This document discusses various approaches to quality improvement in healthcare. It defines quality from several perspectives, including from the viewpoint of customers/patients, providers, and products. Several quality improvement models and strategies are described, such as total quality management (TQM), Six Sigma, Lean, and the 5S methodology. Key dimensions of quality like quality assessment, assurance, control, and improvement are explained. The document also provides definitions of terms used in healthcare quality such as accreditation, certification, clinical governance, benchmarking, and clinical audits.
Improving the Health Outcomes of Both Patients AND PopulationsCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 23, 2019 | 2 p.m. EST
In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
Quality assurance is one of the important topic for our Nursing field this is important for M.Sc. Nursing Final Year students for the subject of management that will also help to all nurses either in the filed of clinical as well as education
Title is self explanatory
However:
Evolution of Quality Assurance (QA)
Quality definitions
Objectives of QA,
Principles,
components
difference bet QA n QC
MODELS of QA
SPO
PDCA
ANA
Improving the Health Outcomes of Both Patients AND PopulationsCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 23, 2019 | 2 p.m. EST
In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
Quality assurance is one of the important topic for our Nursing field this is important for M.Sc. Nursing Final Year students for the subject of management that will also help to all nurses either in the filed of clinical as well as education
Title is self explanatory
However:
Evolution of Quality Assurance (QA)
Quality definitions
Objectives of QA,
Principles,
components
difference bet QA n QC
MODELS of QA
SPO
PDCA
ANA
quality assurance slides include components, models, approaches, cycle of quality assurance is included in the slides.
the slide gives a brief ides regarding all the points and gives a comprehensive picture of the topic.
Power Point Presentation made to a major pharmaceutical manufacturer in 1998. Identifies cause of Medical Crisis and how Pharm mfgrs can use regulations to add value to their contracts with MCOs.
Quality assurance is a way of preventing mistakes and defects in manufactured products and avoiding problems when delivering products or services to customers; which ISO 9000 defines as "part of quality management focused on providing confidence that quality requirements will be fulfilled".
quality assurance slides include components, models, approaches, cycle of quality assurance is included in the slides.
the slide gives a brief ides regarding all the points and gives a comprehensive picture of the topic.
Power Point Presentation made to a major pharmaceutical manufacturer in 1998. Identifies cause of Medical Crisis and how Pharm mfgrs can use regulations to add value to their contracts with MCOs.
Quality assurance is a way of preventing mistakes and defects in manufactured products and avoiding problems when delivering products or services to customers; which ISO 9000 defines as "part of quality management focused on providing confidence that quality requirements will be fulfilled".
Nursing leadership and management course / Total Quality MnagementMouad Hourani
What is Quality?
Definition of Quality in healthcare?
Quality Evolution .
Quality control.
Quality Assurance.
Total Quality Management.
Old vs. TQM Approach.
The Deming, Juran and Crosby philosophies.
Quality Principles.
Why Quality?
Quality perspectives.
Key Dimensions of Quality.
Good Managers (Leaders)
Total Quality Management in HealthcareGunjan Patel
Now days, Healthcare systems are of fundamental interests to all level of Hospitals in our societies. Eventually, increasing importance and reliance are placed on total quality management in healthcare systems. Due to this rising importance that is also reflected in the increasing percentage of national and international resources for both private and public sector to allocated in hospital management systems. Hospitals and other healthcare organization across the globe have been progressively implementing TQM to reduce costs, improve efficiency and provide high quality patient care.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
1. Prof. Dr Swe Win
Honorary Professor
Professor and Head(retired)
Health policy and management Department
UPH
19.3.2016 Hospital Administration Society
2. To know the various approaches of
quality improvement in health care
services and to select the
appropriate approach applied in
hospital.
3. A 2013 study on the global burden
of medical error found that unsafe
care causes 43 million injuries a
year and the loss of 23 million
disability adjusted life years
(DALYs), about two-thirds of them
in low- and middle income
countries (Jha et al., 2013).
The fifth leading cause of DALYs
lost worldwide (i.e underestimate)
Source: Improving Quality of Care in Low- and Middle-Income Countries:
Workshop Summary;NAP
4. provider/manufacturer/supplier
ongoing process of building and
sustaining relationships by
assessing, anticipating and
fulfilling stated and implied needs
Error-free
Reducing the variation around the
target
doing right things right
Customer/user/consumer/client
Customers’ perception of the value
of suppliers’ work output
value-added care and service that
meets and/or exceeds both the
needs legitimate expectations
properties of products and/services
that are valued by the customer
The degree to which something
meets or exceeds the expectations
of customers (Degree of excellence
or degree of goodness)
fulfillment of expectation
ability of a product or service to
meet a customer’s expectations for
that product or service
5. FEIGENBAUM (1983): Quality is total composite product (goods and
services) characteristics, through which the product in use will meet
the needs and expectations of the customers. Concept of quality
must start with identification of customer quality requirements and
must end only when the finished product is placed into the hands of
the customer who remains satisfied through various stages of
relationship with the seller
Institute of Medicine (1990) definition: “Quality is the extent to
which health services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with
current professional knowledge.”
