Process of Care and Model of Good Care
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Transcript of Process of Care and Model of Good Care
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PROCESS OF CARE (POC)
MODEL OF GOOD CARE
(MOGC)
DR ISABELLA CHIAUNIT KUALITI PENJAGAAN PERUBATAN
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PROCESS OF CARESequential steps of activities
whilst providing a particular
healthcare services.
The steps is adopted from the
professionally accepted standardor norm , SOP, guidelines,
circulars, CPG, etc
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PROCESS OF CARE
Data Analysis tools Flow chart
Flow chart a graphicrepresentation of how a processworks, showing the step by stepseqence of processes an!sbprocess that incl!ee"ents,reactions or !ecisions
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#$% &EED PROCESS OF CARE
'o i!entify the actal path aprocess follows
'o i(pro"e or increase efficiency'o generate hypotheses abotcases
'o sti(late co((nication a(ongparticipants'o establish a co((on
n!erstan!ing abot the process
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#$E& 'O )SE A F*O# C$AR'
Dring proble( i!entification, !ata analysis,soltion planningClarify how things are crrently working
Clarify how the process can be i(pro"e!Assist in fin!ing the key ele(ents of aprocess+critical step-!entify appropriate tea( (e(bers who can
pro"i!e inpts or resorcesEstablish i(portant areas for (onitoring process
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AD.A&'A/ES OF A F*O#C$AR'
Describe the actal processA basis for !esigning an! i(pro"ing
processes-n"ol"e the people who ha"einfor(ation abot the processes
On co"er potential proble(s an!bottlenecks-!entify proble(s an! opportnities
for i(pro"e(ent
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PROCESS OF CARE
For 0A, the flowchart shol! containspecific acti"ity + refer to a particlarprocess of care1(anage(ent in the
2area of concern for
i(pro"e(ent
-t (st co"er all steps of care that weare intereste! into3
Flow of care can be se! to gi!e the!e"elop(ent of 24o!el of /oo! Care5
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FLOW CHART SYMBOLS
First 6 last step
Decision point
Processing step
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PROCESS OF CARE*isten to Dr
-sabella 5slectre
)n!erstan!all what
she sai!7
- can procee!with the 0A
st!y
- (st askqestion
afterwar!
Still notn!erstan!
?
Start the
0AP st!y
yes
no
no
yes
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MANAGING HYPOTHERMIC PRETERM BABIESIN LABOUR ROOM , HOSPITAL TAIPING
Preparation for pre(atrebaby !eli"eries
8aby !eli"ere!
$ypother(ia
'ransfer to SC&
NoEn!
Yes
Anticipate 4anage(ent of pre(atrity
'reat(ent
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CAR'A A*-RA& ASA* PE&/E&DA*-A& 9ES-8) 8ERSA*-& D- P88R, $'AA
Pendaftaran masuk di PAC
Saringan di buat oleh
Jururawat y/m mengikut
checklist
Risiko Ti!!i
Di(askkan keDewan8ersalin
Risko Re"#$
Pemeriksaan ibu
dan janin di Pusat
BersalinBermasaalah
Tidak
bermasaalah
8ersalin !i P88R
Pen:agaan ib!an bayi !ipostnatal
DISCAJ
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FLOW CHART ON PROCESS OF OBTAINING URGENT PLATELET COUNT FOR
DENGUE CASES
REQUEST PLATELET COUNT Ix
BY DOCTOR
DR FILL UP FORM (URGENT SPECIMEN)
FORM CHECKED BY NURSE
NO
YES
COMPLETE ?
S/N LABEL & TAKE BLOOD CALL
UP MLT & A/K
SPECIMEN RECEIVED BY MLT
& CHECKED BY MLT
COMPLETE ?
NO
YES
A/K DESPATCH BLOOD
SPECIMEN TO LAB
S/N CALL FOR MLT
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OUR P%O%C &&
Too s'#i!$' o*#"I+oe+' s-.o/s&
A00o0i#'eess&
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ISCAJ ARI
WA KANAK-KANAK
PK MOBILE TEAM
(PROGRAM KZM)
MEN APAT
BAKUL KZM
TI AK MEN APAT
BAKUL KZM
MENCAPAI TARGET
Z SCORE < 2
MENCAPAI TARGET
Z SCORE < 2
TEMUJANJI RUTIN
KLINIK PAKAR
YA
TI AK
TI AK
REA MISSION KE
WA KANAK-KANAK
4E&/)RA&/9A& ; 9E4AS)9A& SE4)*A PESA9-' 4A*&)'R-S- D- 9A*A&/A&9A&A9
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WHAT IS MOGC
4O/C is the process of care with a @goo!!esign
B/OOD5 is base! on the @specificationsconsi!ere! opti(( an! achie"able
B/OOD5 is !efine! by Criteria an! Stan!ar!s
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Strctre P(o+essP(o+ess Otco(e
/oo! process willpro!ce goo! otco(e
Goo"Po+ess
/oo!Strctre
/oo!otco(e
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'he goo! steps can be a!opte! fro(the professionally accepte!stan!ar! or nor( , SOP, gi!elines,circlars, CP/, etc
-t (ay also be inno"ations thoght
of, by the grop
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WHAT IS MOGC&
Etracte! fro( critical steps in the process
of care Each step will contribte to the final ser"ice
otco(e 'his chosen critical steps of care (st be
acco(plishe! within the set criteria an!stan!ar!
