Introduction to Quality in Healthcare

Introduction to Quality in Healthcare

• Students will be able to define quality and recognize its dimensions by the end of the lecture.
• The lecture will cover quality in health care, including definitions, elements, and measurement.

What is Quality

• Quality is defined as the level of excellence.
• It relates to conforming to standards.
• Meeting customer needs, going above and beyond expectations.
• Fitness for its intended purpose.
• Quality of care is the degree to which health services improve health outcomes.
• It is based on professional knowledge and essential for universal health coverage.
• Quality of care is imperative as countries strive for "Health for All."

Defining Quality in Healthcare

• In practice, quality in healthcare means doing things right the first time for every individual.

How to Measure Quality

• Performance and results are judged through methods like metrics and patient feedback to evaluate quality.

Standards

• Standards are the measurable benchmarks against which judgments are made.
• They should be relevant, achievable, and measurable.
• Quality is compliance with standards.
• Quality is the degree of adherence to established criteria or standards.

What is Quality (according to WHO)

• The proper performance of interventions (standardized) that are safe, affordable for society, and impactful on morbidity, mortality, disability, and malnutrition.

Dimensions of Quality

• Accessibility, acceptability, safety, timeliness, effectiveness, appropriateness (clinical needs consistent with current knowledge), patient-centered care, efficiency, equity, continuity, competency, comprehensiveness of care, amenities, respect and caring, and support for healthcare providers.

Accessibility

• Geographical reach of services.
• Affordability.
• Considering patient needs and values

Acceptability

• Client satisfaction in the care environment.
• Meeting patient preferences.
• Standards of practice.

Safety

• Reducing risks from incidents.
• Unplanned events that could result in injury or loss.
• Examples of incidents: wrong doses or medication, falls, allergies

Timeliness

• Shortening wait time.
• Immediate access to care.
• Minimizing delays.

Effectiveness

• Achieving desired outcomes through the correct manner.
• Science-based treatment.
• Evidence-based practice.

Appropriateness of care

• Care consistent with recipient's clinical needs.
• Based on current state of knowledge.

Patient-centered care

• Putting the patient at the center of care systems.
• Respecting patient preferences, needs, and values

Efficiency

• Maximizing outcomes while reducing costs.
• Avoiding unnecessary risks and expensive measures.

Equity

• Fair care irrespective of gender, ethnicity, location, and socio-economic status.

Continuity

• Providing a complete range of services without interruption.
• Ensuring efficient and effective care.

Competency

• Healthcare providers meet the expectations for health and satisfaction for customers.

Comprehensiveness of care

• Treating patients considering various aspects of their needs and health.
• Coordination among healthcare providers in complete patient care.

Amenities

• Appropriate appearance and environment of the facilities.
• Cleanliness, privacy, waiting areas, and working time.

Respect and Caring

• Provider’s respect and responsiveness to patient needs.
• Establishing good interpersonal relations to build trust.

Support for Healthcare Providers

• Community support for economic and social needs.

Forms of Quality

• Quality Assurance, Quality Control, Total Quality Management and Continuous Quality Improvement

Quality Control

• Monitoring actual performance against standards to correct gaps.
• A reactive approach reliant on checks and inspections

Quality Assurance

• A proactive system to ensure quality of service with minimal expenditure.
• Achieved by doing things right the first time.

Steps for Quality Assurance Cycle

• Planning QA elements.
• Setting standards (guidelines, procedures, rules, specifications, performance standards)
• Communicating standards.
• Monitoring implementation.
• Auditing.
• Identifying problems and prioritizing them.
• Defining the issue.
• Team selection.
• Root cause analysis.
• Developing solutions.
• Implementing and evaluating improvement actions.

Total Quality Management (TQM)

• Integration approach for achieving continuous improvement of services to meet customer satisfaction.
• TQM involves all functions, processes, and employees.

Total Quality Management (TQM) further Points

• Meeting customer needs and exceeding expectations.
• Processes for improvement based on a broader scope than QA or QC.
• Encouraging participation to develop quality improvement ideas.

Total Quality Management (TQM) further Points

• Benchmarking current activities against leaders in their industry.
• Identification of performance gaps and taking necessary actions.

Continuous Quality Improvement (CQI)

• Continuously improving the level of performance within the organization.
• Doesn't adhere to fixed standards but continually seeks new ones for improvement.

Differences between TQM and CQI

• TQM and CQI have similarities with experts disagreeing on clear differences.
• CQI is a broader concept of TQM including non-stop improvement and wider participation.

Accreditation

• Formal processes for an authorized body to assess healthcare organizations' compliance with predetermined, standards.

Auditing

• Examining and evaluating the inputs, process, and outputs of a system for conformity with standards.
• A problem-solving process to identify what went wrong, why it happened, and what actions should be taken to prevent future issues.

Customer Satisfaction

• Major part of the quality management system.
• Meeting customer requirements; affects service processes.
• External customers: e.g., patients, contractors, supplies
• Internal customers: e.g., staff (doctors, nurses, administrators)

Activity (True or False)

• Benchmarking is comparing current activities with standards.
• Quality assurance is proactive while quality control is reactive.

This quiz explores the key concepts of quality in healthcare, including definitions, dimensions, and measurement methods. Students will learn how quality translates into improved health outcomes and the importance of standards. Gain insights into evaluating healthcare performance through various metrics and patient feedback.