Terri Hood-Brown, MSN, RNCTerri Hood-Brown, MSN, RNC

As you view the slide show and read your articles,

focus on the key principles in quality care in both industrialized countries and developing countries.

Be prepared to discuss The organization of delivering quality care, common

errors in quality, resources available, in the U.S. and a developing country (one you select).

What Millennium Development Goals (MDGs) are and how they could assist in improving quality care.

What steps the World Health Organization (WHO) and the Institute of Medicine (IOM) would like in place to improve quality of care.

How nursing affects quality of care in both the U.S. and your selected developing country. (Positively and Negatively)

QUALITY IN HEALTH CARE

A system that is built and continuously

maintains in order to contend with death, disease, disability, dissatisfaction and (social) disruption

A collection of curative, preventive, rehabilitative and promotive services

Health care is a social and economical attempt involving activities by providers, consumers, financiers and government

HEALTH CARE

Anand, V. (n.d.)

Avoidable errors Underutilization of services Overuse of services Variation in services Communication problems Lack of Evidence Dissatisfied consumers

What’s wrong in today’s Health Care?

Anand, V. (n.d.)

Do nothing Better education and training Regulating, Inspecting, Punishing Change, Improve, Reward Comprehensive Approach: Quality Assurance

What can we do about it?

Anand, V. (n.d.)

Why should we define quality of care?

Reach consensus among employees. Do you define quality the same as your peers?

Avoid confusion and in-house fighting. Does the board of directors, nurses and physicians define quality of care the same?

Allow for sound evaluation. If we do not agree, how can we measure?

Allow consumers to make a choice! Quality of care is reportable. Would you select a healthcare facility with negative quality of care?

Definition of Quality

Anand, V. (n.d.)

Quality Assurance: the overall philosophy on

quality and its promise to provide high quality of care.

Total Quality Management: one of the newest organizational and managerial approaches to Quality Assurance in the (not) for profit industry.

Continuous Quality Improvement: an important organizational and managerial mechanism for quality assurance in the health sector.

You may here these terms used interchangeably!

Quality :Terminology

Anand, V. (n.d.)

Important elements in determining the success of

Quality Assurance: External and internal customer satisfaction

(patients, families, other healthcare providers, employees, insurance companies…Can you think of others?)

Management leadership Involves all personnel Uses statistical methods (Evidence Based Practice) Focuses on improvements in errors, processes,

patient outcomes.

Continuous Quality Improvement

Anand, V. (n.d.)

Quality is working according to specifications.

Following EBP Following policies and procedures Following your scope of practice Knowing standards of care.

Quality is providing effective services with a minimum of unnecessary use of resources. What does that mean to you?

Quality is to exceed customers expectations and to have excellent patient outcomes.

Definition of healthcare quality

Anand, V. (n.d.)

Quality assurance is an evaluation and

improvement process similar to the nursing process, a never ending process… Assess the issue at hand: What data do you

have or need? Diagnose the problem(s): Do 60% of our

abdominal surgery patients develop wound infections? Why?

Plan: What is the overall goal? What are our measurable outcomes? What interventions are we going to put into place?

Implementation: Put our plan into action! Evaluate: Are our outcomes being met? Yes or

No? Now what happens? You all should know!!

The Key Principles

Anand, V. (n.d.)

Assuring(i.e. assessing and improving) quality

is the responsibility of the provider. Who is the healthcare provider? Remember, we’ve promised (assured) that we would provide quality care!

Of all the necessary principles (knowledge, skills, attitudes, values) values and attitudes are the most important! Why?

The Key Principles, cont.

Anand, V. (n.d.)

Focus on professional quality Focus on consumer satisfaction Focus on system(s) effectiveness Focus on interconnections (how are our

services intertwined Organizational and societal unification. What

does that mean to consumers? What does that mean to you as a nurse?

TOTAL QUALITY

Anand, V. (n.d.)

Because I know it is needed Because I am told to do so Because I must survive Because I need to follow the rules

Why is the word ‘I’ used instead of ‘we’?

WILL YOU SURVIVE WITHOUT QUALITY CARE?

Why improve our quality of care?

Anand, V. (n.d.)

Select key professionals. Who needs to be involved? Why? Design appropriate training. Is training required for all

providers? Why? Organize continuous training sessions. Do we need to

make the training mandatory? Available for all shifts? Evaluate results of training including satisfaction. Did the

providers learn from the training? Were they satisfied with the type of, time of and outcomes of the training?

Reward participants. What types of rewards should be made available for the participants, if any?

Repeat training regularly. Annually? Bi-annually? Monthly, until quality is improved?

Quality Training

Anand, V. (n.d.)

Focus: Process and Outcome Structure: better equipment/resources Process: doing the right things better! Outcome: obtain better results in - quality outcomes - costs - consumer satisfaction

Improvement of care

Anand, V. (n.d.)

Principle: Doing the right things better! Is our

process based on current evidence? Doing the right things more effective! Doing the right things more efficient! But

safely!Includes: Appropriate use of technology Appropriate use of personnel Consumer/provider relationship

Improvement of Process

Anand, V. (n.d.)

Quality improvement is essential for survival.

Why?

Consumer satisfaction is important for survival Why?

Survival

Anand, V. (n.d.)

Define the decision makers:

Who and What drives quality care? Who decides what quality care is? Who decides in specific healthcare

environments? Home health, Hospice, In-patient, Offices,

Who decides about quality improvement implementation?

Who evaluates interventions? Who is ultimately responsible?

Key Concerns:

Anand, V. (n.d.)

What are the roles of each of the decision

makers? The Consumers

The Professionals

The Managers

The Government, Policy Makers

Roles and Functions in Decision making in Quality Improvement

Anand, V. (n.d.)

Definers of Quality Evaluators of Quality Informants of Care Co-producers of care Targets of Quality Assurance Controllers of Practitioner Behavior Reformers of Health Services

The Seven Roles of the Consumer

Anand, V. (n.d.)

To be accountable To provide quality care(plan, implement) To safeguard the quality of care services To be evaluated by colleagues To evaluate his colleagues To continue learning To collaborate with colleagues and

management

The Seven Roles of the Provider

Anand, V. (n.d.)

Do their job(Quality Management) Exert leadership Participate in Quality Management Communicate on Quality matters Be accountable re: quality Evaluation of Quality Management Provide resources

Seven Roles and Functions of Management

Anand, V. (n.d.)

Who decides the role of government? Is it different from government to

government? Should they have an:

Active role with responsibilities? Support role with limited responsibilities? No role at all?

Role of Government

Anand, V. (n.d.)

Improvement in health status Increase in satisfaction Elimination of impairment Elimination of disability Elimination of risks

What are benefits of quality care?

Anand, V. (n.d.)

After you have viewed this Power Point and

read all of the readings for this week participate in the discussion board titled: Quality of Healthcare.

Follow the directs and grading rubric carefully to receive full credit.

If you have any questions email your instructor.

Your Assignment

Anand, V. (n.d.). Quality in health care

delivery. Retrieved from www.hosmac.com

References