Quality Assurance in Health Care Services PDF

QUALITY ASSURANCE IN HEALTH CARE SERVICES DAMARIS PAGAN TORRES OD, MPH FAAO EPH0 OBJECTIVES • UNDERSTAND THE DIMENSIONS OF QUALITY IN HEALTHCARE. • RECOGNIZES THE DIFFERENCES BETWEEN QUALITY CONTROL (QC) AND QUALITY ASSURANCE (QA) • UNDERSTAND THE THEORETICAL MODEL OF QA (DONABEDIAN) STRUCTURE, PR...

QUALITY ASSURANCE IN HEALTH CARE SERVICES DAMARIS PAGAN TORRES OD, MPH FAAO EPH0 OBJECTIVES • UNDERSTAND THE DIMENSIONS OF QUALITY IN HEALTHCARE. • RECOGNIZES THE DIFFERENCES BETWEEN QUALITY CONTROL (QC) AND QUALITY ASSURANCE (QA) • UNDERSTAND THE THEORETICAL MODEL OF QA (DONABEDIAN) STRUCTURE, PROCESS, OUTCOME. • MENTION THE SERVICE QUALITY FACTORS THAT INFLUENCE IN VISUAL CARE • DESCRIBE THE CYCLE OF QA DIMENSIONS OF QUALITY TECHNICAL PERFORMANCE ACCESS TO SERVICES EFFECTIVENESS OF STANDARDS DIMENSIONS OF QUALITY EFFICIENCY OF SERVICE DELIVERY CONTINUITY OF SERVICES SAFETY WHAT IS QUALITY? • QUALITY INVOLVES A MEASURE OF EXCELLENCE OR A STATE OF BEING FREE OF DEFECTS, DEFICIENCIES OR SIGNIFICANT VARIATIONS. • INVOLVES THE TOTAL SATISFACTION WITH A PRODUCT OR IMPLIED NEEDS. WHAT IS QUALITY ASSURANCE? • IT IS A MANAGEMENT METHOD THAT IS DEFINED AS “ALL THOSE PLANNED AND SYSTEMATIC ACTIONS NEEDED TO PROVIDE ADEQUATE CONFIDENCE THAT A PRODUCT OR A SERVICE WILL SATISFY GIVEN REQUIREMENTS FOR QUALITY AND BE FIT TO USE”. • ALL THE ACTIVITIES REQUIRED TO ACHIEVE THE STANDARD. • ISO: INTERNATIONAL ORGANIZATION FOR STANDARDIZATION QUALITY ASSURANCE IS… • DEFECT PREVENTIONS…. • DIFFERENT FROM QUALITY CONTROL THAT LOOKS FOR DETECT DEFECTS AND REJECTION • IS THE HEART AND SOUL OF QUALITY CONTROL… • QA = QC + GMP • GMP= GOOD MANUFACTURING PRACTICES GOOD MANUFACTURING PROCESS • PRACTICES REQUIRED IN ORDER TO FULFILL THE GUIDELINES RECOMMENDED BY AGENCIES THAT CONTROL THE AUTHORIZATION AND LICENSING OF THE MANUFACTURE AND SALE OF FOOD, BEVERAGES, COSMETICS, PHARMACEUTICAL PRODUCTS, DIETARY SUPPLEMENTS AND MEDICAL DEVICES. PURPOSE OF QA • TO MEET THE EXPECTATIONS OF THE COSTUMERS OF QUALITY OF SERVICES • HELP THE PATIENTS BY IMPROVING QUALITY OF CARE • ASSESS COMPETENCE OF MEDICAL STAFF, TO KEEP UPDATE AND PREVENT FUTURE MISTAKES. • BRING TO NOTICE OF HEALTH CARE FACILITIES ADMINISTRATORS ABOUT THE DEFICIENCIES AND IN CORRECTING THE CAUSATIVE FACTORS. • ELIMINATING MEDICAL ERRORS • EXERCISE REGULATORY FUNCTIONS. PRINCIPLES OF QA • IS A NEVER ENDING PROCESS OF CONTINUOUS IMPROVEMENT AND CONTINUOUS UPDATING WITH THE ADVANCES OF SCIENCE AND TECHNOLOGY AND MEDICAL KNOWLEDGE. • THE EMPHASIS IS ON ESTABLISHING PROFESSIONAL EXCELLENCE AND PT SATISFACTION IN AN AFFORDABLE WAY. • QUALITY IS NOT PROPORTIONATE TO THE USE OF SOPHISTICATED TECHNOLOGY OR TO BE EXPENSIVE. • CUSTOMERS DEFINE THE QUALITY METHODS OF QA • RETROSPECTIVE QA- MEASURES THE ACTUAL DOCUMENTED OUTCOMES AGAINST DESIRABLE AND VALUED OUTCOMES. DATA FOR DOCUMENTATION IS OBTAINED FROM THE MEDICAL RECORDS OF THE PATIENT POPULATION AFTER THE PT ENCOUNTER, WHEN THE PT IS DISCHARGED. • CONCURRENT QA- EVALUATES THE PT CARE WHILE IT IS IN