performance management & quality of care of mater dei's diabetes clinic by: jennie bauer,...
TRANSCRIPT
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Performance Management & Quality of Care of Mater Dei's
Diabetes Clinic
By: Jennie Bauer, Thomas Maselli, Samantha Read, and Jeffrey Wagoner
James Madison University
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Background of Diabetes in Malta. Around 10% of the Maltese population suffers from Diabetes, 30,000- 40,000 people. The percent of those suffering is expected to double in the next few years. Expected high number of those with Diabetes and are not aware of their condition
http://www.diabetesmalta.org/Profile.html
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Background of Mater Dei’s Diabetes and Endocrine Clinic
Mission Statement:We strive to offer be a centre of excellence in:
.Providing the best clinical service to patients suffering from diabetes & other endocrine disorders in a friendly environment, making best use of
the resources available to us.Performing research which furthers knowledge of diabetes and endocrine
disorders, in collaboration with the University of Malta Medical School .Promoting awareness of and knowledge about diabetes and endocrine
disorders as well as healthy life-styles amongst the general public, in collaboration with the Health Promotion Department and the Maltese
Diabetes Association .Postgraduate training of doctors in the specialty of Diabetes and
Endocrinology
https://ehealth.gov.mt/HealthPortal/health_institutions/hospital_services/mater_dei_hospital/diabetes/diabetes_endocrine_clinic_mdh.aspx
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Background of Mater Dei’s Diabetes and Endocrine Clinic
Services offered at the clinic:. Nursing staff for basic diabetic care . Podiatrist. Optometrist (retinopathy care). Dietitian . Diabetes education and health promotion
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Background of Mater Dei’s Diabetes and Endocrine Clinic
Diabetes Education and Health Promotion:. Have a class room in the clinic. Hold diabetes education classes for all patients . Appeal to children diabetes education with Lenny the Lion
http://www.medtronicdiabetes.com/lenny-carb-app/
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Background of Mater Dei’s Diabetes and Endocrine Clinic
By the numbers… Total No. of New Patients:
1,250 - as of March 25th 2010 (a total of 6,140 New Patients in 2010)
994 - as of February 4th 2011
Avg. wait time from date when appt was done to actual appt date
231.2 Days - as of March 25th 2010
203.2 Days - as of February 4th 2011
*Number’s gathered from Clinic Records
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Background of Mater Dei’s Diabetes and Endocrine Clinic
By the numbers continued…..
*Number’s gathered from Clinic Records
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Logical Framework Analysis (LFA)
• LFA is an integrated quality management model and adopts brainstorming sessions among the hospital managers, practicing doctors, nurses and support staff in workshop environment.
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Develop Performance Parameters - The process parameters are both objective and
subjective in nature. Identifying those factors and developing a framework to analyze them are to be carried out to derive process performance.
. Used qualitative observations
. Conducted interviews with staff and patients
. Used and analyze data from the clinicDey, P. K., & Hariharan, S. (2006). Integrated Approach to Healthcare Quality Management: A Case Study. The TQM Magazine , 583-605.
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Measure Current Performance-Extensive data collection and analysis in line with the performance measurement framework with the active involvement of the process owners are to be carried out in order to measure performance of each process.
. Qualitative Measures
. Use of prior knowledge of quality care
. Qualitative assesment of interviews Dey, P. K., & Hariharan, S. (2006). Integrated Approach to Healthcare Quality Management: A Case Study. The TQM Magazine , 583-605.
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Accessibility to Diabetes Information
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Lack of Diabetes Literature
• Brochures not readily accessible
• Posters displayed are not relevant to diabetes
• Pamphlets need to be patient friendly - available in both Maltese and English - clear of excessive medical jargon
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Solutions • Provide diagrams ex. Illustrating proper injection sites• Instructional/procedural Posters ex. Administration of insulin• Health posters ex. Posters on nutrition, vision etc…
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Patient Confidentiality
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Organization of Files
• Files need to be organized in a manner which is easily understood and not disorganized– More space– Shelving to accommodate the number of records
• The location of the filing room is easily accessible to anyone in the clinic– New location– Properly secure access
• Abbreviated files– Files were bulky and potentially cause clutter and confusion
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File Misplacement
• Files were liberally scattered throughout the clinic and in few cases were even on the floor– Have a system where files are not in the open
• Fully integrate a digital filing system– Paper files used as a backup rather than primary
source– Use of laptops or tablet PCs by doctors
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Vocalization
• Patient names should be called out using only their daily number
• Medical conditions should only be talked about behind closed doors
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Patient Discrimination?
• Does the breach in patient confidentiality cause employer discrimination?
• Could be a problem if not closely monitored
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Patient Wait Times
• New system of patient progression
• Create clearly labelled patient waiting areas
• New Scheduling System– Extend appointment scheduling times– Train Receptionists
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Final Remarks
Special Thank You to:
Moira Grixti Antonella Grima
Dr. Sandra Buttigieg
Questions?