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Quality Enhancement Cell
So many things to handle!
Why QC tools
To find that our process/activity is fulfilling requirements To have a pictorial view of process/data so that: •We can find good elements of the process •To find the problematic areas •Their causes •The major causes •The solutions to problematic things •Verifying the effectiveness of solutions To reduce costs To improve quality of work and product
4 Where to use : In KPI Reports In Corrective Action Requests In Routine Analytical Reports In finding solution to work problems .
copier issues. air flow problems. crowded. noisy. no patient privacy PC printers needed More VistA printers needed Lack of response to delinquency letters by physicians More WUC staff needed Coders have other duties Physician notification & education & orientation & reponsibilities for medical records Medical Records staff need their own copier Need 1 PC for File Room with Outlook Interruptions People Space for 3 more needed: volunteer. staff has 10-11 staff. noise # 9: Quiet work area. signing from CU/ UNMC New process with Inaccurate CPRS reports of chart incompletions to physician Chart not assembled correctly CPRS= Delete loose filing Transfer missing current clinical volume Data Base Integration. OP chart missing Transfers to file room L/GI patients Cross coverage between IRR staff Timeliness & Accuracy Effects Timely dictation Charge & recharge issues Charts appear on MR walls & are not charged to Delays in Incomplete receiving Records Room.5 Quality Tools & Techniques Incomplete Records Processing Team 04/18/01 x4905 gets calls for ROI Charts not locked on wards Supplies Methods Delinquent physician list is inaccurate to COS office (more than 24-48 hours old) Filing of information that is already in CPRS Access issue. plus physicians (were 4 staff before). new supervisor Environment Confidentiality & security of records/ area. 419/ Error Reports Notification in a timely manner of transfer discharges by social worker Current volume may be unavailable Physician access New records are made without old volume available. 2 entrances Equipment . open area & shelves. lack of space. file staff. charts (for people don't dictation) recharge them Release of Information & coding function Lack of physici an privacy.
6 Bar Graph A bar graph can be used to display and compare data The columns are positioned over a label that represents a categorical variable .
7 Double Bar Graph 90 80 70 60 50 40 30 20 10 0 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr Can be used to compare two related sets of data .
8 Histogram Histogram is a bar graph that shows the frequency of data within equal intervals. There is no space in between the bars. They show how many observations on a given variable have a particular attribute .
. With histograms. each column represents a group defined by a quantitative variable.9 DIFFERENCE BETWEEN BAR CHARTS AND HISTOGRAMS With bar charts. each column represents a group defined by a categorical variable.
.13 When to Use a Histogram When the data are numerical. When you want to see the shape of the data’s distribution. When you wish to communicate the distribution of data quickly and easily to others. When analyzing whether a process can meet the requirements. especially when determining whether the output of a process is distributed approximately normally. When seeing whether a process change has occurred from one time period to another. When determining whether the outputs of two or more processes are different.
I 9 IIII IIII .III 1-3 4-6 7-9 15 17 16 .IIII IIII .14 Step 1 Number of Frequency hours of TV 1 2 3 4 5 Number of hours of TV II 6 III IIII 7 IIII .IIII 8 III IIII .
20 Number of Frequency hours of TV 16 12 8 4 0 1-3 4-6 7-9 1-3 4-6 7-9 15 17 16 . The greatest value on the scale should be at least as great as the greatest frequency.15 Step 2 • Choose an appropriate scale and interval for the vertical axis.
The height of the bar is the frequency for that interval. Bars must touch but not overlap.16 Step 3 • Draw a bar for each interval. • Label the axes and give the graph title Hours of Television Watched 20 Number of students 16 12 8 4 0 1-3 4-6 7-9 Hours Number of hours of TV Frequency 1-3 4-6 7-9 15 17 16 .
Cause & Effect/Fishbone/ Ishikawa Diagram .
19 Cause & Effect Diagram Also known as a fishbone diagram (looks like a fish spine) & as the Ishikawa diagram (Japanese designer of this tool) Used to identify the potential causes for an effect (problem) in the process Identifies and organizes potential areas for improvement activities .
Ensure effectiveness by observing the implemented recommendation solutions. Gather data and evidence.21 ROOT CAUSE ANALYSIS Define the problem or describe the event factually. classifying that along a timeline of events to the final failure or crisis. Ask "why" and identify the causes associated with each stwards the defined problem or event. . Implement the recommended root cause correction(s). " Identify solutions that effective. Include the qualitative and quantitative attributes (properties) of the harmful outcomes.
Scatter Plots Scatter Plot .
The graph looks like a bunch of dots.23 Scatter Plot A scatter plot is a graph of a collection of ordered pairs (x.y). . but some of the graphs are a general shape or move in a general direction.
and they are related. . This means that both are going up.24 Positive Correlation If the x-coordinates and the y-coordinates both increase. then it is POSITIVE CORRELATION.
25 Positive Correlation If you look at the age of a child and the child’s height. it is positive correlation. you will find that as the child gets older. the child gets taller. Because both are going up. Age 1 Height 25 “ 2 3 31 34 4 36 5 40 6 41 7 47 8 55 .
This means that 1 is going up and 1 is going down. making a downhill graph.26 Negative Correlation If the x-coordinates and the ycoordinates have one increasing and one decreasing. . This means the two are related as opposites. then it is NEGATIVE CORRELATION.
00 $23.35 0 0 0 0 . This is negative correlation.70 $15. Age 1 of car Value $30.000 2 3 4 5 $27. the car is worth less.50 $18. you will find as the car gets older.27 Negative Correlation If you look at the age of your family’s car and its value.
28 No Correlation If there seems to be no pattern. then it is no correlation. and the points looked scattered. . This means the two are not related.
Scatterplots Which scatterplots below show a linear trend? 29 a) c) Negative Correlation e) Positive Correlation b) d) f) Constant Correlation .
Manama. Barcega APG School.30 References: • • • • www.org/wiki/Root_cause_analysis .world of teaching.k12.lemars.ppt Princess C./Scatterplots%5B1%5D. Bahrain. Bittner MD MSc http://en.us/webfiles/ccollins/.ia.wikipedia. Marvin J.com Cause and effect diagram and Pareto charts... www.
! .31 Thank you….