Glossary

Glossary of Health Care Quality Terms

The field of healthcare quality and quality improvement have a specialized vocabulary.

                                           A

Acceptable quality level (AQL): The maximum percentage or proportion of nonconformities in a lot or batch that can be considered satisfactory as a process average.

Acceptance sampling:Statistical quality control technique used in deciding to accept or reject a shipment of input or output.

Active data gathering: A method for gathering data that involves approaching respondents to get information.

Actively solicited customer feedback: Proactive methods for obtaining customer feedback such as calling customers on the telephone or inviting customers to participate in focus groups.

Acute care: Acute care is short-term medical treatment, most often in a hospital, for people who have a severe illness or injury, or are recovering from surgery.

Admission or hospital admissions: Admission or hospital admissions is the process of being admitted to a hospital as a patient. The rate and quality of this process may be a good indicator of the local health system’s performance and the effectiveness of health plans in managing care.

Affinity diagram: A tool that is used to help groups identify the common themes that are associated with a particular problem.

Agency for Healthcare Research and Quality (AHRQ): The Agency for Healthcare Research and Quality (AHRQ) is the nation’s lead federal agency for research on health care quality, costs, outcomes and patient safety.

Alignment: Term that refers to optimal coordination among disparate departments and divisions within a firm.

Ambulatory care: Ambulatory care is medical care provided on an outpatient basis—therefore, not requiring a person to be admitted to the hospital.

Appraisal costs: Expenses associated with the direct costs of measuring quality.


Assurance: A dimension of service quality that refers to the knowledge and courtesy of employees and their ability to inspire trust and confidence.

Attrition: The practice of not hiring new employees to replace older employees who either quit or retire 

B

Basic seven (B7) tools of quality:These are the fundamental methods for gathering and analyzing quality-related data. They are: fishbone diagrams, histograms, Pareto analysis, flowcharts, scatter plots, run charts, and control charts.

Benchmark (benchmarking): Benchmarking is a way for hospitals and doctors to analyze quality data, both internally and against data from other hospitals and doctors, to identify best practices of care and improve quality

Best practices: Best practices are the most up-to-date patient care interventions, which result in the best patient outcomes and minimize patient risk of death or complications.

C

C-chart: A chart used to monitor the number of defects in a production process.

Capability: Likelihood a product will meet specification.

Catchall:Term used to describe the iterative nature of the Hoshin planning process.

Categorizing: The act of placing strengths and weakness into categories in generic internal assessment.

Cause and Effect (or fishbone or Ishikawa) diagram: A diagram designed to help workers focus on the causes of a problem rather than the symptoms.

Center for Health Improvement (CHI): The Center for Health Improvement (CHI) is a national, independent, nonprofit health policy and technical assistance organization dedicated to improving population health and encouraging healthy behaviors. Since its inception in 1995, CHI has used evidence-based research to help public, private and nonprofit organizations strengthen their capacity to improve the quality and value of health care and enhance public health at the community level.

Certification audits: Audits relating to registration (e.g., ISO 9000 audits).

Chain of customers: A philosophy that espouses the idea that each worker’s “customer” is the next worker in the chain of people that produce a finished product or service.

Change: In the context of quality management, this means to move from one state of operation to another state of operation.

Check sheets: Data-gathering tools that can be used in forming histograms. The check sheets can be either tabular or schematic.

Clinical practice guidelines: Clinical practice guidelines are a set of systematically developed statements, usually based on scientific evidence, that help physicians and their patients make decisions about appropriate health care for specific medical conditions.

Compensate:(1) To pay or remunerate for some work; (2) To make up for some lack of ability or acuity.

Complaint-recovery process: Process associated with resolving complaints.

Complementary products: Products that use similar technologies and can coexist in a family of products.

Component reliability: The propensity for a part to fail over a given time.

Computer-aided testing (CAT): Technology for taking tests or examinations.

