This document discusses various tools and methods for quality assessment and improvement in healthcare. It defines key terms like quality, improvement, and tools. It describes quality assessment as evaluating structure, process, and outcomes to achieve continuous medical care improvement. Quality improvement principles include focusing on systems/processes, patients, teamwork, and data. Common quality tools include flowcharts, control charts, and cause-and-effect diagrams. Models for quality improvement outlined are the Care Model, Lean Model, Model for Improvement, FADE, and Six Sigma. A directory of additional tools is also provided.

2. H.M.I.S PRESENTATION
TOOLS FOR QUALITY ASSESSMENT
RESPECTED MA’AM
GROUP 4
 MR MUHAMMAD ATEEB

3. Introduction (Definitions)
 Quality: Do the right thing right from the first
time and every time
 Improvement: To make things better
 Method: A series of steps
 Tool: Something that aids in accomplishing a
task

4. Quality assessment/
Improvement
 Quality assessment (QA/QI) in primary care is a
process of planned activities whose ultimate goal is to
achieve a continuous improvement of medical care
through the evaluation of structure, process, and
outcome measures

5. Quality Improvement
Methods
 Simply quality improvement includes:
 Product improvement
 Process improvement
 People based improvement

6. Principles of Quality
Improvement:
 Quality is directly linked to an organization’s service delivery
approach or underlying systems of care.
 To achieve a different level of performance (i.e., results) and improve
quality, the following four key principles are important:
 QI work as systems and processes
 Focus on patients
 Focus on being part of the team
 Focus on use of the data

7. QI Work as Systems and Processes:
 To make improvements, an organization needs to understand its own delivery
system and key processes.
 The concepts behind the QI approaches in this toolkit recognize that both
resources (inputs) and activities carried out (processes) are addressed
together to ensure quality of care (outputs/outcomes).
 In this, process map play an important role which provides a visual diagram
of a sequence of events that result in a particular outcome
 Basically process mapping is a tool commonly used by an organization to
better understand the health care processes within its practice system.

8.  This shows how a health care delivery system consists of
resources, activities, and results
Resources
(Input)
• Infrastructure
• Materials
(Vaccine)
Activities
(Processes)
• What is done
• How its done
Results
(Output)
• Health services
delivered
• Changes in health
behavior
• Changes in health
status
• Patient satisfaction

9. Focus on Patients
 An important measure of quality is the extent to which
patients’ needs and expectations are met.
 Services that are designed to meet the needs and
expectations of patients include:
 Systems that affect patient access
 Care provision that is evidence-based
 Patient safety
 Support for patient engagement
 Coordination of care with other parts of the larger health
care system
 Cultural competence, including assessing health literacy of
patients, patient-centered communication, and linguistically
appropriate care

10. Focus on Being Part of the Team
 At its core, Quality improvement is a team process.
 Whether an organization is seeking to improve patient wait
times, telephone service, diabetes care, or other goals it
deems important, a team effort helps an organization to
achieve significant and lasting improvements.

11. Focus on Use of the Data
 Data is the cornerstone of QI. It is used to describe how well
current systems are working; what happens when changes
are applied, and to document successful performance.
 Both quantitative and qualitative methods of data collection
are helpful in QI efforts.
 Common strategies for collecting quantitative data in a health
care setting are:
 Finding the average of a specific laboratory value
 Calculating the frequencies of timely access to care
 Calculating the percentages of patients that receive an
appropriate health screening

12. Cont…..
 Common strategies for collecting qualitative data in a health
care setting are:
 Patient and staff satisfaction surveys
 Focus group discussions
 Independent observations

13. Basic Quality Tools in Continuous
Improvement Process
 To make rational decisions using data obtained on the product, or
process, or from the consumer, organizations use certain graphical
tools.
 Graphical methods are easy to understand and provide
comprehensive information; they are a viable tool for the analysis of
product and process data.
 So, If organizations wish to achieve continuous quality improvement
they need to use appropriate selection of quality tools and
techniques.

14. Cont…
 There are seven basic quality tools (7QC tools) that can be used in
all process phases are:
 Flow chart
 Pareto diagram
 Check sheet
 Control chart
 Histogram
 Scatter plot
 Cause-and-effect diagram
 These tools further involved in some phases of continuous
improvement process (PDCA-cycle), Six Sigma (DMAIC) and Design
for Six Sigma (DMADV) methodologies, and Lean Six Sigma.

15. Introduction to QI Models
 There are a variety of QI models currently in use and five
are highlighted here.
 Two of the models highlighted, Care Model and Lean
Model, provide a framework to improve patient care.
 The other three models, Model for Improvement, FADE,
and Six Sigma, focus on processes that monitor the
results of measures

16. QI Models Explanation
 Care Model: There are six fundamental aspects of care identified in
the Care Model, which creates a system that promotes high-quality
disease and prevention management. It does this by supporting
productive interactions between patients, who take an active part in
their care, and providers, who have the necessary resources and
expertise.
 Lean Model: This model defines value by what a customer (i.e.,
patient) wants. It maps how the value flows to the customer (i.e.,
patient), and ensures the competency of the process by making it
cost effective and time efficient.
 Model for Improvement: This model focuses on three questions to
set the aim or organizational goal, establish measures, and select
changes. It incorporates Plan-Do-Study-Act (PDSA) cycles to test
changes on a small scale.

17.  FADE: There are four broad steps to the FADE QI model:
 Focus—define process to be improved
 Analyze—collect and analyze data
 Develop—develop action plans for improvement
 Execute—implement the action plans, and Evaluate measure
and monitor the system to ensure success
 Six Sigma: Six Sigma is a measurement-based strategy for
process improvement and problem reduction. It is completed
through the application of the QI project and accomplished
with the use of two Six Sigma models:
1) DMAIC (define, measure, analyze, improve, control) which is
designed to examine existing processes,
2) DMADV (define, measure, analyze, design, verify) which is
used to develop new processes.

18. Directory of tools for quality
improvement
Tools to measure care against agreed standards
Clinical audit Checks clinical care meets defined quality
standards
Statistical process
control
Measures quality within predefined parameters
Performance
benchmarking
Measures quality against peers or national targets
Tools to understand the cause of the problem
Process mapping Maps the patient journey for quality
improvement opportunities
Root cause analysis Systematically uncovers the causes of events
affecting quality

19. Tools to plan and test improvement projects
Model for
Improvement
Decides upon, test and refines quality
improvements
Plan do study act Introduces and tests potential quality
improvements on a small scale
Lean Six Sigma Eliminates waste and redirects resources for
quality and efficiency
Tools to promote change in practice
Technological
innovations
Automates processes and systems for care
quality improvement
Decision trees Improves the quality and consistency of processes
in healthcare
Communication
tools
Improves quality of care through structured
information exchange

20. It is evident that a continuous
improvement process cannot be
realized without quality tools,
techniques and methods.

21. Any
Qustion