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Quality in Health Care . Dr. Abdul Sattar Khan MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK) Assistant Professor Family Medicine Department drsattarkhan@gmail.com. Which car would you like to have?. ASK. At the end of this course participants will be bale to;
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Quality in Health Care Dr. Abdul Sattar Khan MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK) Assistant Professor Family Medicine Department drsattarkhan@gmail.com
At the end of this course participants will be bale to; • Describe the concept of quality • Should know that the quality of the output process • Describe the quality of health services • Count the benefits of quality Objectives ASK
Quality is doing the right things right , first time What is quality? ASK
In…. manufacturing, a measure of excellence or a state of being free from defects, deficiencies, and significant variations, brought about by the strict and consistent adherence to measurable and verifiable standards to achieve uniformity of output that satisfies specific customer or user requirements What is quality? ASK
To ensure : • The best possible outcome for patients. • Satisfaction for all our many customers. • Retentions of talented staff. • Sound financial performance. Why? ASK
Quality in Health Care The proper performance ( according to standards) of interventions that are known to be safe, affordable to the society, and have the ability to produce an impact on morbidity , mortality, disability and malnutrition . WHO , 1988 ASK
Quality in Health Care Author/Organization ---Definition Donabedian (1980) ---Quality of care is the kind of care which is expected to maximize an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts. IOM (1990)--- Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. ASK
Author/Organization Definition Department of Health Care (UK) (1997) • doing the right things (what) • to the right people (to whom) • at the right time (when) • and doing things right first time. Council of Europe: Quality of care is the degree to which the treatment dispensed (1998) increases the patient’s chances of achieving the desired results and diminishes the chances of undesirable results, having regard to the current state of knowledge. WHO (2000) Quality of care is the level of attainment of health systems’ intrinsic goals for health improvement and responsiveness to legitimate expectations of the population. IOM: Institute of Medicine; WHO: World Health Organization. ASK
Principle 1 : Customer focused • Principle 2 : Leadership • Principle 3 : Involvement of people • Principle 4 : Process approach • Principle 5 : System approach • Principle 6 : Continuous improvement • Principle 7 : Factual approach • Principle 8 : Mutually beneficial supplier relationship Quality Principles ASK
Quality Iron Triangle of Health Care Cost Access ASK
Structure, process, outcome • Quality Domains: effectiveness, responsiveness …. • Quality of services versus quality of systems • Health care helps individuals and populations to realize their potential health • Quality relates to compliance of practices with evidence • Quality relates to health outcomes attributed to services Dimensions of excellence to assess clinical performance ASK
Tool to monitor and evaluate all processes • Must be measurable, well defined, specific, objective and clearly related to an important aspect of care • Indicators can measure quality, adequacy, accuracy, timeliness, effectiveness, customer satisfaction etc. Quality Indicators ASK
HEALTH SYSTEM QUALITY INFORMATION SUPERVISION/INFORMATION QUALITY OF A HEALTH CARE INSTITUTION/CENTRE SUPERVISION/INFORMATION INFORMATION QUALITY OF INDIVIDUAL HEALTH CARE Cycle for quality ASK
GROUPS OF ACTIVITIES FOR QUALITY IMPROVEMENT QUALITY IMPROVEMENT CYCLES MONITORING QUALITY PLANNING OR DESIGN ASK
Benefits of maintenance of quality • Patient safety • Reduction of medication errors • Reductions in re-admission rates • Reduction the occurrence of complications • Provision of Evidence Based Care • Maintain healthy community • Productive society & country ASK
Revision • What is quality? • How can we maintain quality in health care? • What are principles of quality? • Define Iron triangle of health care quality? ASK
Where are we going? Thanks