PROGRESS. DOCUMENTATION IS OBTAINED BY REVIEWING THE RECORD AND THE OBSERVATION AND INTERVIEWING OF THE PATIENT AND PT EXAMINATION. THE PROS OF IT IS THAT PROVIDES OPPORTUNITIES FOR IMPROVEMENT PT CARE WHILE IT IS IN PROGRESS. COMPONENTS OF QA • STRATEGIC OR ORGANIZATIONAL LEVEL- DEALING WITH THE QUALITY POLICY, OBJECTIVES AND MANAGEMENT AND USUALLY PRODUCED AS THE QUALITY MANUAL. • TACTICAL OR FUNCTIONAL LEVEL- DEALING WITH GENERAL PRACTICES SUCH AS TRAINING, FACILITIES. • OPERATIONAL LEVEL: DEALING WITH STANDARD OPERATING PROCEDURES WORKSHEETS AND OTHER ASPECTS OF THE DAY TO DAY OPERATIONS. MODEL OF QA • DONABEDIAN MODEL• STRUCTURE ELEMENT: PHYSICAL, FINANCIAL, AND ORGANIZATIONAL RESOURCES PROVIDED FOR HEALTHCARE. • PROCESS ELEMENT: ACTIVITIES OF A HEALTH SYSTEM OR HEALTHCARE PERSONNEL IN THE PROVISION OF CARE. • OUTCOME ELEMENT: A CHANGE IN THE PATIENT’S CURRENT OR FUTURE HEALTH THAT RESULTS FROM MEDICAL INTERVENTIONS SERVICE QUALITY FACTORS IN PRIVATE VISUAL HEALTH INSTITUTIONS(FAJARDO, ROJAS ROBAYO, 2018) • ACCESSIBILITY • WAITING TIME • ARRIVING ON TIME • PROFESSIONAL COMMUNICATION • AVAILABILITY • FOLLOW UP • TRUST • ENVIRONMENT • SERVICE TIME ACCREDITATION • IS THE PROCESS OF FORMALLY OBTAINING CREDIBILITY FROM AN AUTHORIZED BODY, SUCH INTERNATIONAL ORGANIZATION FOR STANDARDIZATION (ISO), ACCREDITATION COUNCIL ON OPTOMETRIC EDUCATION (ACOE) , JOINT COMMISSION INTERNATIONAL (USA) ETC. CERTIFICATION • IS A VOLUNTARY PROCESS WITHIN THE PROFESSION. • EDUCATIONAL BACKGROUND, EXPERIENCE AND PERFORMANCE ON EXAMINATION ARE USED TO DETERMINE THE PERSON’S QUALIFICATIONS FOR FUNCTIONING IN AN SPECIALTY AREA. SPECIFIC APPROACHES • PEER REVIEW • STANDARD AS A DEVICE FOR QA • AUDIT AS A TOOL FOR QA • CLIENT SATISFACTION SURVEY • EVALUATION STUDY • UTILIZATION REVIEW • INCIDENT REVIEW • QUALITY CONTROL • QUALITY AWARDS QUALITY REPORTS TYPES OF QA • EXTERNAL • INDEPENDENT ASSESSORS FROM OUTSIDE THE CLINIC • INTERNAL • LOCAL ASSESSORS (USUALLY SENIOR PERSONNEL FROM THE CLINIC QA CYCLE plan Design and implementation of solutions Define problem and analyze it standards Monitor and id of opportunities for improvement FACTORS AFFECTING QA IN HEALTHCARE Lack of resources Personnel problems, lack of incidents reports Lack of medical records Absence of accreditation law Absence of patient satisfaction survey Absence of well informed population QA VS QC Process oriented Product oriented QA QC Is used to verify the quality of the output Used to verify the quality of the output QC VS QA QC IS PRODUCT ORIENTED ACTIVITY QA IS PROCESS ORIENTED ACTIVITY • A SET OF ACTIVITIES DESIGNED TO EVALUATE A DEVELOPED WORK PRODUCT. • A SET OF ACTIVITIES DESIGNED TO ENSURE THAT THE DEVELOPMENT AND/OR MAINTENANCE PROCESS IS ADEQUATE • QC FOCUS ON FINDING DEFECTS ONCE THE PRODUCT IS MANUFACTURED. • ITS FOCUS ON THE PROCESS ELEMENTS OF A PROJECT. • IS A CORRECTIVE PROCESS • IS A FAILURE PREVENTION SYSTEM THAT PREDICTS SAFETY, QUALITY STANDARDS AND LEGALITY. • IT IS AN EVALUATION PROCESS • IT IS A MONITORING PROCESS. TO ENSURE A SYSTEM WILL MEET ITS OBJECTIVES.