quality of health services, principles of quality, definition of quality, quality assurance

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QUALITY
Dr. Amany Rashad Abo-el-Seoud
Prof. of Community Medicine,
Zagazig University

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Topics of Discussion
 What is quality?
 Why we care with quality?
 Who must do quality?
 When?
 Where?
 How?

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what is Q
 To reach standards that meet customer needs
& satisfaction.
 Is to do the right thing right at the first time
 It is zero defect rate
 Q for clinicians is to examine their patients
carefully, ethically and give them the best
treatment according to EBM.
 Q for medical education staff is to teach up-to-
date knowledge, use new and best methods for
teaching and evaluation of their students.

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Why Q?
 For existence, development and competition
 Development is a must, to cope with rapid world
changes and to be able to compete.
 For saving resources and for more profits.
 Bad Q products will have no market for sale.
 Bad Q health service will lose its patients
 Bad Q medical school will lose its students

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Who must do Q
 Any one must follow quality philosophy for
himself , his job and for his community.
 Top managers, head of team, members of
team all must follow quality standards.

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When & where to do Q?
 Now start Q, keep it and always improve it.
 Any where , at factories, schools, services, at any
process, job, function, task
 Start by asking do I do the right thing? Do I do it
perfect? Try to change to reach the ideal.
 Q culture must be started from childhood, no
reluctance or negligence of parents towards their
children faults. Child must learn doing his tasks
perfectly, complete at the first time and all the time.

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How?
 Any task, job, service consists of certain
processes to be done to get an outcome.
 Each process has inputs and outputs e.g.
eating process: food intake digestion to
get energy. Education process: data
brain to get information. Treatment of
patients: diagnosis then prescribe drug to
regain physiological functions.

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How to achieve quality?
Inputs Process Outputs
Quality assurance Quality control
Total quality management

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What are the inputs?
 Plan of work : situational analysis, needs
 Resources (man, materials, money, time
Information). Standards, SMART objectives
 Flow chart of different steps and processes in
sequence, interaction between steps.

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Next Step is process/performance
Act , work, do, perform the planned action in
accordance to standards
 Maximal use of resources.
 Managerial support, good communication
 Training & continuous education of employee
 Incentives, motives.
 Clear job responsibility

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Check/evaluate your output
 Do you do reach your objective? Effectiveness,
satisfaction of customer, increased sales, profit,
competitive product, gain trust, promotion.
 Is benefit overcomes cost?
 Can we do it in better way or with less cost?
(quality improvement)
 Statistical analysis of data for accuracy of
evaluation.

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Quality improvement
Put new process,
Put new standard
Change an already existing
Process to reach standard
Create something
new
Modify or change in
Persisting condition

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Quality improvement
There is always something to improve! Nothing is
100% all the time.
Steps for QI:
1- define all processes/actions in the place
2- draw a flow chart for these processes
3- define inputs & outputs for each process
4- state standards for each process/step
5- evaluate what is done with what should be done

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QI steps
6- collect data for % of compliance to standards
7- use statistical analysis to know roots of causes
(methods: pareto, cause effect matrix)
8- put priority for improving defects
9- think in solutions (methods), choose one
10-plan for improvement, do, check results if
succeeded choose another problem or defect and
so on.

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Tools for quality improvement
 Brain storming for new ideas
 Seek expert advice
 Changing standards
 Benchmarking
 Management commitment
 SWOT (force-field) analysis
 Training, replacement, decrease time, removal
of unnecessary procedure, decrease waste,
decrease harm, add more qualification.

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Methods for Q. improvement
 BSSBIP= basic six sigma breakthrough
improvement process: design, measure,
assess and improve
 PDCA = plan, do, check and act
 FOCUS-PDCA= find, organize team, clarify
process, understand causes, select an
improvement, plan, check, do, act.

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” “ ‫يتقنه‬ ‫أن‬ ‫عمل‬ ‫أحدكم‬ ‫عمل‬ ‫اذا‬ ‫يحب‬ ‫ال‬ ‫ان‬
‫شريف‬ ‫حديث‬
‫استماعكم‬ ‫لحسن‬ ‫شكرا‬