Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 17 Quality Management
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Quality Management What is quality? Indicators of quality in health care
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 JCAHO Indicators of Quality of Care Appropriateness Availability Continuity Effectiveness Efficacy
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 JCAHO Indicators of Quality of Care Efficiency Respect Caring Safety Timeliness
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Quality Assurance Accountability of provider to deliver quality care
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Quality Improvement Process of attaining a higher level of performance
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Measuring Quality Identify key indicators Identify key processes Enhance key processes Determine outcome achievement
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Total Quality Management (TQM) Continuous Quality Improvement (CQI) Based on work of W. Edwards Deming Continual improvement Efficient systems
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Historical Development of Quality in Health Care Nightingale’s pioneering efforts Quality assurance emphasis Standards of care National Association for Healthcare Quality JCAHO quality control
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 International Organizations for Quality Health Care International Society for Quality in Health Care European Society for Quality Healthcare
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Why is quality important to community health nursing?
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Quality (According to Juran, 1988) Quality planning Quality control Quality improvement
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Quality (According to W. Edwards Deming, 1986) Key points Continual improvement Examine processes and systems Create a trusting environment Empower staff to make decisions
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Total Quality Management/Continuous Quality Improvement Management philosophy Process driven Teamwork Leadership
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Total Quality Management/Continuous Quality Improvement (cont.) Empowerment Individual responsibility Prevent outcomes Data-based collaborative approach Systematic, cyclical
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 How to Develop a Quality Assurance/Quality Improvement Program Performance knowledge Performance measurement Performance improvement
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Evaluative Models Donabedian’s model Structure Process Outcome
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Purpose of Outcomes research in nursing Determine “best practice” Determine cost-effective interventions Demonstrate nursing’s contribution to health care delivery
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Applying QA/CQI in Community and Public Health Settings Structure Process Outcomes
Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 17 Applying QA/CQI in Community and Public Health Settings (cont.) Evaluation Identify strengths and weaknesses Compare care standards and health care practice Communication Communicate findings Action Develop action plan