3. What is quality ?
Conformance to acceptable standards or specifications (engineering
perspective)
Ex. outer and inner diameter of a hollow shaft
Fitness for use (user perspective)
Ex. Washing machine ,Television etc.
Satisfaction of wants ,need and expectations (service perspective)
Ex. Hospital systems.
Loss of society (societal perspective )
Ex.loss due to waste ,reworking , internal failure and external failure , loss of
goodwill, etc.
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4. Quality assurance
It is an on-going, systematic comprehensive evaluation
of health care services and the impact of those services
on health care services.
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5. Functions of QA
Safe: Delivering health care that minimizes risks and harm to service users,
including avoiding preventable injuries and reducing medical errors.
Effective: Providing services based on scientific knowledge and evidence-
based guidelines.
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6. Equitable: Delivering health care that does not differ in quality
according to personal characteristics such as gender, race, ethnicity,
geographical location or socioeconomic status.
Timely: Reducing delays in providing and receiving health care.
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7. THE CONCEPT OF QUALITY ASSURANCE
Quality assurance is a cybernetic activity consisting of: the measurement of quality through the
systematic collection and analysis of data; the detection of shortfalls in the achieved level of care as
compared to the predefined professionally acceptable "optimum achievable standard"; the
development and implementation of strategies for improvement; subsequent reassessment of
improvement.
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8. This concept of quality assurance can be applied to almost any aspect of health care. For
example, in clinical care it can be applied to: technical aspects, e.g. diagnosis, clinical
management follow-up, etc.: psychosocial aspects, e.g. patient compliance with therapy,
patient satisfaction, etc.
In management of resources, it can be applied to: providing "efficient" services viz., services
that are prompt, adequate, appropriate, comfortable, etc.; cost-effective use of resources, e.g.
in relation to the productivity and appropriateness of use of skilled manpower, abuse or
waste of expensive resources like hospital beds, investigative procedures, expensive drugs,
etc.
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10. In practical terms, quality assurance is
concerned with determining the
difference between the "optimum
achievable result" and the result being
actually achieved
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11. The concept of Achievable Benefit Not
Achieved (ABNA)
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12. ABNA could arise from
sins of omission,
sins of commission and
sins of inefficiency (cost-
effectiveness).
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13. Primarily the concepts of "quality of care" and of ‘’ABNA"
have to be understood and accepted by the health care
professionals and inculcated into everyday terms practically.
Hence, it is necessary to identify the elements of care for
which quality will be measured.
For instance, it is possible to measure quality in terms of
the outcome of care, e.g. rates of survival, levels of
functional status or "quality of life" etc..
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14. The second major problem in implementing QA is the need for
adequate documentation of medical care (i.e. adequate medical
records), and a practical and feasible system of extracting, compiling
and analysing the relevant items of information from patient records
The third major constraint in QA is that so far, little work has been done
in evaluating the appropriateness and effectiveness of different
strategies for improving various aspects of quality.
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