PRESENTED BY : TIARA

What is quality

A high level of value of exellence (mariam-

webster dictionary).

Quality is an optimal balance between

possibilities realized and framwork of norms
and values
 What is quality care
Fitness to use by the custumer (Joseph Duran).

It is the complete satisfaction of the needs of

thosewho are in most need of health services
for the lowert organizational cost, within the
given limit guidlines of higher administrative
bodies and those paying ( Overetveit in
Riptonja, 1998)
 Where quality of health care stars
Quality health care, whether delivery is seen
at the patients and or from the provider
organizations perspective, stars with two
principal actions :
1. decision making selection of the most
appropriate health intervebtion
2. Performance action- effective, efficient and
timely aplication of the selected intervention
 Why is quality of care important?
1. tougher competition
2. Frequent medical errors
3. Rising cost, limited health expenditure
4. Rising demands, limited health resources
5. Concern with variations in health care
outcomes and costs
 Basic concepts of quality
effective, delivering health care that is adherent to an evidence base and
results in improved health outcomes for individuals and communities,
based on need;
effi cient, delivering health care in a manner which maximizes resource use
and avoids waste;
accessible, delivering health care that is timely, geographically reasonable,
and provided in a setting where skills and resources are appropriate to
medical need; acceptable/patient-centred, delivering health care which
takes into account the preferences and aspirations of individual service
users and the cultures of their communities;
equitable, delivering health care which does not vary in quality because of
personal characteristics such as gender, race, ethnicity, geographical
location, or socioeconomic status;
safe, delivering health care which minimizes risks and harm to service
users.
Dimenstions of quality health care
Most clusters of quality indicators were and
often continue to be comprised of the 5Ds-
Death, desease,disability,discomfort and
disatisfaction- ratger than more positive
component of quality
Thus safety is the foundation upon which all
other aspects of qulaity care are built
 Quality control
Involve inspection of finished products aimed at
the detection of deviations from their
predetermined design
These deviations were considered errors or or
defect, defect products were eitehr re-worked or
discarded
However, it soon became apparent that quality
control was and expensive and wasteful process.
This is very apparent in health care
 Quality Assurance
This perspective looks at the prescription of a
set of preventive activities to ensure the
quality of the finished product
These activities evaluate whether the process
of planning, execution, delivery and
maintenance of goods and services are being
performed and according to stated design
 Quality improvement
It is the combined and unceasingf efforts of
everyone-healthcare proffesionals, patients
and their families, researchers, payers,
plannerss and educators-to make the changes
that will lead to better patient outcomes
(health), better system performance(care) and
better professional development (Bataden &
Davidoff, 2007)
 Quality Improvement Cycle
A quality improvement cycle is a planned
sequence of systematic and documented
activities aimed at improving a process
 Quality management
The name implies managerial oversight of
quality of health care (Donabedian, 2003)
When the pursuit of quality includes the
perspectives of internal (staff and funders)
and external customers(patients, payors and
contractors) the process is called total quality
managemen(TQM)
 Total quality management
TQM being client-driven, participatory, and
process and team-oriented it calls for fllatter, less
hierachical organizations where managers direcly
lead teams built around principlal worh processes
(Milakovich, 1995)

In a hospital setting, this would mean organizing

patient entry, care and discharge team with each
group composed of doctor, nurses and support
staff
MAGNET HOSPITAL The Gold Standard
for Nursing Care
Term magnet was developed in 1982 by
American Academy of Nursing to describe
hospitals that attract and retain nurses
because of the quality of the nurse work
environment
 Essentials of Magnetism
Working with clinically competent nurses
Good nurse/physician relationships
Nurse autonomy and accountability
Supportive nurse supervisor
Nurse control over nursing practice and the
practice environment
Support for education
Adequate nurse staffing
Concern for patient is paramount
 Magnet Hospitals
Concept developed in US but now
disseminating internationally:
www.nursecredentialing.org
Voluntary accreditation process
Organized around 14 standards of nursing
administration and clinical care
Staff nurses assume key roles in
implementingMstrategies to meet standards
Blueprint works in developed and developing
countries to improve nurse retention and satisfaction
and improve patient outcomes:
 Magnet Accredited Hospitals
Almost 200 in U.S.
About 250 applications pending in US
Most U.S. hospitals aspire to be magnet
hospitals
International: Magnet concept has been
successfully implemented internationally
Over 20 countries at some stage of magnet
Magnets approved in Australia and England
Journey to Nursing Excellence Awards in Russia
and Armenia