American Society of Quality Control (ASQC) and American National
Standard Institute (ANSI): totality of features and characteristics of
product (goods and services) that bears on its ability to satisfy given
needs
6. Product
Perfection
Consistency
Eliminating waste
Compliance with policies and procedures
Providing a good, usable product
Service delivery
Speed of delivery
Doing it right, do right thing
User
Delighting or pleasing customers
Total customer service and satisfaction
Degree of goodness
Quality = Degree of performance
The standard set
empowerment
standards
satisfaction
7. Product/production/provider based
Features
Augmented product
Conformance
Degree to which characteristics of
the product meet pre-established
standards
Performance
Product’s primary operating
characteristics
Serviceability
Speed, competence & courtesy of
providing services.
Value/ judgmental /user based
Aesthetics
Look, feel sound, taste, smell
Perceived Quality
Resulting from advertisement,
image, brand name, earlier use,
hearsay
Durability
Length of time a product can be
used before it deteriorates or
becomes non functional
Reliability
Ability of the product to function at
the specified level of performance
9. Mass Inspection
Inspecting
Salvaging
Sorting
Grading
Rectifying
Rejecting
Quality Control
Quality manuals
Product testing using SQC
Basic quality planning
Quality Assurance
Emphasis on prevention
Proactive approach using SPC
Advance quality planning
Total Quality Control
All aspects of quality of inputs
Testing equipments
Control on processes
10. Company wide Quality Control
Measured in all functions connected with
production such as
R&D
Design
Engineering
Purchasing,
Operations etc
Total Quality Management
Measured in all aspects of business,
Top management commitment
Continuous improvement
Involvement & participation of employees
12. Accreditation: Accreditation is a formal recognition that
an organization is competent to carry out specific
activities
Audits: The objective of audits is to enhance the
effectiveness and efficiency of programme
Audits should be conducted by:
People who are technically competent, but
Do not have any direct responsibility for those
activities
13. Quality Assurance
planned and systematic actions necessary to provide adequate
confidence that a product or service will satisfy given requirements for
quality.
Examples of QA:
type testing, performance testing, and quality audits required by a
regulatory body.
blind testing and quality audits of the service provider performed by
the user of the service.
14. The operational techniques and activities that are
used to fulfill requirements for quality.
Examples of QC:
routine (i.e. daily)
various statistical analyses used to verify continued
system performance.
Quality Control
15. Identifies gaps exist between services actually provided and expectation of
services
lessens these gaps not only to meet customer needs and expectation, but
to exceed them and attain unprecedented level of performance
QI focus on the Client, Systems and process, teamwork, and the use of data
16. Total Quality Management (TQM)
is a comprehensive and structured
approach to organizational
management that seeks to
improve the quality of products
and services through ongoing
refinements in response to
continuous feedback
17. 1.It involved in all stages of system
approach ie. input, process and
output stages
2.Participation of all stakeholders
3.Linkage with problem solving
approach and accountability
4.Key process is PDCA /
PDSA(Continuing Improvement)
5.Standardization
.(Accreditation/certification/Bench
mark)
18. A management approach for an
organization ,centered on quality,
based on the participation of all its
members and aiming at long-term
success through customer
satisfaction, and benefits to all
members of the organization and
to society. (ISO definition)
19. 2.The 5 key principles of TQM
initiative (a)management
commitment
(b)employee commitment
(c)fact based decision making
(d)continuous improvement
(e)customer focus
22. Six sigma
A philosophy and measurement process
developed in the 1980s at Motorola.
To design, measure, analyze, and control
the input side of a production process to
achieve the goal of no more than 3.4
defects per million parts or procedures.
A philosophy and measurement process
that attempts to design in quality as a
product is being made.
one percent of health
care providers in the
United States have
deployed Six Sigma
methods.
23. Methodological sequences:
DMAIC—define, measure, analyze,
improve, and control; or DMADV—
define, measure, analyze, design,
and verify. DMAIC is generally used
to improve existing systems that
have fallen below Six Sigma levels,
DMADV is used to design and
develop new processes or products
at Six Sigma levels
Six Sigma projects require to have
expertise in basic statistical tools
such as Pareto Diagrams,
descriptive and higher level
statistics including regression, and
statistical modeling techniques as
well as control processes
24. The essence of Six Sigma
methodologies is both
improvement of the knowledge
and capability of employees, and
also behavior changes through
training.
