Quality Improvement in Healthcare
Expert-defined terms from the Certified Professional in Electronic Health Records Documentation and Coding course at London School of Business and Administration. Free to read, free to share, paired with a globally recognised certification pathway.
**Abstraction** #
**Abstraction**
Abstraction is the process of collecting and interpreting data from electronic h… #
Clinical data abstraction involves the extraction of specific clinical data elements from EHRs by trained healthcare professionals.
**Accreditation** #
**Accreditation**
Accreditation is the process by which a healthcare organization is evaluated and… #
Accreditation bodies, such as ACCME and TJC, establish and enforce these standards to ensure that healthcare organizations provide high-quality care to their patients.
**Audit** #
**Audit**
An audit is a systematic review of an organization's processes, systems, and rec… #
Internal audits are conducted by the organization's own staff, while external audits are conducted by independent organizations. Compliance audits focus on the organization's adherence to specific regulations and laws.
**Benchmarking** #
**Benchmarking**
Benchmarking is the process of comparing an organization's performance, processe… #
Performance benchmarking compares outcomes, such as mortality rates or patient satisfaction scores, while best-practice benchmarking identifies and adopts successful practices from other organizations. Process benchmarking compares processes and workflows to identify opportunities for improvement.
**Clinical Decision Support (CDS)** #
**Clinical Decision Support (CDS)**
CDS is a technology that provides healthcare professionals with evidence #
based recommendations and alerts to support clinical decision-making. CPOE is a type of CDS that allows healthcare professionals to enter and transmit orders electronically. Clinical guidelines and best practices are often integrated into CDS systems to ensure that care is consistent with current standards. Alerts and reminders are also common CDS features, providing timely notifications to healthcare professionals regarding important patient information, such as medication allergies or abnormal test results.
**Clinical Quality Measures (CQMs)** #
**Clinical Quality Measures (CQMs)**
CQMs are standardized measures used to assess the quality of healthcare services… #
CQMs are reported to regulatory bodies, such as the Centers for Medicare and Medicaid Services (CMS), as part of quality reporting programs, such as meaningful use. eCQMs are CQMs that are electronically extracted from EHRs, allowing for automated and standardized data collection.
**Continuous Quality Improvement (CQI)** #
**Continuous Quality Improvement (CQI)**
CQI is an ongoing, systematic approach to improving the quality and safety of he… #
CQI involves the use of data to identify areas for improvement, implementing changes, and continuously monitoring and evaluating the impact of those changes. The PDSA cycle is a common CQI tool, providing a structured approach to testing and implementing changes. Root cause analysis is a technique used to identify the underlying causes of problems or variations in care.
**Data Analytics** #
**Data Analytics**
Data analytics is the process of examining and interpreting large datasets to id… #
Big data refers to the vast amounts of data generated by healthcare organizations, including clinical, financial, and operational data. Predictive analytics uses statistical models to predict future outcomes based on historical data, while machine learning algorithms can automatically learn and improve from experience without being explicitly programmed.
**Electronic Health Record (EHR)** #
**Electronic Health Record (EHR)**
An EHR is a digital version of a patient's medical record, containing comprehens… #
An EMR is a similar system used primarily by hospitals and ambulatory care settings, focusing on clinical data. A PHR is a patient-controlled record that may contain similar information as an EHR, but is not part of a provider's EHR system. Interoperability refers to the ability of different EHR systems to exchange and use data, enabling seamless communication and coordination between healthcare providers.
**Evidence #
Based Medicine (EBM)**
EBM is the integration of clinical expertise, patient values, and the best avail… #
Clinical practice guidelines are systematically developed statements that provide recommendations for appropriate healthcare in specific clinical circumstances. Systematic reviews and meta-analyses are rigorous evaluations of the scientific literature, synthesizing the findings to provide evidence-based recommendations.
**Health Information Exchange (HIE)** #
**Health Information Exchange (HIE)**
HIE is the electronic sharing of health information between healthcare organizat… #
Direct messaging is a secure method for exchanging health information between authorized parties, while query-based exchange allows providers to access external records for a specific patient.
**Lean Methodology** #
**Lean Methodology**
Lean methodology is a continuous improvement approach that focuses on eliminatin… #
Value stream mapping is a tool for visualizing and analyzing the flow of materials, information, and processes to identify areas for improvement. Kaizen is a philosophy of continuous improvement, encouraging small, incremental changes to processes and workflows. 5S is a Lean tool for organizing workspaces, promoting efficiency, and reducing waste.
**Patient #
Centered Medical Home (PCMH)**
PCMH is a model of primary care that emphasizes patient #
centered, coordinated, and continuous care. A PCMH is a medical home for patients, providing comprehensive and accessible care that addresses their physical, mental, and social needs. Care coordination is a key component of the PCMH model, ensuring that patients receive seamless care across providers and settings.
**Performance Improvement (PI)** #
**Performance Improvement (PI)**
PI is the process of identifying and addressing areas for improvement in healthc… #
PI may focus on specific aspects of care, such as medication safety or patient satisfaction, and often involves the use of data to identify trends, patterns, and opportunities for improvement. Quality improvement and CQI are related concepts, focusing on systematic and ongoing approaches to improving care. Root cause analysis is a technique used to identify the underlying causes of problems or variations in care.
**Population Health Management (PHM)** #
**Population Health Management (PHM)**
PHM is a proactive, data #
driven approach to improving the health of populations by identifying and addressing the underlying determinants of health. PHM may involve the use of data analytics, predictive modeling, and targeted interventions to manage the health of specific patient populations, such as those with chronic conditions. Value-based care is a related concept, focusing on the delivery of high-quality, cost-effective care based on the needs and preferences of patients.
**Root Cause Analysis (RCA)** #
**Root Cause Analysis (RCA)**
RCA is a problem #
solving technique used to identify the underlying causes of problems or variations in care. RCA may involve the use of tools such as fishbone diagrams, 5 Whys, or FMEA to systematically analyze the contributing factors and develop targeted interventions.
**Six Sigma** #
**Six Sigma**
Six Sigma is a data #
driven approach to continuous improvement that aims to reduce variation and eliminate defects in processes and workflows. The DMAIC methodology is a structured problem-solving approach used in Six Sigma, consisting of five phases: Define, Measure, Analyze, Improve, and Control. Variation refers to the inherent or common causes of inconsistency in processes, while defects are deviations from desired outcomes.
**Telehealth** #
**Telehealth**
Telehealth is the use of technology to deliver healthcare services remotely, ena… #
Telemedicine is a specific type