-f not followe!, it (ight case a @(ltiplyingeffect of failre in the series of care
Finally, will en!
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MULTIPLYING EFFECT OF FAILURE
Morbidity
Mortality
Dee+' #' #s'e0 *i//
+o'i.4'e 'o '$e#i/4e o
s4.se54e' s'e0si+/4"i! '$e i#/
o4'+o-e
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MODEL OF GOOD CARENO PROCESS CRITERIA STANDARD
1 A 1.2.3.
2 B 1.2.
3 C 1.2.3.
4 D 1.
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)SA/E OF 43O3/3C
0ality assrance A generic ter( enco(passing any
syste(atic effortto ensre 6 i(pro"eqality of health careser"ices
Assess(ent of the actal qality ofcare an! correction of the obser"e!!efect
'he focs is on ensring the pro"isionof best possible carefor all clients
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)SA/E OF 43O3/3C
Assess(ent of the actal qality of care
< the etent to which actal care is in
confor(ity with preset criteria forgoo! care
< (easrable !ifference what is
realie! an! what shol! be realie!
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)SE OF 43O3/3C
As a (o!el processthat is thoght to be
goo! an! achie"able
Co(pare this (o!el with the
real sitation
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ii)-nfor(ation shol! be obtaine! < *4P of antenatal (other on booking
< Pre"ios (e!ical1srgical history of crrentillness on a!(ission< Specific1relate! sy(pto(s for certain c1o
< Possible co(plication of chronic patient on F1p
iii'hings to recor!s < essential eternal signs on P1E of specific con!ition
< hea! chart 1 le"el of consciosness of 4.A patients
with hea! in:ry < plan of R 1 4 after re"iewing the patient< partogra( for (other in progress of labor
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Stan!ar! setting in the 4O/C
-is 2the (ini(( le"el of acceptable perfor(ance5 for therespecti"e step in the process of care + referre! to as 2Opti(( Achie"able Stan!ar! 2 +OAS
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SOURCE OF STANDARD
Own situational analysis / studyPast experience / performance
National, internationally accepted Std.
Expert panel opinionsConcensus opinions among healthcare
providers.
CPG, evidence-based research
Textbook, scientific journals
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No Procedure Criteria Standard
1
MOGC 6 THE TEMPLATE
No Procedure Criteria Standard
Pre
RemedialMeasures
1
No Procedure Criteria StandardPre
RemedialMeasures
PostRemedialMeasures
1
8efore-(ple(entation ofRe(e!ialMeasures
After-(ple(entation ofRe(e!ial 4easres
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R
ED)C-&/DE*A%-&
AD4-&-S'
ER-&/
F
-RS'DOS
EOF-.A&
'-8-O'-C
'O
-
C)PA'-E&
'S
Doctor write prescription
Any problem? Clarify with doctoryes
No
Supply available in ward? Get supply from pharmacyNo
Need to take C & S
specimen?
Doctor take C & S specimenyes
Check drug availability in ward
Check the requirement to take C & S specimen
yes
No
Check the need to withold the administrationof drug eg. hemodialysis
Should withold drug
administration?
Withold administration until procedure
finish
SN prepare and administer
drug to patient
yes
No
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MODEL OF GOOD CARENO PROCESS CRITERIA STANDARD PRE
REMEDIAL
1 Doctor writeprescription
-SS first antiiotic need to ecountersi!ned " specialist
efore sent to p#armac"
1$$% &2.'%
2 (et antiiotic fromp#armac"
-)f antiiotic not a*ailale inward+ !et suppl" from p#armac"
wit#in 1 #our
1$$% ,2%
3 C#ec t#ereuirement to tae
C / S specimen
-Doctor need to tae C / Sspecimen from patient wit#in 2
#ours after prescription written.
1$$% ,$%
4 Staff nurse prepareand administer dru!to patient
-Administer dru! wit#in 4 #ours 1$$% 03.3%
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'A-P-&/
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41
'A-P-&/
S=AR=
A
)ntuation /
>entilation
Admission to
)C?
Assess for )ntuation
)n*asi*e
Procedures
No
Yes
Continue *entilation
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TO REDUCE DENTAL FEAR IN SCHOOL CHILDREN
IN PPD LMS
Introduction to the NEW Guidelines on Permanent Teeth Extraction in Schools
D'- "o" Ex'!%o
N'*" L%, P"0''%o
Too+, '# M'"%'+, P"0''%o
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Lo!'+ A",2",%' ( To0%!'+ L.A.)
Ex'!%o
Po, Ex'!%o I,$!%o
R"3%"4
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-& S)44AR%4o!el of goo! care is abot a Bgoo!5
process !esignB/oo!5 is !efine! by criteria an!
stan!ar!sBActal Care5 is co(pare! to this
(o!el
$elps is focssing an! planningre(e!ial (easres4O/C is &O' S'A'-C
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MOGC8%
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THANK YOU
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