Computer-based training: A form of training that uses specialized software, known as courseware, to address specific topics.

Concept design: The process of determining which technologies will be used in production and the product.

Concurrent engineering :The simultaneous performance of product design and process design. Typically, ­concurrent engineering involves the formation of cross-functional teams. This allows engineers and managers of different disciplines to work together simultaneously in developing product and process designs.

Conformance: A dimension of quality that refers to the extent to which a product lies within an allowable range of deviation from its specification.

Consultant audits: Inspections that are performed by consultants to determine how an organization should be changed for improvement.

Consumer: A consumer is an individual who uses, is affected by, or is entitled or compelled to use a health-related service.

Consumer engagement: Consumer engagement is the situation in which consumers take an active role in their own health care, from understanding their own conditions

Consumer Product Safety Commission (CPSC):An independent federal regulatory agency that helps keep American families safe by reducing the risk of injury or death from consumer products.

Consumer’s risk :The risk of receiving a shipment of poor quality product and believing that it is good quality.

Contact personnel: The people at the “front lines” who interact with the public in a service setting.

Contingency theory :A theory that presupposes that there is no theory or method for operating a business that can be applied in all instances.

Contract review: Contract review involves the steps associated with contracting with suppliers. These steps involve acceptance of the contract or order, the tender of a contract, and review of the contract.

Contrition: Forgiveness for error or mistake.

Control charts: Tools for monitoring process variation.

Control factors: Variables in a Taguchi experiment that are under the control of the operator. These can include things such as temperature or type of ingredient.

Control process: A process involving gathering process data, analyzing process data, and using this information to make adjustments to the process.

Conversion process: Aligning the inputs of a process together to form a product or service.

Coordination of care: Coordination of care comprises mechanisms that ensure patients and clinicians have access to, and take into consideration, all required information on a patient’s conditions and treatments to ensure that the patient receives appropriate health care services.

Criticality: A term that refers to how often a failure will occur, how easy it is to diagnose, and whether it can be fixed.

Cross-functional teams: Teams with members from differing departments and vocations.

Cross-training: Training an employee to do several different jobs.

Customer: Anyone who is the receiver of the goods or services that are produced.

Customer benefits package (CBP): The package of tangibles and intangibles that make up a service.

Customer contact: A characteristic of services that notes that customers tend to be more involved in the production of services than they are in manufactured goods.

Customer co production: The participation of a customer in the delivery of a service product. For example, in many restaurants it is not uncommon for customers to fill their own drinks.

Customer-driven quality: Term that refers to a proactive approach to satisfying customer needs.

Customer expectations: (1) What customers expect from a service provider; (2) A part of the SERVQUAL questionnaire.

Customer future needs projection:Predicting the future needs of customers and designing products that satisfy those needs.

Customer perceptions:(1) How customers view products or services; (2) The second part of the SERVQUAL survey.

Customer rationalization: The process of reaching an agreement between marketing and operations as to which customers add the greatest advantage and profits over time.

Customer-related ratios: Ratios that include customer satisfaction, customer dissatisfaction, and comparisons of customer satisfaction relative to competitors.

Customer-relationship management:A view of the customer that asserts that the customer is a valued asset that should be managed.

Customer retention: The percentage of customers who return to a service provider or continue to purchase a manufactured product.

Customer service surveys:Instruments that consists of a series of items (or questions) that are designed to elicit customer perceptions.

D

Data collection: Data collection is the acquisition of health care information or facts based upon patient and consumer race, ethnicity and language. Data Collection provides health care providers with the ability to perform benchmarking measures on health care systems to determine areas where improvement is needed in providing care.

Disease management: Disease management is an approach designed to improve the health and quality of life for people with chronic illnesses by working to keep the conditions under control and prevent them from getting worse.

Disease registry: A Disease registry is a large collection or registry belonging to a health care system that contains information on different chronic health problems affecting patients within the system. A disease registry helps to manage and log data on chronic illnesses and diseases.

