QUALITY IMPROVEMENT AND PATIENT SAFETY

WHAT IS QUALITY ?

Appropriate application of medical knowledge with due regard to the balance between the hazard inherent in every medical intervention and the benefits expected from it Appropriate application of medical knowledge with due regard to the balance between the hazard inherent in every medical intervention and the benefits expected from it It is, however more complex than this. It is, however more complex than this.

WHAT IS QUALITY ASSURANCE Quality assurance as making sure that the services provided by thehospital are the best possible given existing resources and current medical knowledge.

QUALITY FROM WHOSE POINT OF VIEW ?

Provider of Health care Services Provider of Health care Services Recipient of the Health care services Recipient of the Health care services Organizer of the Health care services Organizer of the Health care services

PROVIDERS CONCERNS To provide care as per established norms To provide care as per established norms Adequate resources Adequate resources Self satisfaction with the final outcome Self satisfaction with the final outcome Should contribute to enhancement of skills, competence and add to experience Should contribute to enhancement of skills, competence and add to experience

RECIPIENTS CONCERNS Accessibility Affordability Prompt attention Less waiting time Early diagnosis and cure Return to Productivity as early as possible Humane Treatment ie to be treated with empathy, respect and concern

ORGANISERS CONCERNS Responsible to the Society for the funds spent on health care Responsible to the Society for the funds spent on health care To ensure safety of public and prevent inappropriate or suboptimal care To ensure safety of public and prevent inappropriate or suboptimal care To meet the requirements of the recipient and provider of the health care services at Acceptable costs To meet the requirements of the recipient and provider of the health care services at Acceptable costs

QUALITY IMPROVEMENT APPROACHES Credentialing Licensure Accreditation Certification Chart recognition

QUALITY ASSURANCE CYCLE Identify values Identify standards criteria Secure measurement Make measurem ent Identify course of action Choose action Take action Reevalu ation

NEW TRENDS IN QUALITY ASSURANCE Quality council Concurrent monitoring High volume case assessment High risk assessment Standard of quality care Inter disciplinary quality assurance Automation of data sources Performance of the staff

WHAT IS ACCREDITATION

Accreditation is an external review of quality with four principal components:  It is based on written and published standards  Reviews are conducted by professional peers  The accreditation process is administered by an independent body  The aim of accreditation is to encourage organizational development.

Focus of standards Patient Safety Patient Safety Staff and employee safety Staff and employee safety Environment and community safety Environment and community safety Information Education and Communication Information Education and Communication

Accreditation Process  Applications  Screening of the Applications  Pre-assessment survey  Assessment Survey  Review of the recommendations of the assessing body by the Accreditation Committee  Recommendations to the board  Accreditation decision

DOCUMENT REVIEW Quality Manual Quality Manual Various Policies and Procedures Various Policies and Procedures Minutes of Meetings of various committees Minutes of Meetings of various committees Medical Records Medical Records Medical / Nursing Audit Medical / Nursing Audit Adverse Events Adverse Events HAI HAI Action Taken Reports Action Taken Reports Personal Records of Staff Personal Records of Staff

OBSERVATIONS Facility Safety Facility Safety Level of compliance with laid down policies and procedures Level of compliance with laid down policies and procedures BMW Management BMW Management Standard Precautions Standard Precautions Patient care Patient care Fire Safety Fire Safety Equipment Management Equipment Management

PROBLEMS AND CHALLENGES HCOs are very enthusiastic HCOs are very enthusiastic Ill prepared Ill prepared Initial preparation is shoddy Initial preparation is shoddy Resources required initially Resources required initially Benefits have a longer gestation period Benefits have a longer gestation period

PROBLEMS AND CHALLENGES Quality Consciousness at all levels will take time Quality Consciousness at all levels will take time Sustenance and consistency of efforts will be required Sustenance and consistency of efforts will be required Commitment on a consistent basis Commitment on a consistent basis High rates of attrition will require repeated and continual training High rates of attrition will require repeated and continual training Public Sector will take a longer time to get into the process Public Sector will take a longer time to get into the process Quality and consistency of assessors and assessments Quality and consistency of assessors and assessments

These May Look Difficult Initially, But the First steps are Never easy.

Also Nothing Is Impossible For,

Impossible Means I’ M Possible

Quality Norms and Accreditation?? Response of Medical Fraternity

Expected Response

THE CURRENT STATUS OF ACCREDITATION IN INDIA Initializing phase is over. Initializing phase is over. Phase of consolidation. Phase of consolidation. The initial steps have been difficult but the journey has begun. The initial steps have been difficult but the journey has begun. The journey has to continue………. The journey has to continue………. Especially since Especially since

ACCREDITATION IS A JOURNEY AND AND NOT A DESTINATION.

BON VOYAGE !!!!!