Quality Assurance and Quality Improvement in Health care

Quality Assurance is the routine maintenance of a desired level of quality be means of attention to every stage of the process of service delivery or production. QA is a systematic and planned approach too monitoring and evaluating the quality of services on a continuous basis. QA should be considered as an integral management component of any health service organization. It refers to the oversight process, including the adherence to standards and guidelines.

Quality improvement (QI) is “a systematic process of assessing performance of a health system and its services, identifying gaps and causes, and introducing measures to improve quality and monitoring the impact”. Quality improvement is about using what is already known (scientific evidence) and innovations to transform how healthcare is delivered in local settings for better health outcomes. It is the process of intentionally making care better (effectiveness, efficiency), with the ultimate goal of improving health outcomes for health care clients.

Quality improvement principles and tools provide an opportunity for continuously improving the quality of care by improving processes of care within local setting needs of all clients are met and standards are adhered.

The essence of quality improvement is:

• Systematic assessment of quality by using data to measure current performance, comparing with expected standards and identifying quality gaps and opportunity for improvement.
• Designing and testing small changes that will hopefully lead to improvement.
• Monitoring the effect of the change to determine if there is adequate improvement
• Using the feedback from the data and its analysis to improve processes to provide better quality services on a larger scale.

Key elements in quality improvement in health services organizations include

• Build organizational commitment to quality
• Focus on the client/service user
• Find ways to measure quality
• Involving health care workers in the processes of improving quality
• Identifying inefficiencies or failures and trace them to their source
• Work closely with referral agencies and other suppliers
• Design service processes with simplicity and client focus in mind
• Improve coordination and collaboration between different functions in the organization.

Quality principles

Principles are broad statements that provide a framework of general rules to shape organizational thinking.

Fundamental decisions affecting health service delivery should be tested against quality improvement principles and rejected when found to be in violation of those principles.

The principles of quality improvement apply equally to every area, function and person in the organization. They are formally documented, widely disseminated, frequently discussed and consistently deployed. The principles define the frame work of general rules for judging behavior and the basis for assessing health system. The relationships among these principles deserve some discussion because their synergy is crucial to program success.

The purpose of QI Principles

• QI principles offer the basis for identifying unnecessary, redundant or incorrect processes, then guide changes believed to yield improvements.
• To achieve a different level of performance, it is essential to change the system in ways that enable it to achieve a different results
• A system left unchanged will continue to achieve the same results.

Principles of QI

1. Focus on clients’ needs and expectations
2. Focus on communication and feedback
3. Focus on teamwork
4. Focus on measurements (data)
5. Focus on systems and processes

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LINKS

• https://www.ovcttac.gov/saneguide/maintaining-a-quality-program/quality-assurance-and-quality-improvement/
• https://pubmed.ncbi.nlm.nih.gov/2315206/
• https://www.nursingtimes.net/opinion/quality-assurance-and-quality-improvement-ensure-the-best-care-for-patients-16-12-2019/
• https://www.mloganzila.or.tz/quality
• https://pdf.usaid.gov/pdf_docs/Pnabq044.pdf
• https://publichealth.nc.gov/lhd/docs/PHNManualQualityImprovementQualityAssurance.pdf
• https://link.springer.com/article/10.1007/s11884-020-00623-y
• https://www.sciencedirect.com/science/article/pii/S0741521498701806