This document discusses continuous quality improvements in hospital management. It covers three main topics: continuous quality improvement and patient safety/satisfaction, improving quality through nursing, and improving quality by risk management. The key points are that continuous quality improvement aims to consistently assess and improve service delivery. Improving nursing quality focuses on staffing levels, education, and giving nurses more autonomy over their work. Risk management identifies risks and develops strategies like risk avoidance, reduction, retention, and transfer to prevent risks and improve quality of care.

1. Lecture 5
Continuous Quality Improvements
Quality Assurance in Hospital Management
Institute for Nile States Strategic Studies and
Researches

2. Lecture Objectives
After this lecture, you should be
able to understand:
◦ Continuous Quality improvements and Patient Safety & Satisfaction.
◦ Improving Quality through Nursing
◦ Improve Quality by Risk Management

3. CONTINUOUS QUALITY
IMPROVEMENTS AND PATIENT SAFETY
& SATISFACTION.
Objective 1/3

4. Quality and Patient Safety &
Satisfaction

5. Continuous Quality
Improvement
• Continuous Quality Improvement (CQI): is an organizational
process in which staff identify, plan, and implement ongoing
improvements in service delivery.
• CQI provides a vital way to assess and monitor the delivery
of services to ensure that they are consistent with an
organization’s best practice clinical principles.
• The primary goal of the Quality Improvement program is the
ongoing improvement of the delivery, quality, efficiency, and
outcome of patient care and services.

6. Quality Improvement Heroes
• Break down barriers between
departments;
• Management should learn their
responsibilities, and take on
leadership
• Improve constantly
• Institute a program of education
and self-improvement.
• This diagram is the (PDCA) cycle
for quality improvements, made
popular by Deming.

7. PDCA in the FOCUS Process
FOCUS on a particular issue.
• Find a process to improve
• Organize to improve a process
• Clarify what is known
• Understand variation
• Select a process improvement

8. IMPROVING QUALITY THROUGH
NURSING
Objective 2/3

9. Improving Quality through Nursing
• The quality of nursing is central to preventing errors in hospitals and
providing high-quality care.
• The impending gap between the need for nurses and the supply ,the
various ways that hospitals and other health organizations are reducing
nurse staffing and increasing nurse workloads. It was have demonstrated
an association between nurses’ workload and the number of deaths in
hospitals.
• It was have also shown an association between nurses’ education and the
number of deaths.
• highly dissatisfied nurses with their working conditions , lack of autonomy,
turnover and burnout. Studies have suggested that when nurses have
more control over their work, care improves and hospitals function better.

10. Functions of the quality improvement department
to improve nursing quality
• Develop mechanisms for using evidence-based practice to
improve quality of care
• Support nursing staff involvement in collaborative quality
initiatives that improve organizational performance and
patient outcomes
• Assist nursing staff to interpret and use data from internal
and external sources to improve care or resolve identified
problems
• Promote safe practices by infusing a culture of safety for both
patients and staff.

11. Functions of the quality improvement
department to improve nursing quality (cont.)
• Promote the use of an institutional set of core outcome
indicators to monitor and improve care
• Facilitate performance improvement efforts of department
and interdisciplinary teams
• Coordinate or conduct interdisciplinary performance
improvements that impact patient care delivery from multiple
services
• Provide education and consultation to internal and external
constituents regarding quality and outcomes management
activities

12. Functions of the quality improvement
department to improve nursing quality (cont.)
• Promote a scientific approach to problem-
solving in management and delivery of patient
care services
• Promote discussion and exchange of
information regarding status and progress of
evidence-based practice, and process
improvement projects.

13. Nursing scope of patient care
The scope of patient care services provided by
the department includes:
• Assessment of patients
• Planning, implementing, evaluating the
nursing plan of care
• Administration of medications
• Administration of treatments and therapies
• Patient and family education

14. IMPROVE QUALITY BY RISK
MANAGEMENT
Objective 3/3

15. Risk management
• Risk management is the human activity which
integrates recognition of risk, risk assessment,
developing strategies to manage it, and
preventing of risk using managerial resources.
• The strategies include transferring the risk to
another party, avoiding the risk, reducing the
negative effect of the risk, and accepting some
or all of the consequences of a particular risk

16. Steps in the risk management process
1. Identification of risk in a selected domain of interest
2. Planning the remainder of the process.
3. Mapping out the following: the social scope of risk
management, the identity and objectives of
stakeholders, and the basis upon which risks will be
evaluated, constraints.
4. Defining a framework for the activity and an agenda
for identification.
5. Developing an analysis of risks involved in the
process.
6. Mitigation of risks using available technological,
human and organizational resources

17. Potential risk treatments
• Avoidance (elimination) :Includes not performing an activity
that could carry risk
• Reduction ( mitigation): Involves methods that reduce the
severity of the loss
• Retention :Involves accepting the loss when it occurs. Self
insurance
• Transfer ( buying insurance) :Means causing another party to
accept the risk, typically by contract