Thus, Six Sigma employs a
classification system that identifies
education and training for
employees, project managers and
executives
25. The term lean was coined as a
word to describe a system
(Toyota’s)that managed to get by
with half of everything and far
fewer than half of the defects and
safety incidents.
All we are doing is looking at
timeline from the moment a
customer gives us an order to the
point when we collect the cash.
and we reducing that timeline by
removing the non-value-added
wastes(Toyota’sTaiichi Ohno
26. Toyota Triangle
Lean is an integrated system of
human development, technical tools,
management approaches ,and
philosophy of that creates a lean
organizational culture.
27. 1.respect for people (eg, patients,
staff members, managers,
physicians),
2. continuous improvement (eg,
easier, better, faster, cheaper), and
3.human development.
28. Specify value – from the
standpoint of the end customer
(the patient)
• Identify the value stream – all
value-added steps across
departmental boundaries (the
value stream), eliminating steps
that do not create value
• Make value flow continuously –
eliminate causes of delay, such as
batches and quality problems
• Let customers pull value – avoid
pushing work onto the next
process or department; let work
and supplies be pulled as needed
• Pursue perfection – through
continuous process improvement
29. Sort
Clear out rarely used
Items by Red Tagging
Straighten
Organise and Label a
Place for Everything
Shine
Clean ItStandardise
Create Rules to Sustain
the first 3 5’S
Sustain
Use Regular Management
Audits to Stay Disciplined Eliminate
Waste
30.
31. Seiri – Sorting
Seiton – Straighten or Set in order
Seiso – Sweeping, shining or
cleaniness
Seikestu – Standardising
Shitsuke – Sustaining the discpline
32. Donabedian concepts
Efficacy (Power or capacity to
produce a desired effect)
Efficiency (value for
money)(lowest amount of inputs,
greatest amount of outputs)
Effectiveness
Optimality (balancing
improvements with costs)
Acceptability (to patients and
families)
Legitimacy (ethical issues-follow
through to treatment)
Equity (access, fairness,
appropriateness)
The U.S. Institute of Medicine
concepts
Patient safety to provider safety
to Environmental safety
Effectiveness (scientifically proven
appropriate care)
Patient centeredness (respect and
responsiveness)
Timeliness (minimal delays
barriers to getting access to care)
Efficiency (minimal waste of
equipment, supplies, ideas, and
energy)
Equity (care provided consistently
across genders ,ethnic groups,
locations and socioeconomic
classes)
34. three dimensions of Quality of
Care i.e. professional technical
aspect of care, interpersonal
aspects of quality and social
aspects of quality.
Professional Technical Aspects
Accuracy of diagnosis
Efficacy and efficiency of treatment
Excellence according to professional
standard
Necessity of care
Appropriateness
Continuity of care
Consistency (Uniformity, Reliability)
35. Inter-personal aspects
Patient Satisfaction
acceptability
Time spent with provider
Attitudes of provider and staff
Amenities
Social Aspects
Efficiency
Accessibility – including financing
36. Accreditation is an external quality
evaluation through which an
accrediting organization formally
recognizes that an institution
meets certain standards. “a
voluntary process by which a
government or nongovernment
agency grants recognition to health
care institutions which meet
certain standards that require
continuous improvement in
structures, processes, and
outcomes.” In English, the terms
accreditation,
certification, and licensure are
often mistakenly used as
synonyms
Benchmarking.
37. Accreditation means official
approval given by an organization
stating that somebody/something
has achieved in required standard
Certification means confirmation
that some fact or statement is true
through the use of documentary
evidence
38. Popular standards
ISO 9000 Quality management
ISO 14000 Environmental
management
ISO 3166 Country codes
ISO 26000 Social responsibility
ISO 50001 Energy management
ISO 31000 Risk management
ISO 22000 Food safety
management
ISO 27001 Information security
management
ISO 45001 Occupational health and
safety
39. A measurement of the quality of
an organization's policies,
products, programs, strategies,
etc., and their comparison with
standard measurements, or similar
measurements of its peers.
The objectives of benchmarking
are (1) to determine what and
where improvements are called
for, (2) to analyze how other
organizations achieve their high
performance levels, and (3)to use
this information to improve
performance.
40. Clinical in-service training is a
broad category of quality
improvement strategies, including
all training for health professionals
who have
already completed their formal
credentialing process.
In-service training is meant to
either reinforce important concepts
and practices or to introduce new
knowledge about how a health
professional should work.
