When evaluating quality and patient safety, which approach defines the framework for Patient Safety and Quality Research Design (PSQRD)?
a. Outcomes are driven mainly by Meaningful Use directives.
b. Consideration of current managerial processes has no effect on patient outcomes.
c. Patient safety is best achieved by minimizing changes to existing processes.
d. Quality and safety are based on organization structure, management and clinical processes, and their linkages to patient outcomes.
ANS: D
Quality is based on organizational structure, process, and their linkages to patient outcomes. Consideration of current managerial processes in place has a latent effect on patient outcomes. The framework for PSQRD builds upon Donabedian's structure-process-outcome model to support evaluation of an intervention from the pre-implementation testing phase, through implementation, and evaluation. In the case of a health information technology (IT) intervention, the expanded framework supports understanding of where the health IT intervention is most likely to have an effect, within the organizational causal chain of quality and safety events. The PSQRD framework provides a means to categorize interventions according to areas of the causal chain targeted (e.g., the structure, the management or clinical processes, and the patient outcomes or throughput that are targeted by the intervention or that drive adoption and use of the intervention in clinical practice).
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