E

Effective care: Effective care includes health care services that are of proven value. The benefits of the services so far outweigh the risks that all patients with specific medical needs should receive them.

Electronic Health (Medical) Record (EHR or EMR): The Electronic Health (Medical) Record (EHR or EMR) is a computerized medical file that contains the history of a patient’s medical care, in contrast to “PHR,” which stands for personal health record., An EHR or EMR enables patients to transport their health care information with them at all times.

Episodes of care: An episode of care is a concept that focuses on a health condition from its inception through evaluation and treatment as a means of measuring both the quality of care received and the efficiency of the care provided.

Evidence-based medicine: Evidence-based medicine is the use of the current, best available scientific research and practices with proven effectiveness in daily medical decision-making, including individual clinical practice decisions, by well-trained, experienced clinicians.

F

Fee-for-service: Fee-for-service is an arrangement under which patients or a third party pay physicians, hospitals, or other health care providers for each encounter or service rendered.

G

Group health plan: A group health plan is a health plan that provides health care coverage to employees, former employees and their families, and is supported by an employer or employee organization.

H

Health information technology (HIT):Health information technology is a global term (which encompasses electronic health records and personal health records) to indicate the use of computers, software programs, electronic devices and the Internet to store, retrieve, update and transmit information about patients’ health.

Hospital discharge: Hospital discharge is the process by which a patient is released from the hospital by health care professionals.

Hospital referral regions (HRRs):Hospital referral regions are used to define regional health care markets. These regions are defined by where patients in surrounding areas are most often referred to for tertiary car.

I

Improving performance in practice (IPIP): The program seeks to establish a designated Quality Improvement Consultant (QIC) to work onsite with the practice leadership team to develop a practice-specific redesign plan utilizing the resources of collaborating experts.

Informed decision-making (IDM): Informed decision-making is a term to describe a process designed to help patients understand the nature of the disease or condition being addressed; understand the clinical service being provided including benefits, risks, limitations, alternatives and uncertainties; consider their own preferences and values; participate in decision-making at the level they desire.

Inpatient care: Inpatient care is the delivery of health care services to a person who has been admitted to a hospital or other health facility for a period of at least 24 hours.

Input: Input is the flow of patients into a medical facility, such as an emergency department.

Institute of Medicine (IOM):The Institute of Medicine (IOM) is a nonprofit organization and honorific membership organization that works outside the framework of government to ensure scientifically informed analysis and independent guidance on matters of biomedical science, medicine and health.

J

Joint Commission (JCAHO) formerly: Joint Commission on Accreditation of Healthcare Organizations: The Joint Commission (JCAHO) is a private, nonprofit organization that evaluates and accredits hospitals and other health care organizations providing home care, behavioral health care, ambulatory care and long-term care services.

M

Medical error: A medical error is a mistake that harms a patient. Adverse drug events, hospital-acquired infections and wrong-site surgeries are examples of preventable medical errors.

Misuse: Misuse occurs when an appropriate process of care has been selected, but a preventable complication occurs and the patient does not receive the full potential benefit of the service. Avoidable complications of surgery or medication use are misuse problems.

Multi-disciplinary teams/multidisciplinary: Multi-disciplinary teams are health care teams made up of health care professionals as well as health educators or community leaders.

N

“Never-Events”: “Never-Events” are medical mistakes that should never occur under any circumstance.

National Committee on Quality Assurance (NCQA):  is a private, nonprofit organization dedicated to improving health care quality through measurement, transparency and accountability.

O

Outcome: Outcome is the result of a process, including outputs, effects and impacts.

Outpatient care: Outpatient care is medical or surgical care that does not include an overnight hospital stay.

Output: Output is the flow of patients out of a medical facility, such as an emergency department.

Overuse: Overuse describes a process of care in circumstances where the potential for harm exceeds the potential for benefit. Prescribing an antibiotic for a viral infection like a cold, for which antibiotics are ineffective, constitutes overuse.

