intro
- 1. QUALITY & ACCREDITATION Dr. Mahmoud Radwan CPHQ
- 2. Quality is the result of a carefully constructed culture; it has to be the fabric of the organization-not part of the fabric, but the actual fabric. Quality in a product or service is not what the supplier puts in. It is what the customer gets out & is willing to pay for.
- 4. Doing: the right thing right from the first time
- 5. Juran defines quality as both: I) Freedom from deficiencies: Causes of customer dissatisfaction Hospital acquired infections Lost lab results Excessive waiting time Cold meals Premature discharge
- 6. II) Product features: Attract & satisfy customers Pleasant waiting area Knowing what to expect Care coordination Computerized health record Follow up care
- 7. Juran trilogy (TQM cycle) Quality planning Quality control Quality Improvement Continuous Circular All parts depend on each other
- 8. Quality Planning: Identifying customers Identifying customer needs & expectations Setting quality goals Designing or redesigning systems & functions Setting priorities What we will do?
- 9. Quality Control Developing performance measures Monitoring current performance Comparing actual to intended performance Performing data analysis Providing feedback How we are doing?
- 10. Quality Improvement Improving existing processes Using scientific problem solving methods Analyzing causes of failures or errors Analyzing data for best practice Finding optimal solutions for chronic problems How to improve continuously?
- 11. IOM: Quality of care Quality of care is the degree to which health services for individuals & populations increase the likelihood of desired health outcomes & are consistent with current professional knowledge
- 12. Aspects Of Healthcare Quality Map of quality Measurable quality Appreciative quality Perceptive quality
- 13. I) Measurable Quality: Compliance with standards Such as protocols or practice guidelines Basis for licensure or accreditation Serving as guidelines for excellence
- 14. II) Appreciative Quality: Appraisal of excellence Going beyond minimal standards & criteria Judgment of like professionals Peer review
- 15. III) Perceptive Quality: Degree of excellence Perceived by recipient of service Respect & care are the most important Essential to prevent dissatisfaction
- 16. Key Dimensions Of Quality Appropriateness Availability Competency Continuity Efficacy Effectiveness Efficiency Prevention/early detection Respect & care Safety timeliness
- 17. Services VS Products In which quality is more sensitive? Products Services Objects Performances Homogenous Heterogeneous inventoried Not inventoried
- 18. Why Now?
- 19. Many pressures affect healthcare organizations making quality as a necessity to survive in the market Utilization management Risk management Concept of value
- 20. Utilization Management (UM) •Managed care •Prospective payment systems •Case management •Use of economic indicators Length of stay Use of expensive drugs or technologies Adherence to CPG & protocols
- 21. Risk Management (RM) Increased risk pressures due to: •Customer awareness of patient rights •Media coverage •Increased claims & law suits •Corporate liability •Advanced technology in healthcare
- 22. Concept of value Value = Quality of care + outcome Cost
- 23. What Changed?
- 24. Traditional quality assurance programs have points of weakness Joint Commission (JCI) started a major change agenda in early 1990s The main concept is CQI
- 25. Traditional common weaknesses Focus on clinical aspects of care only Compartmentalization of QA activities Focus on performance of individuals Reactive activities Separating the quality care dimensions What to do?
- 26. Opportunities for change Include ALL aspects of care Cross-functional approach Focus on performance of processes Proactive activities Integrating all quality dimensions What is the result?
- 27. Change in the focus Was monitoring two elements: 1)What of care = patient care given 2)Who of care = patient care giver Now monitoring also: 1)How of care = care processes 2)Result of care = care outcome
- 28. Basic Principles
- 29. Work is done through processes In any process: Supplier Processor Customer Inputs Feedback Feedback Outputs
- 30. Customer-supplier relationship Necessary for sound quality management Everyone plays the three roles( Ex: the patient) Giving history or feedback Taking medications Receiving care Supplier Processor Customer
- 31. Quality defects due to processes Main source is problems in the process Old assumption: people do the right things wrong New assumption: people do the wrong things right 85/15 theory by Deming
- 32. Poor quality is costly Poor quality results in: Decreased customer satisfaction Decreased revenue & market share Lost time & resources Lost pride & image Increased liability High quality is less costly than poor quality
- 33. Process variability Using SPC to differentiate two types of process variation: I) Common cause variation Intrinsic in stable processes Reduce II) Special cause variation Extrinsic in unstable processes Eliminate or implement
- 34. Focus on vital processes Bad news: Not everything is going to get done Good news: Not everything has to get done Focus on: High risk High volume High cost Problem prone
- 35. Empowering Employee The most knowledgeable Encourage creative thinking & innovation Continuous training & education Cease dependence on mass inspection
- 36. New organizational structures Quality council Quality coordinator Patient safety officer
- 37. Juran trilogy (TQM cycle) Quality planning Quality control Quality Improvement Continuous Circular All parts depend on each other
- 39. Accreditation is: Voluntary commitment To standards Representing optimum quality of care Determined by experts
- 40. License & Accreditation Accreditation License Voluntary Mandatory Standards Laws Optimum Minimum
- 41. Two Types International Joint commission accreditation (JCI) National Egyptian healthcare accreditation program
- 42. How to be accredited?
- 43. Preparedness Plan Leadership Knowledge Readiness Communication
- 44. Periodic self-assessment Walk around inspections Interviews/Focus groups Organized binder Correcting noncompliance issues Review documentation Staff education
- 45. Why to be accredited?
- 46. Organization Pride & positive image Increased customer satisfaction Decreased risks Decreased waste Increased market share Increased revenue
- 47. Customer Increased confidence Active participation High quality Patient safety Patient rights Satisfaction
- 48. Staff empowerment Self respect Motivated Continuous education & training Staff satisfaction Staff retention
- 49. Accreditation process will be a necessity for healthcare organizations to survive in a rapidly changing market with high competition & increasing pressures to achieve best quality with the available limited resources Accreditation = survival
- 50. Thank you