Lecture 2 Quality Management Concepts (3).pptx

Healthcare Quality and Patient Safety HS 415 Lecture 2 Quality Management Concepts Dr. Fahad Khan [email protected] Learning Objectives • Understand the key quality management principles • Describe the difference between quality planning, quality control, quality assurance and quality improve...

Healthcare Quality and Patient Safety HS 415 Lecture 2 Quality Management Concepts Dr. Fahad Khan [email protected] Learning Objectives • Understand the key quality management principles • Describe the difference between quality planning, quality control, quality assurance and quality improvement • Relate the functional aspects of quality to cost • List ways of improving VALUE of care Quality Management Principles Basic Principles 1. Productive work is accomplished through processes 2. Main source of quality ‘defect’ is a problem in processes 3. Poor quality is costly 4. Understanding the variability in processes is a key to improving quality Quality Management Principles Basic Principles 5.The modern approach to quality is thoroughly grounded in scientific and statistical thinking 6.Employee involvement is critical 7.New organizational structures can help achieve quality improvement – like a ‘quality council’ 8.QM involves three basic, closely interrelated activities: – Quality planning, quality control [quality measurement], and quality improvement Quality management • Quality management has four main components: 1. Quality planning 2. Quality control 3. Quality assurance 4. Quality improvement Quality Planning • Systematic process that translates quality policy into measurable objectives and requirements • Provides a sequence of steps to be completed within a specified timeframe. • Done during the development phase of the project life cycle • Involves identifying standards or best practices. Quality Control • Quality control (QC) is a procedure or set of procedures – intended to ensure that a manufactured (finished) product or performed service adheres to a defined set of quality criteria or – meets the requirements of the client or customer *(AFTER) Quality Assurance • QA is defined as a procedure or set of procedures intended to ensure that a product or service under development (before work is complete) meets specified requirements Quality improvement • Formal approach to the analysis of performance and systematic efforts to improve it. A functional description of quality • Quality has two main components—content and delivery • Content quality is concerned with the medical outcome that is achieved. – Measured mostly by physicians and other health care professionals • Delivery quality reflects an individual customer's interaction with the health care system – for a patient, Was the hospital clean?, Were the nurses caring and informative? The relationship of quality to cost • Quality waste represents the resources required to fix a process's output when a quality failure occurs – Low quality leads directly to higher costs. – These costs, arising from an initial process failure and the resulting low quality output, are termed quality waste • Low productivity occurs when two processes produce the same (desired) output, but one consumes more resources to achieve that end The relationship of quality cost Optimalism vs. to Maximalism • • Represents the idea of cost-benefit analysis If an additional unit of care brings only a small benefit to the patient, but costs too much, should it be used? • New technology usually increases costs. • However, it also usually improves the medical outcome that can be achieved • Preventive medicine and environmental health prevent disease. • They have been shown to be a very cost effective form of health care Quality of Management • Quality/cost control has been shown to depend almost entirely on an organization's control systems. • These systems are designed and operated by management. • Quality/cost control therefore depends almost entirely on management, not on worker motivation. Quality of Delivery • Patients are the primary customers. • It is important to measure their health care expectations and strive to meet those expectations 100% of the time. • When patient expectations are not reasonable, patients must be educated so that, over time reasonable expectations are achieved. Value of Care • Value is the combination of the quality of a product and the cost at which that level of quality is achieved. • Value = quality of care + outcome cost Contd… • 5 areas are considered to improve value of care in quality contexts 1. Physical infrastructure: – tools and facilities – technology assessment – integration 2. Professional infrastructure – High-quality health care depends upon the presence of welltrained, dedicated health care professionals and managers – Examples of providing professional infrastructure • graduate medical education, continuing medical education, • traditional peer review, and compliance with standards set by external regulatory bodies Contd… 3. Decision to treat (accessibility, availability, affordability) 4. Manner of intervention – Inappropriate diagnosis can lead to unnecessary hospitalization and treatment. – Inappropriate therapy wastes resources and damages patients, (hence quality waste) 5. Avoiding/mitigating errors (Patient safety component) References • Walburg, J., Bevan, H., & Wilderspin, J. (Eds.). (2006). Performance management in health care: improving patient outcomes: an integrated approach. Psychology Press. • Naidu, A. (2009). Factors affecting patient satisfaction and healthcare quality. International journal of health care quality assurance, 22(4), 366381. • Donabedian, A. (1980). The Definition of Quality and Approaches to Its Assessment [= Explorations in Quality Assessment and Monitoring, vol. 1]. Ann Arbor: Health Administration Press, 8-11.