Presentation given at the USAID SQALE Symposium, Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services, by Charles Kandie on behalf of the Ministry of Health (Kenya). http://usaidsqale.reachoutconsortium.org/
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.
Presentation given at the USAID SQALE Symposium, Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services, by Charles Kandie on behalf of the Ministry of Health (Kenya). http://usaidsqale.reachoutconsortium.org/
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.
Audit of clinical practice
1. What is clinical audit?
2. What is history of clinical audit?
3. Why clinical audit?
4. Audit cycle
5. Stages of clinical audit
Understanding and implementing quality management system in medical laboratoriesPathKind Labs
QMS is essential to run a good laboratory, but the various requirements pose a big challenge. Once you understand the reason for these requirements compliance may be easier.
Audit of clinical practice
1. What is clinical audit?
2. What is history of clinical audit?
3. Why clinical audit?
4. Audit cycle
5. Stages of clinical audit
Understanding and implementing quality management system in medical laboratoriesPathKind Labs
QMS is essential to run a good laboratory, but the various requirements pose a big challenge. Once you understand the reason for these requirements compliance may be easier.
Quality Assurance - Nursing Management
QA programmes in long-term care do provide a mechanism for continuously evaluating & improving nursing practice skills that ultimately make a clinical difference at the bedside. So, the professionals must assume responsibility for their professional actions and be answerable to the recipients for their care. Quality assurance program is thus the need of the hour.
Food quality control in the food industry is the process of monitoring and verifying food product quality throughout the supply chain1. The ultimate goal is to verify that products meet stringent criteria for safety, taste, appearance, and other factors1. Key procedures in food quality control include2:
Product & Recipe Formulation
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".
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.
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.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
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
3. Similarities
• Implementation based on a Quality Improvement Plan
• Focus on 3 key elements: structure, process, output/result
• Reference: healthcare strategic plan II , Constitution and SDGs.
• Principles –customer oriented, strong leadership and stakeholder engagement.
• A functional QIT must be established for each.
• Internal & external monitoring systems
• Evidence based medicine.
• Both have reward based on performance
• Plan, Do, Study, Act(PDSA) cycle –focused
Promoting Quality in Health and Education
8. Definition of PDSA cycle
The Plan-Do-Study-Act (PDSA) cycle is Improvement Model for accelerating
quality improvement.
•The PDSA cycle is shorthand for testing a change
–by planning it,
–trying it,
–observing the results
– and acting on what is learned.
•It’s a scientific method, used for action-oriented learning.
Promoting Quality in Health and Education
11. Remember
• Single Step —Each PDSA often contains only segment of the entire tool.
• Short Duration —Each PDSA cycle should be as brief as possible
• Small Sample Size —A PDSA will likely involve only a portion of the
practice
Promoting Quality in Health and Education
12. Remember…
Once an intervention has been introduced, the intervention and any
improvements need to be sustained. This involve:
• standardization of existing systems and processes
• documentation of policies, procedures, protocols and guidelines
• measurement and review of interventions to ensure that change becomes
past of “standard” practice
• training and education of staff
Promoting Quality in Health and Education
13. Examples of PDSA activities
• Eliminate waste
• Improve work flow
• Optimize inventory
• Change the work environment
• Enhance the producer/customer relationship
• Manage time
• Manage variation
• Design systems to avoid mistakes
• Focus on the product or service
Promoting Quality in Health and Education
14. SafeCare process
Promoting Quality in Health and Education
Outline
•Definition approach
•SafeCare levels
•Quality standards
•Sigma approach
•Assessment areas
•Sustaining factors
•Discussion
15. Definition of SafeCare
• Stepwise process
• Improve structure-process-outcome by applying Quality principles and tools
• Satisfy patients/clients needs in a culturally appropriate way
• Improve adherence to standards and guidelines based on Evidence-Based
Medicine (EBM)
• Facility improvement
• Collaborative
• Implemented in RRS
• End goal is accreditation /certification of a facility
Promoting Quality in Health and Education
19. Quality standards
•Innovative and realistic.
