Controlling

1. DEFINITION
Quality in the traditional sense pertains to examining whether a product
or service meets its expected characteristics and satisfies the consumer.
Institute of Medicine (IOM) has defined quality as “the degree to which
health care services for individuals and populations increase the
likelihood of desired outcomes and are consistent with current
professional knowledge.”

2. Healthcare Quality Domains
Six domains have been identified by IOM that help to achieve a high degree of
quality; health care must be safe, effective, patient-centered, timely, efficient,
and equitable. Meeting all these domains is at the core of quality
management.
The success of health care in achieving these quality domains can be
measured by collecting data and evaluating “the five D’s:” death (mortality),
disability (morbidity), disease (resolution or persistence of disease following
treatment), discomfort (the process of providing medical care) and
dissatisfaction (the patient’s experience during the process of providing care).

3. DEFINITION OF QUALITY MANAGEMENT
 It is defined as “the process by which people are mobilized to achieve
quality goals”. Quality management becomes the umbrella under
which all processes and activities related to quality fall. Quality.
 In healthcare, quality management refers to the administration of
systems design, policies, and processes that minimize, if not
eliminate, harm while optimizing patient care and outcomes.

4. OBJECTIVE OF QUALITY MANAGEMENT
 To ensure that a particular product, service, or organization will
consistently fulfill its intended purpose.

5.  Quality management systems (QMS) are tools used to implement
quality management and organize, standardize, and improve activities
involving a product or service aimed at customers.
 By measuring outcomes and effects of different factors via data
collection, issues within the system are identified, and evidence-based
medicine and resources are used to develop or alter processes to
improve the quality of care.
 Information is then collected regarding new outcomes to determine if
the changes were beneficial or if other alterations are required.
 The ultimate goal is to achieve consistent, high-level care with minimal
morbidity, mortality, disease, discomfort, and high patient satisfaction
while meeting or exceeding all six of the IOM domains.

6. QUALITY MANAGEMENT MODELS AND APPROACHES
Total Quality Management (TQM). TQM is an “integrated process
involving all systems and employees in a continuous effort to improve
quality, reduce cost, and enhance service to customer.”
Continuous Quality Improvement (CQI). CQI involves the systematic
use of tools and processes to identify and analyze strengths and
barriers within an organization and continually test and improve
outcomes.
In healthcare, CQI’s approach to improvement allows for connecting the
most recent best evidence with current practices to achieve better
patient outcomes.

7. Joint Commission
 The Joint Commission, which is a voluntary process that enforces,
monitors, and improves upon the quality of healthcare in the United
States and internationally.
 The Joint Commission measures whether a facility is meeting
accreditation standards for healthcare quality, which includes
incorporating programs that perform quality measurement, evaluation,
and improvement of patient outcomes.
 Accreditation also provides external validity to hospital administration
and increases transparency to patients and providers.

8.  The Joint Commission hospital standards focus on the following
areas:
 Patient-related issues such as care, education, and ethics
 Organization-related functions such as performance, leadership,
surveillance, infection control, and prevention
 Organizational structure such as governance, management, and
medical staff