the clinician and patient perspectives of the radiology journey.

 

Radiology

Topics

  1. Policy: What laws, policies, rules, regulations, etc. improve or worsen the quality and safety of radiology?
  2. Equipment: How do equipment and devices improve or worsen the quality and safety of radiology? Everything from transport, to gurneys, beds, scanners, infusion sets, etc.
  3. Measurement: How do quality, safety, and performance metrics improve or worsen the quality and safety of radiology? Are we measuring the right things?
  4. Environment: What environmental factors improve or worsen the quality and safety of radiology?
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc improve or worsen the quality and safety of radiology?
  6. Materials: What affect does the “medical stuff” patients need improve or worsen the quality and safety of radiology? – the medications, contrast media, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

#MEQAPI – Tweetchat Aug 2-2018 3:00ET Wait Times

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

Waiting is a non-value-added activity.

While an individual may try to recoup the time sitting in a waiting room, waiting for an appointment, or staring at the wall between the time the nurse took vitals and when the physician enters, the net effect is wasted time.

Patients wait between almost every healthcare transaction – from clarifying if they are covered by insurance, to getting an appointment, to be called by the nurse, to seeing the physician, to waiting for test results, to getting medications, to starting treatment. At every step, a patient can expect to be mostly waiting.

There are many causes for waiting, ranging from clinician shortages, to uneven geographical distribution of healthcare facilities, to insurance bureaucracy, and complex conditions,  but the biggest cause is probably a simple matter of process focus. By and large, healthcare is focused on profit and utilization management of high cost and capital resources. The focus is utilization of physicians and capital resources such as operating rooms, MRI scanners, etc. This focus views the patient as a consumer, and therefore externalizes any time they spend waiting. In contrast, an idle physician or MRI or operating room is seen as a disaster.

Waiting is in a large part, therefore, a feature, rather than a defect – as seen through the lens of healthcare priorities.

The effect on patients is heightened frustration and a poor experience, but also decreased access, increased health risks, and increase in missed opportunities. Diseases and injuries seldom wait idly, and generally get worse because of waiting. So the net effect goes beyond frustration, and translates into real harm – increased morbidity, and increased mortality.

This chat is to talk about waiting in the healthcare system – for appointments, for lab results, to see the doctor, … every time the patient or their clinician is simply waiting.

 

Waiting

Topics

  1. Policy: How are wait times influenced by laws, policies, rules, regulations in healthcare?
  2. Equipment: How do equipment and devices used in healthcare affect wait times? Everything from transport, to gurneys, beds, scanners, infusion sets, etc.
  3. Measurement: How do quality, safety, and performance metrics relate to wait time, what metrics are not being collected?
  4. Environment: What environmental factors relate to increased patient wait times?
  5. People: How do the people in healthcare – the staff, cleaners, clinicians, researchers, public, media, friends, family, etc affect patient wait times?
  6. Materials: What affect does the “medical stuff” patient sneed affect wait times? – the medications, instruction sheets, information, medication, test results, etc?

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

#MEQAPI – Tweetchat July 12-2018 3:00ET Women’s Healthcare Experience

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

This is a very difficult blog for me to write, and although I have received input from several women on their experience of healthcare, it is still a very alien terrain for me. It is also somewhat presumptuous of me, as a man, to think that I understand what it is like to need, seek, and obtain medical care, as a woman.

So even though I may have great intentions, my experience level is zero, and my insight potentially very thin. But then that gap is partially why it is important for men to think though what it may be like for women to seek care.

Imagine, as a man, what it would be like if there were no physicians in your zip code, or perhaps for several zip codes around you, that treated very immediate, frequent, and serious health concerns that you had. Imagine that for women this was different. Imagine they had plentiful choices of physicians. Picture that the state made very restrictive laws around core features of your health, and that you paid 20% more for your healthcare than women – not because it cost more to treat you, but simply because of your gender.

Imagine that your typical experience was somewhat dismissive, derogatory, and suboptimal.

By all accounts, this is the typical female experience of healthcare in the U.S.

This chat is to talk about what it is like as a woman to go though the healthcare system – to need care, to seek it, to get it (or not), to pay for it, to have a say in it.

 

Womens health

Topics

  1. Policy: What is the female experience of the laws, policies, rules, regulations surrounding their healthcare?
  2. Equipment: What is the female experience of the equipment and devices used in their healthcare?
  3. Measurement: What is the female viewpoint of the measurement of healthcare safety, timeliness, effectiveness, efficiency, equitibility, patient-centeredness, and accessibility?
  4. Environment: What is the female experience of their healthcare environment – the location of practices, the waiting rooms, the examination rooms, the transport services, parking, etc.?
  5. People: What is the female experience of the people in healthcare – the staff, cleaners, clinicians, researchers, public, media, friends, family, etc?
  6. Materials: What is the female experience of the “medical stuff” they are given – the medications, the instruction sheets, the information, the gowns, sheets, bedding, etc?

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.