P

Patient flow: Patient flow is the movement of patients who seek care in an emergency department through the admission process. This is the process through which patients are granted entry for care at the hospital and seen by a physician.

Patient registry: A patient registry is a patient database maintained by a hospital, doctors’ practice or health plan that allows providers to identify their patients according to disease, demographic characteristics and other factors. Patient registries can help providers better coordinate care for their patients, monitor treatment and progress and improve overall quality of care.

Patient satisfaction: Patient satisfaction is a measurement designed to obtain reports or ratings from patients about services received from an organization, hospital, physician or health care provider.

Patient-centered care: Patient-centered care considers patients’ cultural traditions, personal preferences and values, family situations and lifestyles. Responsibility for important aspects of self-care and monitoring is put in patients’ hands—along with the tools and support they need.

Performance measures: Performance measures are sets of established standards against which health care performance is measured. Performance Measures are now widely accepted as a method for guiding informed decision-making as a strong impetus for improvement.

Personal health record (PHR):A personal health record (PHR) contains the medical and health-related background documents pertaining to a consumer.

Preventive care: Preventive care is health care services      that prevent disease or its consequences. It includes primary prevention to keep people from getting sick (such as immunizations),  secondary prevention to detect early disease  and tertiary prevention to keep ill people or those at high risk of disease from getting sicker (such as helping someone with lung disease to quit smoking).

Primary care: Primary care is basic or general health care traditionally provided by doctors trained in: family practice, pediatrics, internal medicine and occasionally gynecology.

Process improvement: Process improvement comprises techniques and strategies used to make the processes implemented to solve health care problems better.

Provider: A provider is a professional engaged in the delivery of health services, including physicians, dentists, nurses, clinical psychologists, etc. Hospitals and long-term care facilities are also providers.

Public reporting: Public reporting makes information about physician and physician group performance available for consumers to use to compare the performance of local physicians/physician groups.

Purchasers: Purchasers comprise the entity that not only pays the premium for health care costs, but also controls the premium dollar before paying it to the provider.

Q

Quality (of care): Quality (of care) is a measure of the ability of a doctor, hospital or health plan to provide services for individuals and populations that increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Good quality health care means doing the right thing at the right time, in the right way, for the right person and getting the best possible results. According to the mantra for the quality improvement movement, care should be “safe, effective, patient-centered, timely, efficient and equitable.”

Quality (of life):Quality (of life) is the amount of happiness and balance in an individual’s life. Attention to good health will create a better quality of life.

Quality assurance: QA refers to all the arrangements and activities that are meant to safeguard, maintain, and promote the quality of care. and it is systematic process for closing the gap between actual performance and the desirable outcomes.

Quality Control : QC refers to the measures that must be included during each assay run to verify that the test is working properly.

Quality improvement (QI):Quality improvement (QI) is a ways to streamline and improve processes and systems. The most well-known example of quality improvement methodology is the “Six Sigma” method of change, developed by engineers at Motorola. In the health care context, the goal of quality improvement strategies is for patients to receive the appropriate care at the appropriate time and place with the appropriate mix of information and supporting resources. Quality improvement tools range from those that simply make recommendations but leave decision-making largely in the hands of individual physicians (e.g., practice guidelines) to those that prescribe patterns of care (e.g., critical pathways).

Quality indicator: A quality indicator is an agreed-upon structure ,process or outcome measure that is used to determine the level of quality achieved. A measurable variable (or characteristic) that can be used to determine the degree of adherence to a standard or achievement of quality goals.

Quality measures: Quality measures are mechanisms used to assign a quantity to quality of care by comparison to a criterion.

R

Report card: A report card is an assessment of the quality of care delivered by health plans. Report cards provide information on how well a health plan treats its members, keeps them healthy and provides access to needed care.

Resource use: Resource use is the amount of health care services used for a patient, including the number, cost and intensity of services provided.

