Aim - A written, measurable, and time-sensitive statement of the expected results of an improvement process.
Balancing measure - Ensures that changes to improve one part of the system are not causing new problems in other parts of the system. It examines another part of the system to ensure that improvements in one area have no unexpected consequences in another.
Benchmarking - The process of measuring products, services, and practices against the best performers or those companies recognized as industry leaders
Brainstorm - Designed to generate a large number of ideas for the solution of a problem. Brainstorming is a team approach to resolution of problems or creating actionable steps that will lead to improvement
Change Concept: A general idea for changing a process. Change concepts are usually at a high level of abstraction, but evoke multiple ideas for specific processes. “Simplify,” “reduce handoffs,” and “consider all parties as part of the same system,” are all examples of change concepts
Chronic Care Model - A model that represents the ideal system of health care for people with chronic disease and an approach to re-designing health care to mirror that ideal system. Developed originally under the name of the Chronic Care Model (by Dr. Ed Wagner of the Improving Chronic Illness Care [ICIC] Program of the MacColl Institute for Healthcare Innovation with funding from the Robert Wood Johnson Foundation) the model has six components: self-management support, decision support, delivery system design, clinical information systems, health care organization, and community resources/policies. The Care Model strives to achieve an informed, activated patient in productive interactions and a prepared proactive practice team, so that improved health care outcomes can be achieved. The HDC has evolved the Chronic Care Model by applying it to prevention, cancer screening, and other aspects of care such as patient flow. Integration of all of the HDC pilots and demonstrations into a planned care approach is now referred to as the Care Model, as it seeks to address Quality in the full six dimensions of the Institute of Medicine definition of Quality Care
Computerized physician order entries (CPOE) - The process of electronic entry of medical practitioner instructions for the treatment of patients
Clinical guidelines - "Systematically developed statements to assist practitioners and patient decisions about appropriate health care for specific circumstances”: [Field & Lohr 1990]
Clinical Information System — A registry, that is, an information system that can track individual patients and populations of patients, is a necessity when managing chronic illness or preventive care.
Community — To improve the health of the population, a health care organization reaches out to form powerful alliances and partnerships with State programs, local agencies, schools, faith organizations, businesses, and clubs.
Critical pathway - Critical pathways, also known as critical paths, clinical pathways, or care paths, are management plans that display goals for patients and provide the sequence and timing of actions necessary to achieve these goals with optimal efficiency. [Ann Intern Med. 1995;123:941–948}
Day-to-day leader - Organizes and drives the ongoing work, measurement, and team. This person needs to work effectively with the executive leadership and members of the improvement team. The day-to–day leader also serves as the “key contact” responsible for coordinating communication on the progress on a QI project to the overall organization, staff, and board of directors
Data entry person - Carries out the data-entry function, and needs sufficient time and computer access to enter data and submit reports regularly. It is often recommended to train a backup person, who also learns to aggregate monthly and quarterly reports, so that reporting is not interrupted for vacations, illnesses, or other unexpected events.
Data specialist - Collects and analyzes data, and uses QI tools. The person selected does not necessarily need to work in a QI department or hold a specific title as long as he or she is well-versed in QI concepts and tools.
Decision Support — Treatment decisions need to be based on explicit, proven guidelines supported by at least one defining study. A health care organization integrates these guidelines into the day-to-day practice of primary care providers in an accessible and easy-to-use manner.
Delivery System Design — Delivery of patient care requires not only to determine what care is needed, but to clarify roles and tasks to ensure the patient receives the care; that all of the clinicians, who take care of a patient, have centralized, up-to-date information about the patient’s status, and make follow-up a part of their standard procedures.
Key Changes: The list of essential process changes that will help lead to breakthrough improvement, usually on literature and the experience of testing.
Model for Improvement - An approach to process improvement, developed by Associates in Process Improvement, which helps teams accelerate the adoption of proven and effective changes. The model includes use of “rapid-cycle improvement” – which involves successive cycles of planning, doing, studying, and acting – known as PDSA cycles
Nominal group process - A structured problem-solving or ides-generating strategy in which individuals'; ideas are gathered and combined in a face-to-face nonthreatening group situation.
Operations person - Is integrally involved in current processes and needs to be part of the team, because much of the innovative work involves designing new processes and streamlining old ones. Operations personnel may include: nurses, nutritionists, social workers, pharmacists, or others. The appropriate specialty of the operations person becomes apparent when areas for improvement in the current processes are identified.
Organization of Health Care — A health care system can create an environment in which organized efforts to improve the preventive care of people take hold and flourish.
Outcome measure - Quantifies a patient’s health status resulting from health care. (2) In the clinical area, it often measures a patient outcome so it can be compared to a care standard, such as, a patient’s test value.
Pay-for-performance - An emerging movement in health insurance, in which providers are rewarded for quality of healthcare services
Population of focus (POF)- Total number of patients to be focused on and tracked within a quality improvement initiative
Process measure - Quantifies a health care service provided to, on behalf of, or by a patient, that is based on scientific evidence of efficacy or effectiveness. (2) It quantifies a specific system; e.g., to get a test done or a service performed.
Provider champion - An essential member of the QI team due to the clinical nature of the work. The provider champion works regularly with those patients whose care is directly affected by QI efforts. As a leader to help drive change, the provider needs to be an individual who is well-respected and influential among the medical staff, works well with management, and is open to change and new approaches
QI plan – A written and specific plan developed to guide the improvement teams in their QI efforts. The QI plan acts as a guide for the QI Program
QI Program – The organizations overarching approach to QI. Generally driven by the strategic plan a QI program focuses on the organizations approach to quality and not simply a project
QI team - The group of individuals, usually from multiple disciplines, that drives and participates in the improvement process.
Registry – A system that records all relevant patient care information. Utilized by providers, to record critical elements of the care plan, produce quick care summaries at the time of a visit, and enter data to alter the care plan as needed
Self Management —Effective self management is very different from telling patients what to do. Patients have a central role in determining their care and one that fosters a sense of responsibility for their own health.
Spread: The intentional and methodical expansion of the number and type of people, units, or organizations using the improvements. The theory and application comes from the literature on Diffusion of Innovation (Everett Rogers, 1995).
Structure of care measure quantifies a feature of a health care organization (or clinician) relevant to its capacity to provide health care
Systems of care - a service delivery approach that builds partnerships to create a broad, integrated process for meeting