QUALITY ASSURANCE CONTINUOUS QUALITY

IMPROVEMENT,
STANDARDS & MODELS

DEFINITION
Quality

is defined as the extent of resemblance

between the purpose of healthcare and the truly
granted care Donabedian

Continuous

quality improvement or CQI is an

ongoing effort to provide services that meet or
exceed customer expectations through a structures
systematic process.

TOTAL QUALITY MANAGEMENT

A cost effective system for integrating the

continuous improvement efforts of people at all
levels within an organization to deliver products
and services which ensure customer satisfaction.
[Collard et al, 1990]

ELEMENTS OF QUALITY
MANAGEMENT
The

customer

Teamwork
A scientific

approach

FOCUS-PDCA MODEL FOR

QUALITY IMPROVEMENT
F

Find a process to improve

Organize a team that knows the process at

hand
C

Clarify current knowledge of the said process

Understand all sources of variation

Select the improvement

FOCUS-PDCA MODEL FOR

QUALITY IMPROVEMENT
P

Plan the improvement, and continue collecting

data
D Implement the improvement, and collect and
analyze the data
C Check and study the results
A Take steps to sustain any gains from the
improvement, and continue improving

PDCA

MODEL

QUALITY ASSURANCE
Quality

assurance is a judgment concerning the

process of care, based on the extent to which that
cares contributes to valued outcomes- Donabedian

Quality

assurance as the monitoring of the

activities of client care to determine the degree of
excellence attained to the implementation of the
activities.

STANDARDS AS A DEVICE FOR

QUALITY ASSURANCE
JCI

STANDARDS

ANA STANDARDS
JCAHO
AACN
APIE

STANDARDS

STANDARDS

STANDARDS

APPROACHES FOR A QUALITY

ASSURANCE PROGRAMME
GENERAL APPROACH
Credentialing
Licensure
Accreditation
Certification

APPROACHES FOR A QUALITY

ASSURANCE PROGRAMME
SPECIFIC APPROACHES
Peer

review

Standard
Audit

as a device for quality assurance

as a tool for quality assurance

MODELS OF QUALITY
ASSURANCE
A SYSTEM

MODEL FOR
IMPLEMENTATION OF UNIT BASED
QUALITY ASSURANCE
Input
Throughput
Output
Feedback

ANA QUALITY ASSURANCE

MODEL
Identify

values
Identify structure, process and outcome standards and
criteria
Select measurement
Make interpretation
Identify course of action
Choose action
Take action
Reevaluate

QUALITY ASSURANCE
PROCESS
Establishment of standards or criteria
Identify the information relevant to criteria
Determine ways to collect information
Collect and analyze the information
Compare collected information with established criteria
Make a judgment about quality
Provide information and if necessary, take corrective
action regarding findings of appropriate sources
Determine ways to collect the information

FRAMEWORKS FOR QUALITY

ASSURANCE
Maxwell

(1984)
Access to service
Relevance to need
Effectiveness
Equity
Social acceptance
Efficiency and economy

FRAMEWORKS FOR QUALITY

ASSURANCE
Wilson

(1987)

Setting

objectives

Quality

promotion

Activity

monitoring

Performance

assessment

STAGES OF THE
DEVELOPMENT OF
INTERNATIONAL STANDARDS

Stage 1: Proposal stage

Stage 2: Preparatory stage

Stage 3: Committee stage

Stage 4: Enquiry stage

Stage 5: Approval stage

Stage 6: Publication stage

FACTORS AFFECTING QUALITY

ASSURANCE IN NURSING CARE

Lack of Resources
Personnel problems
Improper maintenance
Unreasonable Patients and Attendants
Absence of well informed population
Absence of accreditation laws
Lack of incident review procedures
Lack of good and hospital information system
Absence of patient satisfaction surveys
Lack of nursing care records
Miscellaneous factors

IMPACT OF STANDARDS IN A LOCAL HOSPITAL

IMPACT OF STANDARDS IN A LOCAL NURSING

EDUCATIONAL INSTITUTIONS

CRITICAL ANALYSIS

CONCLUSION

THEORY APPLICATION

JOURNAL ABSTRACT