Quality assurance- continuous quality improvement standards www mediphobia

Quality assurance- continuous quality improvement; standards www. mediphobia. com

Introduction • Quality management (QM) and quality improvement (QI) are the basic concepts derived from the philosophy of total quality management (TQM). Now it is preferred to use the term Continuous Quality Improvement (CQI) since TQM can never be achieved. And the method of monitoring of healthcare for CQI is done with Quality Assurance (QA).

TERMINOLOGY • Quality assurance is a management system designed to give maximum guarantee and ensure confidence that the service provided is up to the given accepted level of quality, the standards prescribed for that service which is being achieved with a minimum of total expenditure. -British Standards Institute

Continuous quality improvement • CQI is an ongoing quality improvement measure using management and scientific methods of quality assurance involving data collection, its analysis, and formulating ways to improve performance outcome according to proposed standards. ‖

QA V/S CQI • OHP

Objectives Public accountability Management improvement Facilitation of adoption of innovations To successfully achieve sustained improvement • Set Incremental goals as needed • •

QA in health: 2 main objectives • To provide technical assistance in designing and implementing effective strategies for monitoring quality and correcting systemic deficiencies and • To refine existing methods for ensuring optimal quality health care through an applied research programme

Concept of QA • Quality assurance is an integral part of client care activities in all health care setting. its objective is to improve the care provided to client. Quality assurance is the effective execution of all the activities concerned with attaining quality.

DIMENTIONS OF QUALITY • OHP

PURPOSES/NEED • • • Improvement of job satisfaction. Highly informed consumer To prevent rising medical errors Rise in health insurance industry Accreditation bodies Reducing global boundaries.

PRINCIPLES OF QA • Managers and workers must be committed to quality improvement. • Customers define quality. • Quality improvement focuses on outcome. • Decisions must be based on data. • QM operates most effectively within a flat, democratic and organizational structure.

Process of quality Assurance • • Setting standards Apprising actual Achievement Planning for Improvement Taking action when required

Need for quality assurance in health care • Professional Factors • Economic Factors • Social/Political Factors

Factor Influencing quality assurance Lack of Resources Personnel Problem Improper maintenance Absence of well informed populace Absence of accreditation laws Lack of good hospital information system Absence of conducting patient satisfaction survey • Lack of nursing care record • •

Approaches/methodologies: • • General approach: Credentialing Licensure Accreditations Certification Recognition Academic degree

Specific approach • • • Audit Direct observation Appropriateness evaluation Peer review Bench marking Supervisory evaluation Self-evaluation Client satisfaction Sentinel

Techniques of quality assurance in nursing • OHP

STANDARDS • Standards are written formal statements to describe how an organization or professional should deliver health service and are guidelines against which services can be assessed.

The Organizations providing Quality Indexes are: • AHRQ –Agency for Healthcare Research and Quality • IHI –Institute for Healthcare Improvement • JCAHO –Joint Commission on Accreditation of Healthcare Organizations • NAHQ –National Association for Healthcare Quality • IOM –Institute of Medicine • NCQA –National Committee for Quality Assurance

What is Quality Assurance (QA) System Standards? • Quality assurance standards (or QA for short) are a set of standards that have been chosen and implemented by businesses all around the world to show commitment to delivering quality products and services to customers • Specifically, quality assurance (or QA) is a standard for meeting customer requirements.

QUALITY STANDARDS: • ISO STANDARDS: • The International Organization for Standardization (ISO) created the Quality Management System (QMS) standards in 1987. They were the ISO 9000: 1987 series of standards comprising ISO 9001: 1987, ISO 9002: 1987 and ISO 9003: 1987; which were applicable in different types of industries, based on the type of activity or process: designing, production or service delivery.

ISO 9001 Certification for Hospital Quality Management Systems • An ISO 9000 implementation gives a basic road map for integration of all functions involved in total health care services. • The latest version, the ISO 9001: 2008, is especially relevant to the Healthcare Services Sector as it focuses on fulfilling customer (patient) expectations, improving the quality of an organisation’s business and management processes, so that when a job is done it is done well, first time, every time.

Quality Assurance in Nursing: Standards • A nursing care standard is a descriptive statement of desired quality against which to evaluate nursing care. It is guideline. A guideline is a recommended path to safe conduct, an aid to professional performance. A nursing standard can be a target or a gauge. When used as a target, a standard is a planning tool. When used as a gauge against which to evaluate performance a standard is a control device.

Characteristics of Standard • Standards must be realistic, acceptable, attainable. • Standards of nursing care must be developed by members of the nursing profession; preferable • Standards must be based on current knowledge and scientific practice. • Standards may be directed towards an ideal

Purposes of standards • Standards give direction and provide guidelines for performance of nursing staff. • Standards provide a baseline for evaluating quality of nursing care • Standards help improve quality of nursing care, increase effectiveness of care and improve efficiency. • Standards may help to improve documentation of nursing care provided.

Cont’d • Standards help supervisors to guide nursing staff to improve performance. • Standards may help to improve basis for decision-making and devise alternative system for delivering nursing care. • Standards my help clarify nurses area of accountability. • Standards may help nursing to define clearly different levels of care.

Sources of Nursing Care Standards • OHP

Classification of Standards • OHP

NABH Standards • The National Accreditation Board for Hospitals & Healthcare Providers (NABH) Standards is today the highest benchmark standard for hospital quality in India. Though developed by the Quality Council of India on the lines of International Accreditation Standards. • Patients are the biggest beneficiaries from the NABH Accreditation, as it results in a high quality of care and patient safety.

LEGAL SIGNIFICANCE OF STANDARDS • Standards of care guidelines by which nurses should practice. If nurses do not perform duties within accepted standards of care, they may place themselves in jeopardy of legal action. Malpractice suit against nurses are based on the charge that the patient was injured as a consequence of the nurses failure to meet the appropriate standards of care.

Areas of QA • • • Outpatient department Emergency medical services In- patient services Specialty services Training

SUMMARY &CONCLUSION