Quality in Health Care

• Quality in Health Care is presented by Dr. Nora Ahmed Abd Allah, Assistant Professor of Nursing Administration

What is quality?

• Quality is a life style
• Quality is an attitude
• Fitness for purpose or use is quality
• A high level of vale or excellence defines quality
• Quality is conformation to standards & requirements
• Doing the right thing and doing it well with the right way from the first time and every time is quality

Juran logo for quality (principles of quality)

• Quality is hard work
• Quality is measurable; what isn't measured can't be managed
• Quality is teamwork involving people
• Quality must be documented
• Communication and coordination are important
• Employ a process approach
• Quality should be a continual improvement

Deming

• Deming: the father of modern quality movement
• Quality is defined as satisfying the needs and expectations of customers

Historical review of quality concepts

• The developmental process passed through 4 phases:
• Quality inspection phase
• Quality control phase
• Quality assurance phase
• TQM Phase (CQI)

I) Quality Inspection

• The focus is on investigating the final product so that defective items can be identified and removed
• Errors are detected after they occur which is too late, especially in health care services

II) Quality Control

• The aim is to reduce the percent of defects, depending on established standards
• Service and product features are kept within upper and lower control limits

III) Quality Assurance (QA)

• Assurance statement or indication inspires confidence
• Quality control refers to any formal and systematic program to identify problems in health care delivery and designing/implementing activities to overcome problems
• Quality assurance includes actions taken to eliminate substandard performance to improve the quality of health care
• Quality assurance in nursing means ensuring adherence to quality standards mandated by regulatory nursing bodies

How can quality be assured?

• Define Quality
  • Standards, norms, guidelines
• Measure Quality
  • The variation in standards
• Improve Quality
  • Comply with norms

IV) Total Quality Management (TQM) or Continuous Quality Improvement (CQI)

• A management philosophy emphasizing commitment to excellence through the organization
  • Based on reliable and accurate information
  • Focus on customer satisfaction
  • Commitment by top management and provision of resources
• Every member of the organization is consulted and involved
• Focus on teamwork and creative thinking
• Long-term concept
• Investment in employee training
• Constant search for improvement
• Preventing errors and continually discovering improvement to satisfy and exceed customer expectations

Definition of quality in health care

• The proper performance (according to standards) must be:
  • Clinically effective
  • Efficient and affordable
  • Services delivered satisfactorily
• Interventions should be carried out correctly to pre-established standards to satisfy consumers and maximize results without generating unnecessary costs or health risks
• Providing the right services in the right way from the first time and every time for every patient regardless to his/her ability to pay
• The goal is to have quality health care for the patient (external stakeholder)

Who is responsible for quality implementation in hospital?

• Everyone in a team
• Together every one achieves more

Perspectives of quality

• The patient's
• The providers
• The manager's

Quality from the Patient's Perspective includes:

• Communication (respect and concern)
• Safe medical environment
• Accessible
• Affordable and timely
• Privacy
• Effectiveness and continuity

Quality from the Providers Perspective

• Educational and technical skills
• Adequate salary and bonuses
• Opportunities for self-development
• Adequate resources
• Healthy environment

Quality from the manager's perspective

• Best services
• Lower cost
• Best results