ELECTIVE

QUALITY STANDARDS FOR HEALTH PROVIDER ORGANIZATIONS

 An emerging field with the potential to improve health outcomes for patients and
health care delivery within practices.
o
Step 4: Pilot Test and Evaluate Solutions
Step 5: Implement Solutions
TQM PROGRAM IMPLEMENTATION STEPS

 A method by which management and employees can become involved in the

continuous improvement of the production of goods and services. Is a
combination of quality and management tools aimed at increasing business and
reducing losses due to wasteful practices.
 Principles of TQM
o PDCA
 Plan (drive, direct)
 Do (deploy, support, participate)
 Check (review)
 Act (recognize, communicate, revise)
o Employee Empowerment
 Training
 Suggestion scheme
 Measurement and recognition
 Excellence teams
o Fact Based Decision Making
 SPC (statistical process control)
 DOE, FMEA
 The 7 statistical tools
 TOPS (FORD 8D – team-orientation problem solving)
o Continuous Improvement
 Systematic measurement of focus on CONQ
 Excellence teams
 Cross-functional process management
 Attain, maintain, improve standards
o Customer Focus
 Supplier partnership
 Service relationship with internal customers
 Never compromise quality
 Customer driven standards
 The concept of Continuous Improvement by TQM
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o There are 3 major mechanisms of prevention:

 Preventing mistakes (defects) from occurring (mistake-proofing or
poka-yoke)
 Where mistakes can’t be absolutely prevented,
 Where mistakes recur, stopping production until the process can be
corrected, to prevent the production of more defects.
 Steps in Managing the Transition
o Beckhard and Pritchard (1992) have outlined the basic steps in managing
a transition to a new system such as TQM:
 Identifying tasks to be done,
 Creating necessary management structures,
 Developing strategies for building commitment,
 Designing mechanism to communicate the change,
 And assigning resources
THE PDCA CYCLE

 P is for plan
o Make sure to identify your goals, delegate work properly and set a clear
action plan with key milestones.
o Don’t forget to document you plans in order to help you analyze its
effectiveness.
 D is for do
o No plan is ever completely perfect, make sure you make a list of problems
as you encounter them, and how you responded to them.
 C is for Check
o Immediately call the team to compile the list of problems and solutions
they’ve encountered. Share the information with the team so that
everyone knows and understands how to avoid these problems or to fix
them if they happen to reappear again later.
 A is for Act
o Solving an issue by fixing the root cause is like uprooting weeds, as they
don’t grow back again. Once the root causes are eliminated, it is important
to standardize these techniques in order to ensure that everyone knows
about it, and that they don’t happen again.

CARE OF THE CHRONICALLY ILL AND THE OLDER PERSON

TERMINOLOGIES
ELECTIVE

 Geriatrics – branch of medicine concerned with prolonging life, delaying of onset

of degenerative aspects of aging and treating the diseases of the aged.
 Gerontology – branch of science dealing with the psychological, sociological,
economic, physiological and medical aspects of aging.
PHYSIOLOGICAL CHANGES

 Decrease in the efficiency of organs

 Decrease in the number of functional capabilities of cells
 Structural changes associated with collagen
NUTRIENT REQUIREMENTS

 Energy
o 50-59 decreased by 10%
o 60-69 decreased by 20%
o 70 & up decreased by 25%
 Protein
 Vitamins and minerals
o Calcium, iron and vitamin C
 Water and fiber
CHANGES/PROBLEMS

 Atrophy of salivary glands

 Loss of taste buds
 Loss of teeth, poor dentition, ill-fitting dentures
 Decreased stomach acid
 Decreased BMR
 Increased fat mass
 Decreased physical activity
 Loss neuromuscular coordination
 Constipation
 Disease states
 Difficulty in sleeping COLLATERAL CIRCULATION -
 Arthritis alternate circulation around a blocked
 Osteoporosis artery or vein via another path, such
as minor vessels. (Why elderly don’t
 Emotional stress easily die from heart attack)
 Boredom, loneliness
 Loss of companionship
NUTRITION AND DISEASES
 Diseases related to how one lives
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o Cardiovascular disease
o DM
o Cancer
 Causes and risk factors to LD (lifestyle Disease)
o Physical inactivity
o Obesity
o Smoking
o Harmful use of alcohol
o Unhealthy diets
o Malnutrition
o Cardiovascular disease
o Diabetes
o Cancer
o Chronic respiratory dieses
o Other NCD’s – cerebrovascular disease
 Interrelationships of disease
 Leading causes of death in the PH
o Heart disease
o Vascular disease
 Benefits of exercise
o Assist weight control
o Improve blood circulation
o Muscle tone of heart and lungs
o Promote sound sleep
o Cope with stress
o Psychological well-being
o Improve self-esteem
o Helps to become motivated
 Smoking and health
o Lung cancer Harmful substance found in cigar
o Chronic bronchitis
 Carbon monoxide
o Emphysema  Nicotine
o Ischemic heart disease  Tar
o Hypertension
o Decrease in appetite
 Tips to quit smoking
o Decide on a date to stop
o Throw away cigarette paraphernalia
o Watch out for untoward signs
o Be physically active
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 Effects of alcohol
o Interferes with nutrient metabolism