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7/28/2019 Quality Assurance Update
1/12
7/28/2019 Quality Assurance Update
2/12
What is quality (Roemer &
Montoya Aguilar, WHO 1988)
Proper performance of intervention that
are known to be safe, that are affordable
to the society, and that have ability to
produce an impact on
Mortality
Morbidity
Disability
Malnutrition
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Quality in health care
Care that meets or exceeds expectations
There are 2 aspects of quality
Technical
Patients satisfaction
The quality of health care delivery may
be evaluated by structure, process and
outcome indicators
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An attempt to protect and enhance qualityIt concerned with patient care that is high inprofessional quality and satisfying the patients
Quality holds the promise of being able to: Deliver the most appropriate and up-to-date medicare
Reduce the chance of unsuitable treatment and care,and an inappropriate variation in the care betweendoctors
Encourage accountability between providers,consumers and founders of health care
Save unnecessary costs by reducing waste,duplication and increasing efficiency
Quality assurance
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Continuing improvement
The steps: Its leader must hold to a shared vision of a
health care system that is undergoingcontinuous improvement
Substantial investment in managerial capital,time and expertise will be required for qualityimprovement
Respect must be established for health-care
worker involved in complex task in a complexsystem
Those served and those serving mustcarefully maintain an open dialogue
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Modern technical, theoretically grounded tools
must be applied to health-care setting
Health-care regulations must be more
sensitive to the cost and ineffectiveness of
relying on inspection to improved quality Professionals must take part in specifying
preferred methods of care that exceed
minimalist standards
Individual physicians must actively participatein the effort for continuous improvement
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QA CYCLE
Implementation of continuing
improvement is done through quality
assurance cycle.
QA cycle is made up of 4 steps
1. Select or review the topic
2. Observe practice
3. Compare practice with explicit standards
4. Implement change
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1. Select or review the topic
QA process begins with setting standards for thetopic under review
Guide for setting standard :
Keep the standard simple
Limit the number of standard Include only essential items
Include items proved effective
Exclude dangerous and ineffective items
Exclude excessive and unnecessary items
Allow the best adoption of provider and patient
resources
Be sure the content is up to date
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2. Observe practice
Data is collected from the practice
Collecting data consist of:
Selection the indicators
Selection the collection method (validity,reliability, feasibility, and acceptability.
Data analysis
It should look at essential aspects of care
Data to be collected must be valid, reliable
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Dimentions of Quality
Technical competence
Access to services
Effectiveness
Interpersonal relations
Efficiency
Continuity
Safety
amenities
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Quality assurance process
Planning for QA
Developing guidelines and settingstandards
Communicating standards andspecifications
Monitoring quality
Identifying problems and selectingopportunities for improvement
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Defining the problem operationallyChoosing a team
Analysing and studying the problem to
identify the root causesDeveloping solutions and actions for
improvement
Implementing and evaluating qualityimprovement efforts