Module 3. Session 2Measuring quality in health care

Quality assurance?

Measuring quality – Avedis Donabedian

Component of health care

Definition

INPUTS All inputs into an activity

People, money, building bedsPROCESSES Activities that constitute the interventions

Strategies, plans, procedures, referral patterns, bed occupancy, waiting times

OUTPUTS Product of the activity

Number operations conductedOUTCOMES Change in health status

Death, disability, adverse events

Component of health care

Definition

INPUTS Number personnel available trained in C sections

PROCESSESClinical guidelines

Number operating theatresWaiting times for C sections

OUTPUTSNumber C sections performed

OUTCOMES Perinatal / maternal mortality

Standards

What are standards

Statement of the quality that is expected

Level of quality against which performance should be measured.

Minimum – to ensure safety Developmental – encourage and support move to better practice Achievable standards Local / international standards

Why standards?

Measures against which can assess performance

Demonstrate improvement

Reduce unacceptable variations on service

Help public know what to expect

Ensure compliance – if you measure them

Six fast track areas

Domain 2. Patient safety, clinical governance and clinical care

This domain ensures how to ensure quality nursing

and clinical care and ethical practice, reduce

unintended harm to health care users or patients. In

identified cases of greater clinical risk, prevent or

manage problems or adverse events, including

health care associated infections and support any

affected patients or staff

This includesSub-domain Focus of standard and criteria

Patient care Procedures in place to ensure delivery of evidence based care

Clinical management for improved health outcomes

Guidelines available to ensure implementation of priority programmesMonitoring of these priority programmes

Clinical leadership Appropriate health professionalsSupervision of health professionalsQuality CommitteeQuality Committee reviews used to improve care

Clinical risk Identify high risk patients – elderly, terminally illSafety protocols

Adverse events Policy on adverse eventsInfection control Policy on infection control