Return on investment (ROI):A return on investment (ROI) is the amount of improvement in care brought about by a certain investment. ROI can also refer to the theory that if you invest in health care quality now, then the quality of care for patients will improve in the future.

Right care: Right care is made up of the treatments that, according to evidence-based guidelines, are effective and appropriate for a given condition. Indicators used to define right care are often grouped into two categories: prevention and chronic care.

S

Self-management: Self-management is the ability of individuals to have the necessary knowledge, attitudes and skills to manage their health problems or disorders on a day-to-day basis

Sentinel event: A sentinel event is any unexpected event in a health care setting that causes death or serious injury to a patient and is not related to the natural course of the patient’s illness.

Standard of care: The standard of care is the expected level and type of care provided by the average caregiver under a certain given set of circumstances.

T

Transparency: Transparency is the process of collecting and reporting health care cost, performance and quality data in a format that can be accessed by the public and is intended to improve the delivery of services and ultimately improve the health care system as a whole.

U

Underuse: Underuse refers to the failure to provide a health care service when it would have produced a favorable outcome for a patient.

 V

Variation: Variation is an instance of change or deviation. There is unwarranted variation in the practice of medicine and the use of medical resources in the United States. There is underuse of effective care, such as the use of beta-blockers for people who have heart attacks and screening of diabetics for early signs of retinal disease. There is misuse of preference-sensitive care, such as the choice between mastectomy and lumpectomy for early-stage breast cancer. And there is overuse of supply-sensitive care, such as admitting patients with chronic conditions like diabetes to the hospital, rather than treating them as outpatients.

W

Work flow: Work flow is a repeatable pattern of activity enabled by the organization of resources, defined roles, and information into a process that can be documented and learned. Improvements in work flow for health care providers will lessen the burden of providing health care and will lead to greater quality health care overall.

 Glossary of infection control Terms

A

Aerosols– Particles of respirable size (<10μm) generated by both humans and environmental sources that can remain viable and airborne for extended periods in the indoor environment; commonly generated in dentistry during use of handpieces, ultrasonic scalers, and air/water syringes.

B

Barrier – An item that blocks the penetration of microorganisms, particulates and fluids, thereby reducing the potential contamination of the underlying surface. Also referred to as ‘Surface barrier’.

Bioburden – Organic material on a surface or  object prior to cleaning or sterilization; (Or) the number of viable organisms in or on the object or surface. Also known as ‘bioload’ or ‘microbial load’.

Biofilm – A complex colony of microorganisms, most notably bacteria, that forms on the surfaces that are bathed with water.

C

Contamination – Presence of microbes on the body surfaces or on inanimate objects or water.

Cross-contamination – Spreading of microorganisms between persons and / or surfaces.

D

Disinfection– Destruction of most pathogenic and other kinds of microorganisms (but not spores) by physical or chemical means.

Droplet nuclei– Microscopic particles (5 microns or less in diameter) formed by the dehydration of airborne droplets containing microorganisms. These particles can remain suspended in the air for long periods of time.

I

Infection – The entry and development or multiplication of an infectious agent in the body.

N

Nosocomial infection – An infection acquired in a hospital as a result of medical care.

P

Parenteral– Taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection.

Pathogens - These are organisms capable of causing infection in a susceptible host.

Percutaneous injury– An injury that penetrates the skin, such as a needle stick or a cut with a sharp object.

Per mucosal- Through mucosa.

S

Secretion- A fluid or substance, formed or concentrated in a gland and passed into the elementary tract, the blood or the exterior.

Sterilant– A liquid chemical germicide capable of destroying all forms of microbiological life, including high numbers of resistant bacterial spores.

Sterilization– A physical or chemical process that destroys all microorganisms, including spores.

One comment to Glossary

  • Meenu Rattan  says:

    Appreciate your initiative. Nice to see increasing awareness & commitment to quality in Kuwait healthcare system……

Leave a reply

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>