Lect QA Study

8/10/2019 Lect QA Study

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QU LITY SSUR NCE

STUDY


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Methodology of QA Study

1. Problem / Opportunity Statement

2. Literature Review / Situational Analysis

3. Objectives of the study

4. Type of Study

5. Variables

6. Sampling7. Data Collection Techniques

8. Mapping the Proposal

9. References


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Methodology of QA Study

1. Problem / Opportunity Statement

A complete opportunity/ problem statementshould describe :

* the problem or area of concern and itssignificance for the quality of care

* possible causes and contributory factors

* rationale of the study* scope of the study

* intention to use the results to improve the

quality of care


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PROBLEM

Other QUALITY

PRACTICAL DAILY LIFEScientific / academic interest

Do nothing CAN DO SOMETHING

Severity

Benefit

ABNA

Problem

prioritisation

BIG MAGNITUDE Small magnitude

? Feasible ? Possible

? Cost benefit ? Study module

DO QA STUDYDo nothing

yes


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2. Literature Review / Situational Analysis

Source of literature;

* text books* scientific journals

* proceedings of conferences

* local, state and national statistics

* reports on QA studies


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Literature review will help us in;

clarify our problemstate the study objectives

know what has happen elsewhere

check the implicit standards

set explicit criteria and standards

suggest suitable study methodsfind appropriate remedial actions

avoid duplication of works


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3. Objectives of the study

Objectivesof study summarise what isfinally to be achieved by the study

If an objective is planning what is to be

accomplished by the study in general term,it is called a general objective

It is possible to be down general objectives

into smaller logically connected partswhich are normally referred to asspecific

objectives


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Objectives should be closely related tothe statement of the problem.

For example; if the problem identified

is high defaulter rate amongst TBpatients, the objectives will be to identifyreasons for this high defaulters and to

find means to improve it.


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Objectives should..

be phrased in such a way that they focus onwhat the study is attempting to solve, indifferent parts of the problem in a logicalway

be clear, phrased in operational termspecifying exactly what one is going to do

keep in mind that when the study / poject isevaluated , the result will be compared to theobjectives

be realistic to be achieved


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Phrasing of objectives

Thegeneral objectivewill mention the overallfinal aim to be achieved in the study

The specific objectivesshould be stated using

action verbs that specific enough to

measures:

To determine - To compareTo verify - To establishTo calculate - To describe


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Avoid the use of vague non-action verbssuch as;

To appreciate

To understand

To believe.


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Specific objectives for QA study

1. To verify the existence of the qualityproblem

2. To measure the magnitude of the

problem3. To identify/describe the actual causes or

contributory factors involved

4. To formulate the remedial orimprovement measures

5. To evaluate the effectiveness of the

measures taken.


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4. Type of StudySTUDY

NON-EXPERIMENTAL EXPERIMENTAL

DESCRIPTIVE ANALYTICAL

QUANTITATIVE

QUALITATIVE

CASE-CONTROL

( retrospective)

COHORT

(prospective )


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Descriptive study:

Systematic collection and presentationof data to give a clear picture of aparticular situation within a particular

period ( cross-sectional)

describe in term of qualitativemeasure or quantitativemeasure


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Analytical study( or; comparative study )

Aims at determining and testing therelationshipbetween several variables to suggestpossible causes of problemCase-control/Retrospective: Check the present

outcome and examine the past possibleexposure factorsCohort/Prospective: Expose different factors to

different group of study samples ( of similarcharacteristic ) and measure their outcomes aftercertain time period


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Experimental study

Strongest possible type of study to provecausation

Individuals are randomly allocated to at least

two groups; one group is subject to anintervention or experiment while the othergroup is not

The outcome of the intervention ( effect ofintervention of the dependent variable) isobtained by comparing the two groups


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Time perspective

PASTRETROSPECTIVE

Looks for past exposureto a factor ordescribe

the past event

NOWCROSS-SECTIONAL

Looks at the presentsituation

FUTUREPROSPECTIVE

Looks at development of acondition over time

Descriptive study; can be retrospective, prospective orcross-sectional

Analytical study; can be either retrospective or prospective

Experimental study is always prospective


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5. Variables

A characteristic of a person, object orphenomenon that is measureable and

can take on different values

Examples;Variable: Height value: tall , short

variable: Sex value: male , female

variable: Knowledge value:Good, poorvariable: Socioeconomic status

value: High income, middle-income,

low income group


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Key Word Definition

To describe the definition of certain/selective key words and terminology usedin this study

The terminology probably applied only forthis study including application of certainvariables, situation, standard.

Must be sound valid, acceptable, reliable,clear and not ambiguous.


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Proposed Indicator and

Standard Describe the indicator proposed to be

applied in the study.

If rate based, what numerator and

denominator will you use.

Proposed the most acceptable standard.


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6. Sampling

Better to get intended information froma certain population ( all ), but limitedwith problems of logistics, costs, time &

other resources.

Thus, we have to do sampling; arepresentative sample with all importantcharacteristics of the drawn population


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Sampling procedures

1. Non-probablility

- Convenience & Non-convenience

2. Probability sampling- simple randomized

- systematic random

3. Stratified sampling4. Cluster sampling

5. Multi-stage sampling


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7. Data Collection Techniques

Review of recorded sources

Observation Interview

Written questionaires


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Plan for Data Collection

WHAT data to collect

WHERE to get the data

HOW to collect them WHO will collect

WHEN will the data be collected

HOW LONG will it takes

QUALITY CONTROL of the data


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Plan for Data Analysis

The plan includes;

Data handling andstoring

Data processing Data analysis


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8. Mapping the Proposal

Construct the Gantts Chart

List down the the plan of processes to be

undertaken in conducting the study Chart the appropriate time frame for each

process

To mark the plan and actual task carriedout

Gantts Chart


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Responsibility Oct

1stwk 2ndwk 3rdwk 4thwk

Nov

1stwk

2nd

wk

3rd

wk

4th

wk

Prepare

Proposal

Group

members

Prepare

Checklist

Group

members

Staff

Briefing

Group

members

QA Study SN ED/ward

Data

collection

SN ED/ward

Data

Analysis

Group

members

Remedial

Action

Group

members

Evaluation Group

members

Report

Writing

Group

Members

Gantt s Chart


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9. References

List down all references quoted or referredin the study


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References

1. Clinical Practice Guidelines on The

Management of HPT

( Academy of Medicine; 2002 )

2. Standard Operating Procedure for MA

( Ministry of Health; 2000 )


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References

1. McCarty D., Zimmet P. 1997. Diabetes 1994 to 2010: Globalestimates and Projection- Interact in Internationaldiabetes. Melbourne, Australia, 1997 ISBN 0640.2448.10.

2. Langer D et al, Pregestational diabetic: Insulin requirementthroughout pregnancy. Am J Obstet Gynae 1988; 159:616-621

3. Life-style changes linked to global rise in diabetes- Expertssay, Press Release ; WHO/59 14 July 1994.12.

4. King H. Revers M. Diabetes in adults is now a third worldproblem. Bulletin of WHO 1991. 69 (b):643 648.14

5. Diabetes facts and figures. 1997. Persatuan DiabetesMalaysia homepage, page 15.

6. America Diabetes Association. Screening for Diabetes,Diabetes Care, 1989; 12: 588 590.5.

Documents

Lect QA Study