I know I wrote about this in my last blog post but today I got this study material in my mailbox so I got a little excited. I have a dream to study abroad. When I was young I never traveled or anything. I worked, took my nursing degree and continued working. And to be honest, I have worked ever since. Now when I’m a PhD student I think that I have increased opportunities to study abroad and the first step to defeat is an English exam. The test is held is Lund which is small town approximately 30 km from my home. The IELTS test consists of four elements, reading, listening, writing and speaking and test dates this spring is on May 5th or June 2nd. I would like to apply to the University of Leicester and there requirement are an IELTS score 7.0 with a minimum score of 6.5 in each element. I will try to study hard and hopefully I will succeed and if not… I will just try again and again…
According to the report “Crossing the quality chasm” from 2001, there are six dimensions of quality. These dimensions represent characteristics of how health care should be and what areas to focus on when improving it.
- Safe – make no harm
- Effective – evidence-based care
- Patient-centered – individual responsive and respectful care
- Timely – access and system responsiveness
- Efficient – cost effectiveness
- Equitable – same quality to everyone
I think that Jessica Uriarte makes the six dimensions understandable in her excellent video.
In the video Jessica talks about how to honor the patients´experiences and that all care must be align with their goals and values. Not unexpectedly that is in line with what the report Crossing the Quality Chasm has declared:
“Patient-centered encompasses qualities of compassion, empathy,
and responsiveness to the needs, values, and expressed preferences of the
Health care should focus on adapted care that is flexible and aware of the specific needs of individuals to provide patient-centeredness.
Quality improvement is a process of continually evaluating clinical practices using patient outcomes as the basis of evaluation. Berwick (2002) argues for patients’ outcomes as the fundamental source of defining quality. By ignoring the patients´experiences and perceptions we could end up with a care that is inhuman, out of compassion and empathy. Instead we should honor the patients´ needs and take their goals and values into account when striving towards high-quality care.
I believe that the core in my forthcoming research will be to highlight the patients perspective. To put it in a nutshell, it seems to be impossible to conduct high-quality endoscopic procedures without taking the patients´ experiences into account.
Berwick D (2002) A User’s Manual for the IOM’s Quality Chasm Report. Health Aff (Millwood), 21(3), 80-90.
Institute of Medicine (2001) Crossing the Quality Chasm: A New Health System for the Twenty-first Century. Washington, National Academy Press.
Uriarte J (2015) 6 dimensions of Healthcare Quality. https://youtu.be/QexTk38euzY
PHOTO: MIRRORED DIMENSION BY JOHN DAVID JOHNSON (CC BY-SA 2.0)
Oh dear, what have I done? Today´s lesson is nothing less than an understanding of the impossible thing I´m about to do. How on earth am I going to measure patient satisfaction during endoscopic procedures? My ambition is to achieve a standard for measuring patient satisfaction in the name of quality assurance and by that create a tool for quality improvement.
Fred Lee in this TEDx talk is excellent and fun when he describes an experience of taking a blood sample. (Let me get this straight – I don´t fancy Fred Lee´s old fashion description of him being a manly male and us being female nurses categorized into gentle vs. rough but if you see beyond that I totally get his point.) So this is how it goes, at first he meet “the good nurse” rough Rudy who concentrates on her task and accomplish it without any vital errors. Afterwards he describes another encounter with “the great nurse” gentle Cherie. She mastered the task of taking a blood sample in a different more compassionate way, where she cared for the person in front of her. The patient, Mr Lee´s perception of the two meetings was an example of how good went into great and of course he want caring gentle Cherie to come for tomorrow mornings blood sample.
He also makes an comparison with a trip to Disney world… it was good but not fun. Guess we all want a trip to Disney world to be more than good and, if I´ve understood the point of this video, we in the health care business ought to think the same. Our patients are supposed to experience something satisfying in their encounter with us.
The father of quality – Edward Deming – is quoted in the video:
If you can´t measure it, you can´t improve it. But, the most important figures one needs for management are unknown and unknowable.
The question of how do you measure the effort of going from good to great in patient perceptions still remains and that will be my headache for eight looong years 😉