Quality concepts

HealthcareQuality Concepts

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الجودة تعريف

الجودة في

الرعاية الصحية

الخدمة متلقي تعريف

الخدمة مقدم االدارة تعريف تعريف

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ImprovingQuality

MeasuringQuality

DefiningQuality

QualityAssurance

The Quality Assurance Triangle

QualityEvaluation Regulation Accreditation Audit

Policy Making

Quality (Re)-Designing

Benchmarking

Problem Solving

Management Actions

Structural Re-Organization

IncentivesMotivation

Standards Setting

Monitoring Systems

Supervision

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What is QualityQuality means doing the right things

right the first time. Quality can be said to be, at least in

part, compliance with standards. Standards are created when experts are able to understand what the right things are and how the right things are best achieved based on Research and Clinical Evidence

When recipients of care define quality, they judge whether or not the right things are done in ways that meet their own needs and expectations.

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What is Quality

The Institute of Medicine defines quality as: "The degree to which health care services for individuals and populations increase the probability of desired health outcomes and are consistent with current professional knowledge of best practice."

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Aspects of Quality

Measurable Quality

Appreciative Quality

Perceptive Quality

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Measurable Quality

Can be defined objectively as compliance with, or adherence to standards.

Clinically, these standards may take the form of practice parameters or protocols, or they may establish acceptable expectations for patient and organizational outcomes.

Standards serve as guidelines for excellence.

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Appreciative QualityIs the comprehension and appraisal

of excellence beyond minimal standards and criteria.

Requires the judgments of skilled, experienced practitioners and sensitive, caring persons.

Peer review bodies rely on the judgments of like professionals in determining the quality or non-quality of specific patient-practitioner interactions.

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Perceptive Quality

Is the degree of excellence which is perceived by the recipient or the observer of care rather than by the provider of care.

Is generally based more on the degree of caring expressed by physicians, nurses, and other staff than on the physical environment and technical competence.

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Dimensions of Quality

The key dimensions of care/performance provide the framework for quality management activities in all healthcare settings and balanced and well-integrated quality, cost, and risk perspective. They are foundational as ways of thinking about patient care, what is important to patients, and what should be prioritized in performance measurement.

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Dimensions of Quality1. Appropriateness (مالئمة ) o The degree to which the

care/intervention is given the current state of knowledge.

o “correct” suitable resource utilization, as

judged by peers.

o Doing the right things in accordance with the purpose.

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Dimensions of Quality…

2. Availability ( الحصول ومتاح متوفرة ( عليها

o The degree to which appropriate care/intervention is obtainable to meet the patient's needs.

o The ease with which healthcare can be obtained in the face of financial , organizational, procedural, emotional, and cultural barriers (access).

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3. Competency ( وكفاءة (أهلية o The practitioner's ability to

produce both the health and satisfaction of customers.

o The degree to which the practitioner adheres to professional and/or organizational standards of care and practice.

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4. Continuity ( ومتواصلة (مستمرة o The coordination of needed

healthcare services for a patient or specified population among all practitioners and across all involved organizations over time.

o The delivery of needed healthcare as a coherent unbroken succession of service (truly managed care).

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5. Effectiveness ( ومؤثر (فعالo The degree to which care is

provided in the correct manner, given the current state of knowledge, to achieve the desired or projected outcome(s) for the individual.

o The degree to witch a desired outcome is reached, the positive result of care delivery.

o Performance that is equivalent to state requirements: (doing the right things right)

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6. Efficacy ( وفعالية (قدرةo The potential, capacity, or

capability to produce the desired effect or outcome, e.g., through scientific research. (evidence-based) findings.

o The power of a procedure or treatment to improve health status.

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7. Efficiency ( كفاية, (فعاليةo The relationship between the

outcomes (results of care) and the resources used to deliver care.

o The relationship of outputs (services produced) to inputs (resources used to produce the services) [JCI Second Edition]

o A combination of skill and economy of energy in producing a desired result.

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8. Respect and Caring ( العناية (واالحترام

o The degree to which those providing services do so with sensitivity for the individual's needs, expectations, and individual differences, and the degree to which the individual is involved in his or her own care decisions.

o The degree to which the individual or a designee is involved in his or her own care and service decisions [JCAHO 2003]

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9. Safety ( واألمان (السالمةo The degree to which the risk of an

intervention ... and risk in the care environment are reduced for a patient and other persons including health care practitioners.

o The degree to which the organizational environment is free from hazard or danger.

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10.Timeliness (( المحدد الوقت والمطلوب

o The degree to which needed care and services are "provided to the patient at the most beneficial or necessary time.

o The degree to which services are

provided to customers in accordance with their perception of promptness.

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11.Prevention/Early Detection

o The degree to which interventions, including the identification of risk factors, promote health and prevent disease.

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Reference…

Healthcare Quality Handbook OfJanet A. Brown, RN, CPHQ

Education

Quality concepts