.

The centers for Medicare and Medicaid defined

Quality as:
The right care for the right person every time.

The Juran Institute defined quality as both:

1.

Freedom of deficiencies, and

2.

Product features.


.
.

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."

The US Government Agency for Healthcare

Research and Quality (AHRQ) defines quality
healthcare as:

Quality Healthcare is Healthcare that is accessible,

effective, appropriate, safe, efficient,
timely.etc


10

,



.

12

 .1

Efficiency

2.

3.

.2

.3

Safety

.4

Appropriate

4.

.5

...

Continuity of care

5.

.6

Timeliness

6.

.7

Respect and caring

7.

Competency

8.

.8
13

Effectiveness

1.

14

15

16

17

18

Types of indicators
Structure Indicator
Describes characteristics of the setting that supports and has an impact on
care (examples: availability of approved least restraint devices on a unit,
RN:patient ratio).

Process Indicator
Measures an activity that is carried out to care for patients
Focuses on the nature and amount of care nurses provided during the
hospital stay (examples: rate of patients on fall prevention program, nurse
satisfaction).
Outcome Indicator
Describes the patient's status at the defined time following care
interventions.
Measures the result of nursing care/process (examples: pressure ulcer
prevalence rate, fall injury rate).

19

20

21

22


Monitoring Plan

23

Indicators are reliable and valid measures used to screen/assess

organizational and practitioner performance issues, but not direct
measures of quality
24

25



.
An indicator is a measurable variable (or
characteristic) that can be used to determine
the degree of adherence to a standard or
achievement of quality goals
26

 Well defined
Objective
Measurable (reliable and valid)
Comparative and
Graphically displayed

) (

27

Out come indicators

Process indicators

Structure indicators

Sentinel events

28

29

30

Quality Assurance

Interpretation
Understanding

Information

Analysis

Quality Control

Knowledge

Information
Management
Cycle

Data

Quality Improvement

Hypothesis

Design

Collection

31

32

Scope of Service
33

34

.
.

35

 :

(
)...

36

 :

.

37

38

 :

.
Decision-Oriented measures

39

40

41

 :

.

42

43

44

Quality Assurance

Interpretation
Understanding

Information

Analysis

Quality Control

Knowledge

Information
Management
Cycle

Data

Quality Improvement

Hypothesis

Design

Collection

45

o
o
o

o
o
o
o
46


ORACLE
MEDICOM
o .
o

o .

o
47

:


48

but remember, bad data will result in bad

information (GIGO)

Garbage In , Garbage Out

Also, data can be no more accurate than the
instruments and the systems used for
recording them and reporting them

49

Central-Tendency measures

()

50

51

52

53

 Comparison
:


benchmarking

( trend )
54


:
( )

( )

Pareto Chart

Control Chart
55

Pareto Chart

14
12
10
8
6
4
2
0

56

...

Control Chart
Colonic biobsy / day

Average

Upper Limit

Lower Limit

10
9
8
7
6
5
4
3
2
1

Dec

Nov

Oct

Sep

Aug

Jul

Jun

May

Apr

Mar

Feb

Jan

Dec

Nov

Oct

Sep

Aug

Jul

Jun

May

Apr

Mar

Feb

Jan

.
57

58

59

.1

.2

.3

.....

.1
.2
.3
.4
.5

60

 .
:

()

61

62

 :
.
Sequence of interdependent and linked procedures which, at
every stage, consume one or more resources to convert
inputs into outputs. These outputs then serve as input for the
next stage until a known goal or end result is reached.
BusinessDictionary.com

63

.
64

Patient Flow :
.
.

65

66

67

:
Value Chain Analysis

Define the process

Draw a flow chart (understand the steps)

Identify the value of each step

Suggest the changes and results

Pilot study

Implement
68

:
FOCUS Plan-Do-Check-Act
Find
Organize
Clarify
Understand
Select

Define the process

Draw a flow chart (understand the steps)

Identify the value of each step

P
D
C
A

Suggest the changes and results

Pilot study

Implement
69

70