• Step-wise improvement process
• Improve the reputation of healthcare facilities
• Increase efficiencies
• Qualify facilities
• Increase patient flows and sustainability
• Increased trust in services provided to clients
Promoting Quality in Health and Education
20. A SafeCare facility
• Is safe for patients and staff
• Offers integrated clinical services which meet the needs of patients
• Adopts self monitoring process for its initiatives
• Consistently reports its achievements and gaps
• Increases access to services
• Utilized resources appropriately
Promoting Quality in Health and Education
21. A SafeCare facility…
• Begins with risk identification
• Analysis of risk and prioritization
• Planning
• Quality improvement implementation
• Standardize care
• Audit till positive results are achieved.
• Accreditation/Certification
Promoting Quality in Health and Education
24. Factors to consider to sustain
quality
• Leadership (Frontline manager, Board members ,Departmental heads)
• Staffing (Employing qualified personal)
• Developing & using Policies/Guidelines/SOPs.
• Team work (Facility QIT /management and Patients)
• Stakeholders support and Public private partnership
• Clinical Audits
• Incentivization of Quality
• Recognition/Awarding Quality
Promoting Quality in Health and Education
25. Remember
• Achieving a 99% level of quality would mean accepting
error
In Kenyan health sector a 1% error rate
would mean everyday
W minutes without water or electricity
X patients dissatisfied by your services
Y new born/patients falling from the bed
Z lunches contaminated by bacteria
U medication errors reported
V hospitals lacking appropriate equipment
Promoting Quality in Health and Education
1%
26. Discussion
i. Share are the experiences of quality improvement in your facility.
ii. What solutions can we have within our limits
iii. How do we ensure that the culture of quality is cultivated within
the hospital despite challenges experienced
Promoting Quality in Health and Education
27. QI Planning & Monitoring
Promoting Quality in Health and Education
Definition
Roles and elements of QIP
Examples of QIP activities
Monitoring
QIT roles
28. What is a QIP
QIP (Quality improvement plan)- A set of activities aligned with specific
objectives on improving identified gaps in a health facility.
•QIP must be SMART
•QIP is not
– Too complicated
– Rocket science
– Just more to do
– Red tape
Promoting Quality in Health and Education
29. QI planning is…
• Finding the way to do it
– Better
– Faster
– Easier
• Part of everyday life
• Used to make improvement to a process
• Enhance systems
Promoting Quality in Health and Education
30. Benefits of QIP
• Monitor tool
• Improve patient experience and outcomes
• Focus on highest quality of service
• Builds on integration
• Informs decisions
• Achieves excellence
• Reference tool
• Prioritization
Promoting Quality in Health and Education
33. How to monitor QIP
• Review meetings
• Quality Improvement Teams(QIT)
• Audit reports
• Self assessment reports
• Exchange visits
Promoting Quality in Health and Education
34. How will you notice improvement?
Measure over time using run charts
Make measurement intervals as short as possible Monitor measurements and
change as needed.
Your systems are creating your outcomes.
To GET something different, you have to DO something different.
Promoting Quality in Health and Education
35. QIT roles
Coordinate planning and implementation of QIP activities
Document QIP activities.
Provide quarterly /monthly reports to management and stakeholders on
quality activities.
Ensures healthcare remains focused on safe and reliable patient care, staff
vitality, process efficiency and waste reduction.
Promoting Quality in Health and Education
36. QIT roles…
Creates a supportive environment within the hospital.
Manages, investigates, and concludes
Audits reports on patient and customer complaints, compliments.
Manages, organises, audits and reports on patient satisfaction feedback
Promoting Quality in Health and Education
38. Discussion
Do you have a quality committee?
How do you ensure the QIT stays focused
What are the challenges experienced?
How do you intend to improve this initiative?
How do you promote team work in a QIT
Promoting Quality in Health and Education
40. Sustaining quality
• Meetings
• Audits
• Capacity and orientation
• Benchmarking & Peer review
Promoting Quality in Health and Education
41. Promoting Quality in Health and Education
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