Module 3. Session 2 Measuring quality in health care

Quality assurance ?

Measuring quality – Avedis Donabedian

Component of health care Definition INPUTS All inputs into an activity People, money, building beds PROCESSES Activities that constitute the interventions Strategies, plans, procedures, referral patterns, bed occupancy, waiting times OUTPUTS Product of the activity Number operations conducted OUTCOMES Change in health status Death, disability, adverse events

Component of health care Definition INPUTS Number personnel available trained in C sections PROCESSES Clinical guidelines Number operating theatres Waiting times for C sections OUTPUTS Number 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 includes Sub-domainFocus of standard and criteria Patient careProcedures in place to ensure delivery of evidence based care Clinical management for improved health outcomes Guidelines available to ensure implementation of priority programmes Monitoring of these priority programmes Clinical leadershipAppropriate health professionals Supervision of health professionals Quality Committee Quality Committee reviews used to improve care Clinical riskIdentify high risk patients – elderly, terminally ill Safety protocols Adverse eventsPolicy on adverse events Infection controlPolicy on infection control