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Evaluation of Patient Care & Quality, TQM Tools: Benchmarking, Key…
Evaluation of Patient Care & Quality
2. Why is Quality Important? (Benefits)
For the Organization: Accreditation, cost control, identifies weak areas.
For Patients: Better outcomes, shorter stays, higher satisfaction.
For Staff: Higher job satisfaction, less turnover, more training.
3. The Aspects & Dimensions of Quality
3 Aspects: Measurable (standards), Perceptive (by patient), Appreciative (by peers).
1. What is Quality?
Definition: The degree to which health services increase desired health outcomes and are consistent with best practice (IOM).
1. Oxford English Dictionary: A degree of excellence in a product or service.
Keyword: Degree of Excellence
5. Institute of Medicine: Services that increase desired health outcomes and are consistent with best practice.
Keyword: Outcomes & Best Practice
4. Donabedian: The agreement between reality and set criteria.
Keyword: Reality vs. Criteria
3. Juran: Fitness for purpose.
Keyword: Fitness for Purpose
2. Crosby: Conformance to requirements to satisfy the customer.
Keyword: Conformance to Requirements
Clinical Indicator: A quantitative measure to monitor quality.
Criterion: A measurable element to see if a standard is met.
Standard: A statement of desired performance.
7. Dimensions/Characteristics of Quality
Appropriateness
Definition: Care is relevant to the patient's clinical needs.
Keyword: Relevant Care
Availability
Definition: Appropriate care is obtainable by the patient.
Keyword: Obtainable Care
Competency
Definition: The practitioner's ability to provide care that meets standards.
Keyword: Practitioner Ability
Continuity
Definition: The coordination of care over time and across providers.
Keyword: Care Coordination
Effectiveness
Definition: Care is provided in the correct manner to achieve the desired outcome.
Keyword: Correct Manner
Efficiency
Definition: Achieving desired results with minimal resources
Keyword: Minimal Resources
Efficacy
Definition: The capability of care to produce a desired effect, based on evidence.
Keyword: Proven Capability
Respect and Caring
Definition: Providing services with sensitivity and involving the patient in decisions.
Keyword: Sensitivity & Involvement
Safety
Definition: The reduction of risk in the care environment and interventions.
Keyword: Risk Reduction
Timeliness
Definition: Care is provided at the most beneficial time.
Keyword: Right Time
Prevention and Early Detection
Definition: Interventions that promote health and prevent disease.
Keyword: Health Promotion
5. The Evolution of Quality in Healthcare
Inspection → Quality Control → Quality Assurance (QA) → Quality Improvement (QI) → Total Quality Management (TQM)
QA vs. QI:
QA: Focuses on inspection,
QI: Focuses on prevention and improving processes.
4. How Do We Evaluate Quality? (The Approaches)
Structure: Evaluates the system (e.g., staff, equipment, policies).
Process: Evaluates the actions (e.g., how care is delivered, tasks performed).
Outcome: Evaluates the results (e.g., recovery rate, satisfaction, infection rate).
6. Key Mechanism: The Nursing Audit
Purpose: To review and verify that care meets accepted standards.
Types:
Concurrent: During hospitalization (e.g., open chart audit, observation).
Retrospective: After discharge (e.g., closed chart audit, patient surveys).
TQM Tools: Benchmarking, Key Performance Indicators (KPIs), Six Sigma.