This document provides an overview of key concepts related to quality including: - The evolution of quality concepts from medieval guilds to modern quality gurus like Deming and Juran. - Definitions of quality focusing on meeting customer needs, fitness for use, and conforming to requirements. - Dimensions of healthcare quality including effectiveness, efficiency, equity, patient-centeredness, safety, and timeliness. - Different perspectives for evaluating quality from the service, peer review, and measurable standards perspectives. - Models for quality including the phases of quality, continuous quality improvement (CQI), the Donabedian model for measuring care quality, and Juran's trilogy for quality management.

1. Quality Concepts
Ms. Zerin Ziaudeen

2. Overview :
✗ Road Map of Quality Evolution
✗ Quality Gurus
✗ What is quality
✗ Dimensions of quality
✗ Aspects of Quality
✗ Perspective of Quality
✗ CQI
✗ Donabedian Model
✗ Juran’s Trilogy
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3. Roadmap OF Quality Evolution
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1 3 5
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Introduction of guild among artisans
and merchants - late medival ages
(5th to 15th century )
20th century scientific management principles
popularised by F.W Taylor , work specification
and division of labour was introduced
WW-2 ravaged Japan , quality
movement rebuild their industry ,
Embraced – customer focus and
statistical process control concepts by
Deming and Shewhart
Industrial revolution period 1760 – 1840
Need for mass production , accountability taken
away from single worker
Inspection was practiced to
identify and remove defects before
moved out of factory line
In 5 years Japan
emerged as the market
leader

4. Quality Gurus
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Walter Shewhart
Physicist , Engineer &
Statistician
(1891-1967)
Grandfather of Quality
movement ,Run charts &
control charts
Wiiliam Edward
Deming
Physicist & statistician
(1900- 1993)
SPC,PDCA,!4 principles
Joseph Juran
Engineer
(1904 -2008)
Quality management, education
training of top and middle level
management, Jurans Trilogy
customers perspective of quality
Philip Corsby
Businessman
1926-2001
Cost of poor quality , right
first time

5. What is quality ?
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6. Quality Definition
✗ “Meeting of Customers needs”( E.W Deming )
✗ “Fitness for use” ( J.Juran )
✗ “Conformance to requirements” (Philip B.Corsby)
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7. The Institute of Medicine ( IOM ) defines Quality as-
"the degree to which health care services for individuals and
populations increase the likelihood of desired health
outcomes and are consistent with current professional
knowledge.“ (IOM 2001)
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8. Healthcare Quality Dimensions (STEEP)-AHRQ
Effectiveness
Relates to providing care
processes and achieving
outcomes as supported by
scientific evidence
Efficiency
Relates to maximizing the
quality of a comparable unit
of health care delivered or
unit of health benefit
achieved for a given unit of
health care resources used.
Equity
Relates to providing health care
of equal quality to those who
may differ in personal
characteristics other than their
clinical condition or preferences
for care..
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Patient
centeredness.
Relates to meeting patients'
needs and preferences and
providing education and
support..
Safety
Relates to avoiding actual or
potential bodily harm.
Timeliness
Relates to obtaining needed
care while minimizing delays.

9. Quality from different perspective /Aspect of CARE
Perspective
Quality –
Service perpective
Perceived/judged by
the recipient of care.
(Meet or exceed the
stated or implied
needs of the patients
every single time)
Appreciative
quality -
Eg : peer review
Judged by
experienced
practitioners rely not
only on standards but
personal experience
as well
Measurable
quality –
Judged by provider
through comparative
measures between
actual performance
versus standard one
Eg: standards,
protocols
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10. Phases of quality
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11. Continuous Quality Improvement (CQI)
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Continuous Quality Improvement is a management philosophy used by
organizations to reduce waste, increase efficiency, and increase internal and
external customer satisfaction.
It is an ongoing process that evaluates how an organization works and ways to
improve its processes.

12. Donabedian Model –Measuring Quality Of Care
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13. JURAN – Trilogy
( approach to cross functional management )
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14. Accreditation & Quality
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 Accreditation is a tool towards Quality Improvement
 Accreditation provides the framework
 If intent is not met, the acceptance of stakeholders is
minimized
 If appropriate outcomes not measured, it is a non- value
add service
 It is a team exercise
 Doorman to chairman

15. Thank you !!
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