Quality MANAGEMENT skills

1. (
‫التوفيق‬ ‫هللا‬ ‫نسأل‬ ‫للجميع‬ ‫هدية‬ ‫المحاضرات‬ ‫هذه‬
)
Medical Audit
(TQM & Audit Management
‫الصحة‬ ‫في‬ ‫ألجودة‬
Dr EZIZ ALFAHD
afkaabba@gmail.com

2. Objectives
The Definition of Quality &Audit .
What is Medical Audit applications ?
Audit Planning & Cycles
How to practice Quality and Audit in
medical field ?

3. INTRODUCTION
& DEFINITIONS
Quality
Investment of the best skill &
effort possible to produce excellent
results.

5. 5
Definitions: Quality!!!
Healthcare Quality
• “The degree to which health care services
for individuals and populations increase the
probability of health outcomes and are
consistent with current professional
knowledge of best practice”
The Institute of Medicine

6. 6
Definitions:
Quality Control & Quality assurance
• Quality assurance: All the planned and systematic
actions implemented within the quality system, and
demonstrated as needed to provide adequate
confidence that an entity will fulfill requirements for
quality
• Quality Control: Operational techniques and
activities that are used to fulfill requirements for
quality

7. 7
Benchmarking (‫مرجعية‬ ‫المعيار‬
-
‫عالمة‬ )
• A basis for comparison; a reference point
against which other things can be evaluated
• A standard, a reference point, or a criterion
against which the quality of something can be
measured, judged, and evaluated, and against
which outcomes of a specified activity can be
measured. The UNESCO definition of

8. Key performance indicators
KPIs (‫الرئيسية‬ ‫األداء‬ ‫)مؤشرات‬
• Key Performance Indicators:
• are preset quantifiable measurements that
reflect the critical success factors of an
organization
• They are measures that describe how well a
program/ institution is achieving its objectives

9. Quality is a Journey,
not a Destination

10. Other Definition
Clinical Audit (Medical Audit)
“The systematic critical analysis of
the quality of medical care,
including diagnosis, treatment,
outcome, use of resources & effects
on quality of life of the patient”.

11. (More than 50 meaning of Audit
)By combining any word from each
columns in Table I in order, it is possible
to produce more than 50 phrases that
either have been or can be used to mean
review of health care (audit).

12. TABLE I: AUDIT BY ANY
OTHER NAME?
Medical
Health
Clinical
Professional
Care
Standards
Activity
Quality
Evaluation
Assessment
Assurance
Improvement
Review
Monitoring

13. What is a Standard?
A standard is the level of care to be
achieved for any particular criterion.
For example:
1. 95% of the female population at risk
should receive protection against rubella.
Antenatal care standard

14. CRITERIA & STANDARDS
“Criterion” ( (
‫يقاس‬ ‫معيار‬ measurable
item of health care which describes
quality. They are usually written in
the form of statements which
describe what should happen, eg.
all females of susceptible age should
be immunized against rubella.

16. How to Do An Audit
Medical audit can be seen as a series of
steps (The audit cycle):
Step 1:
Choosing a topic & setting a standard
Step 2:
Collecting data from the practice
Step 3:
Analysis of the collected data

17. Step 4:
Interpretation & compare the result
with the standard
Step 5:
Modifying the practice to make the
standard attainable
Step 6:
Repeating the process to confirm
improvement

18. The Audit Cycle
Step 1:
Defined Standard
Step 2:
Data Collection
Step 3:
Data Analysis
Step 4:
Interpretation & Compare
with Standards
Step 5: (Change)
Corrective Actions
Step 6:
Follow-up

20. THE BENEFITS OF AUDIT
Meeting patients’ needs
& expectations
Educational stimulation
Demonstrating good
care
Improving effectiveness
Changing the future
Avoiding frustration
Lasting improvement
Allocate resources
appropriately
Use & promote higher
standards of care
Dynamic promotion of
standards of medical care
Investigate & reduce
organizational error
Team work &
communication enhancement

21. PROBLEMS WITH AUDIT
Time
Knowledge
Skills
Resources
Motivation
Interest
Commitment
Organizational
problems

22. Areas Of General Practice
Which Can Be Audited
Clinical Practice:
Diabetes, asthma & hypertension are major
areas, but almost any clinical area can be
audited.
Practice Finance:
Income areas are particularly popular, eg.
How you are performing on items of service
payments like tetanus vaccination or
contraceptive claims (as a % of the eligible
practice population.

23. Prescribing:
Audit can concern itself with wider, perhaps
financial issues or narrower specific areas;
eg. HRT prescription.
Referrals:
An audit of referral patterns is a relatively
simple & painless exercise.
Practice Management:
Eg. The appointment system, the visiting
system, or the computer prescribing system.

24. THANK YOU