2. Meaning of Quality
Quality is weighing – out between results and costs
to fulfill certain expectations in health care.
3. CONCEPT OF QUALITY ASSURANCE
“Quality assurance is a dynamic process through which nurses assume
accountability for quality of care they provide. It is planned and systematic
actions and programs that are designed to provide confidence that a product
or service will meet the customer expectations and that improve a company’s
credibility and enable them to compete better with others”.
(ISO 9000)
4. Definition of Quality Assurance
• “Quality assurance can be defined as all activities that contribute to
defining, designing, assessing, monitoring and improving the quality
of care.”
MARKER
6. Quality Improvement
Principles:
• - Knowledge of customer expectation needs.
• - Processes of customer supplier relationship.
• - Belief in people.
• - Statistical analysis.
• - Costs of poor quality.
7. Conditions in the work environment:
• - Employer involvement.
• - An environment that supports risk taking.
• - Team work.
• - Data collection and analysis skills.
• - Group interaction skills.
• - Tools to facilitate the improvement.
8. Framework for quality:
• Quality defined: Before the nurse manager and staff can measure
trends in nursing practice, they first must know the standards or
guidelines that define quality.
• Professional standards: They are authoritative statements used by the
profession in describing the responsibilities for which its practitioners
are accountable. (Peters 1995)
o Policies
o Job description
o Outcomes
9. MODELS OF QUALITY ASSURANCE: -
1) A System Model for implementation of unit Based Quality
assurance
2)American Nurses Association Model
3)ANA Quality Assurance Model
12. FACTORS AFFECTING QUALITY IN NURSING CARE
• Lack of resources
• Lack of manpower
• Improper maintenance
• Absence of strong accreditation laws
13. • Lack of awareness of malpractice litigation
• Lack of incident review reports
• Lack of good hospital information system
• Lack of nursing care records
14. DEVELOPMENT OF A QUALITY ASSURANCE
PROGRAM
• Foster Commitment Quality
• Conduct a Preliminary Review of Quality
• Develop the Purpose and Vision for the Quality Assurance Effort
• Determine level and scope of initial Quality Assurance Activities
• Assign responsibility for Quality Assurance
16. GENERAL APPROACH
Done by external evaluation systems or regulatory bodies
Types are…..
• Licensure
• Accreditation
• Certification
17. LICENSURE
• Ensures the minimum
legal requirement or
qualifications for a
health care
professionals and for
organisations.
• It defines scopes and
limits of practice.
• Licensure of nursing is
mandated by law in
1903.
18. ACCREDITATION
• Accreditation focuses on continuous
improvement strategies, achievements of
optimal quality standards and ongoing
education.
• Done with the help of professional standard
review organizations.
(JCAHO,ISO,NCQA..)
• Certificate regarding quality was provided.
19. JCAHO’S 10 STEPS
FOR ACCREDITATION
• Establish responsibility and
accountabilty for program
• Define the scope of service of a
chemical area
• Define key aspects of service of
that chemical area
• Develop quality indicators to
monitor the system
• Establish a threshold for evaluation
20. • 6. Collect and analyse data from monitoring activities.
• 7. Evaluate results of monitoring activities to determine the
need for change in practice.
• 8. Resolve problems through development of action plans.
• 9. Revaluate to determine if the plan was successful.
• 10. Communicate Q.I results to the organization.
21. CERTIFICATION
• Certification is the voluntary practice of
validating that an individual nurse has got
minimum standards of nursing
competence in advanced practice areas.
• Certification recognizes excellence in
nursing practice.
• Certification is usually by non-
governmental organization.