Improving Quality and Safety in the Endoscopy Unit (On-Demand) | October 2024-01_Palchaudhuri

01_Palchaudhuri_Domains of Quality

Pdf Summary

Dr. Sonali Palchaudhuri's presentation at Massachusetts General Hospital focuses on utilizing the Institute of Medicine (IOM) domains of quality in decision-making to enhance quality and safety in endoscopy units. The IOM domains are pivotal in defining and improving quality in healthcare settings, especially in endoscopy. These domains include Safety, Effectiveness, Efficiency, Patient-centeredness, Timeliness, and Equity, with some considering a seventh domain, Sustainability.<br /><br />Safety entails preventing harm to patients from the care intended to assist them, while Effectiveness involves providing scientifically backed benefits and avoiding unnecessary interventions. Efficiency focuses on reducing waste. Patient-centered care respects patient preferences and needs, ensuring their values guide clinical decisions. Timeliness addresses reducing delays for both patients and providers, and Equity ensures consistency in care quality regardless of personal characteristics.<br /><br />Given these domains, quality improvements are discussed with illustrations such as measuring complication rates, ensuring efficient endoscopy processing, and adherence to care guidelines. The physician also highlights potential challenges when considering implementation changes, such as BMI-based site restrictions, adding simethicone to flush water, and adjusting scheduled procedure times, illustrating potential impacts across these quality domains.<br /><br />Dr. Palchaudhuri emphasizes the importance of performance metrics and a quality improvement team to measure and drive improvement, referencing the Donabedian Model as a framework. This model focuses on structural aspects, processes, and outcomes to ensure all facets of care are assessed for quality enhancements.<br /><br />The presentation suggests that the journey to a high-quality, value-based health system requires careful consideration of each IOM domain and a collaborative team-based approach, stressing that resource allocation and strategic planning are vital for successful quality improvement initiatives.

Keywords

endoscopy

quality improvement

IOM domains

patient safety

healthcare effectiveness

efficiency

patient-centered care

timeliness

equity

Donabedian Model