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_____ in health care is an approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others
quality improvement
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What is TJC
The Joint Commission
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TJC was also known as
- JCAHO
- Joint Commission on the Accreditation of Healthcare Organizations
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____, a non for profit organization dedicated to improving the quality of care in health care settings
- TJC
- this is who should take a little visit to St Augustine
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____ focuses on performance measurement, which is based on the comparison of processes with outcomes to quality indicators, the measurable dimension of quality that defines monitoring.
Quality Assurance
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____are the measurable dimensions of quality that defines what is to be monitored.
outcomes
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______- stresses control and assessment of performance
quality control
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______ involves the systematic collection and review of quality assurance data
quality assessment
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A ____ plan integrates quality assurance, quality control, and assessment into a complex, systemwide improvement program revolving around the heathcare mission and goals.
- CQI
- continuous quality improvement
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_____ eliminates duplication of quality assurance and quality improvement efforts but still provides assurance that services are of high quality.
- CQI
- continuous quality improvement
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_____ in radiation oncology involves ongoing activities encompassing administrative, clinical, physical, and technical aspects of the radiation oncology process as defined by ____
- Quality Improvement
- ACR
- American College of Radiology and
- AAPM
- American Assoc of Physicists in Medicine
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ACR stands for
American College of Radiology
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AAPM stands for
American Assoc of Physicist in Medicine
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A ____ and audit mechanism is an integral part of the plan
peer review
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Before the process of quality improvement can be implemented ____ must be developed by which one can ___, ____, and ____
- standards
- compare
- evalutate
- establish quality control
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NRC stands for
US Nuclear Regulatory Commission
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The ____ was created in 1974 as a result of Congress passing legislation to divide the Atomic Enercy Commission that since 1954 had been managing the nation's atomic energy programs
NRC
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EPA stands for
Environmental Protection Agency
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_____ was established in 1970 to consolidate into 1 agency a variety of federal research, monitoring, standard sitting and enforcement activities to guarantee protection of the environment
EPA
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The ____ is involved with regulation of the disposal, storage and handling of nuclear waste materials as it relates to ___ issues.
- EPA
- environmental protection
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The transportation of hazardous materials is monitored by ____, which is another federal agency assisting NRC carrying out its mission
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The DOT's effort is coordinated thru the
- OHM
- office of hazardous materials
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Who is responsible for overseeing a national safety program for transporting hazardous materials by air, rail, highway, and water
DOT OR OHM
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BRH stands for___ but is now called ____
- Bureau of Radiologic Health
- Center for Devices and Radiologic Health
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FFDCA stands for
Federal Food, Drug, and Cosmetic Act
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To ensure safe and healthful working conditions, the Congress passed the
Occupational Safety and Health Act
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_____was created to save lives, prevent injuries, and protect the health of American Workers
- OSHA
- Occupational Safety and Health Administration
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____ also set standards for exposure to cadmium and lead, which primarily covers industrial work environments, but these standards would apply to mold rooms where Cerrobend (shielding) block is constructed in rad oncology facilities
OSHA
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______ provides a basis for the NRC to relinquish to the states portions of its regulatory authority relating to licensing and regulating bu product material (isotopes), source materials (uranium and thorium) and certain quantities of special nuclear materials
Section 274b of the Atomic Energy Act of 1954
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The 1st agreement state was established in ____, there are currently ____ states that have entered into agreements with NRC
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The ____ is highly involved with the agreement states keeping all chains of communication open in a variety areas
NRC
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The ____, an organization for physicists has been a forerunner in the development of min standards to guide medical physicists in the development of a quality assurance program as it relates to treatment planning and delivery
AAPM
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______ in reference to radiation oncology is the totality of features characteristics of a radiation therapy process that bear on its ability to satisfy stated or implied needs of the patient
Quality
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____ is all those planned or systemic actions necessary to provide adequate confidence that a product or service will satisfy given requirements for quality
Quality assurance
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All aspects of the radiation therapy process must be routinely and continuously measured, results analyzed and corrective action taken as required to ensure patient care. These types of review are called
Quality Audit
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____ is the operational techniques and activities used to fullfill requirements for quality
Quality Control
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The TJC has replaced the term quality assurance with _____ or _____ because quality is ongoing to determine improvements
- Quality Assessment
- Quality Improvement
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The key word is on going hence this program is often referred to as ___ or ____
CQI or TQM (total Qlty Mgmt)
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_______-- a pictorial representation of the steps necessary in a process
flow chart
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Flow charts use ovals to identify the ___ or ____ of process rectangles to indicate ____, and diamonds to represent ____
- start or end of a process
- action to be taken
- decision
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Quality indicators are developed for each important
Aspect of Care
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____ is a system wide set of methods and tools for improving a process by emphasizing speed and efficiency
Lean
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____ is another process improvement method that focuses on improving the process through precision and accuracy with the elimination of defects in the process. It incorporates the martial arts ranking terminology to define leadership roles.
Six of Sigma
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QA of simulators are always a tolerance of 2mm except
- Monthly
- gantry collimator angle indicators 1 degree
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CT simulator is always a tolerance of 2 mm except
- Monthly
- table vertical and longitudinal motion which is 1mm over the range of table motion
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QA of medical accelerator is always 2mm except
- Daily
- dosimetry xray output/electron output 3%
- Monthly
- dosimetry electron beam flatness constancy
- xray and electron symmetry 3%
- mechanical checks
- gantry/collimator angle indicators
- Annually
- dosimetry monitor chamber linearity 1%
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