41. designed for quality improvement
in family planning and is now also
used in maternal, child, and
reproductive health.
uses group problem solving and
self-assessment to identify
problems and set priorities for
quality improvement starts with an
orientation for managers at the
worksite, followed by a self-
assessment where participants
identify and rank their main
problems.
COPE® is meant to be
implemented with other tools for
continuous quality improvement,
such as supervision and training
42. use a continuous quality
improvement process
iterative problem solving,
encourages prompt process
improvements
Collaboratives usually last about 9–
24 months, during which time the
participating teams analyze a
problem and its causes; plan
changes
Collaboratives can be used to
improve processes for patients and
providers ,teams, organizations, or
systems.
43. SBM-R is a management method
developed by Jhpiego that aims to
improve quality of care by
improving health worker
performance.
It adapts the four main elements
of the continuous quality
improvement cycle (plan, do,
study, act) to standardize, do,
study, and reward
1.Assessment-standardsAction-
self assessment ,internal
assessment and External
assessments.
recognized for their efforts;
rewards, such as feedback, praise,
and social recognition,
44. Supportive supervision refers to a
process of working with staff to set
goals, identify and correct
problems, and monitor staff
performance.
It generally takes one of three
forms: managerial, clinical, or
educational.
45. TQM / SQI = Professionalism x Motivation x Leadership x Management x
Partnership
a. Practice professionalism by all categories of health
professionals
b. Fulfill basic and social needs to motivate professionals
c. Develop leadership quality
d. Better management and use management tools
Establish strong partnership both internal and external users
45
Prof.Dr Mya Oo
46. The governance
means the process of
decision making and
the process by which
decisions are
implemented
48. 1. Clinical Effectiveness
2. Research & Development
3. Openness
4. Risk Management
5. Education & Training
6. Clinical Audit
In 1990s, the UK introduced clinical (including doctors, nurses and therapists)
audit programs to assess the performance of clinical process and to educate the
health workforce concerned. This form of self regulation activities should be
welcome. We should avoid blame culture and develop our learning from those
experiences.
This form of clinical audit should be introduced and promoted in central
tertiary care hospitals.
49. Clinical audit is a process that has
been defined as "a quality
improvement process that seeks to
improve patient care and
outcomes through systematic
review of care against explicit
criteria and the implementation of
change“
The key component of clinical audit
is that performance is reviewed (or
audited) to ensure that what
should be done is being done, and
if not it provides a framework to
enable improvements to be made
Definition was announced
by the NHS executive:“
Clinical audit is the
systematic analysis of the
quality of healthcare,
including the procedures
used for diagnosis,
treatment and care, the
use of resources and the
resulting outcome and
quality of life for the
patient."
50. WHO HPH movement focuses on
four areas: promoting the health of
patients, promoting the health of
staff, changing the organization to
a health promoting setting, and
promoting the health of the
community in the catchment area
of the hospital. These four areas
are reflected in the definition of a
health promoting hospital:
51. A health promoting hospital does
not only provide high quality
comprehensive medical and
nursing services, but also develops
a corporate identity that embraces
the aims of health promotion,
develops a health promoting
organizational structure and
culture, including active,
participatory roles for patients and
all members of staff, develops itself
into a health promoting physical
environment, and actively
cooperates with its community”
53. Step1. Identify -Determine what
to improve
Step 2.Analyse -understand the
Problem
Step3.Develop -Hypothesize
about what changes will improve
problem
Step4. Test/Implement- Test the
hypothesized solution to see if it
yeilds improvement; based on the
results, decide whether to
abandon, modify, or implement
solution.
54. Individual
Problem solving
approach
Rapid Team
Problem solving
approach
When to use the
approach
When you know
the problem is
dependent on only
one person
When the team
needs quick
results and has a
lot of intuitive
ideas
Teams Unnecessary Ad hoc
Data Almost none Can succeed with
little data
Time Little Little
55. Systematic Team
problem solving
approach
Process
improvement
approach
When to use the
approach
When the problem
is complex or
recurring,
requiring analysis
When a key
process or system
requires ongoing
monitoring or
continuous
improvement
Teams Ad hoc Permanent
Data Need data to
understand the
causes of problem
Data from
continuous
monitoring, may
need to collect
more
Time Limited to the time
necessary
continuous
56.
57. 1. cost-effectiveness,
2.The method’s affordability
3.The feasibility of the method—
4.it is realistic to implement
5.the replicability of results in new
settings and
6.the scalability, or ease of
expansion,
7.Lastly, the sustainability of the
method, or the extent to which a
program can be integrated into
existing system,.
58. THANK YOU FOR YOUR ATTENTION
dr.swewin1969@gmail.com