Quality assurance & monitoring in opd and outreach services

1. ALIPURDUAR LIONS EYE
HOSPITAL

2. QUALITY ASSURANCE & MONITORING IN OPD & OUTREACH
SERVICES
PRESENTED BY
ALIPURDUAR LIONS EYE HOSPITAL

3. WHAT IS QUALITY
QUALITY: A piece of work done with perfection. it is the
basic need to survive in today's world. 100% or more. It has
become the integral part of any organization. Quality is the
level of Patient Satisfaction.
Quality has become the KEY DRIVER with the increase in
awareness, and paying capacity.
It is the perception and expectation of the patients to which
extend the service provider can provide quality
establishments.
The process of building quality starts with the understanding
of patients expectations and translating this understanding
into improved treatment, facilities etc.

4. DIMENSIONS OF
QUALITY
QUALITY
PRODUCT
WHAT is delivered
SERVICE
HOW it is delivered
- Quality of surgery - Basically abstract
- It is quantifiable & tangible - Not quantifiable, intangible
- Diagnostics and treatment - treatment process
e.g. post operation complication, e.g. communication,
Visual acuity, ambience
Safe medicine and appropriate staff behavior
prescription etc.,

5. QUALITY
ASSURANCE
PLAN
MEASURE
ACT UPON
REVIEW MONITOR
Quality Assurance: Is a systematic process of checking to see whether a
product /service is meeting specified requirements
Quality assurance focuses on enhancing and improving the process that
is used to create the end result.
QA is a continuous process, it is not something that is to be done only
once or construed as additional burden. It is the continuous quality
improvement

6. IMPORTANCE OF
MONITORING o Helps an organization to understand oneself better.
o Monitoring increases the effectiveness as well as the
cost effectiveness can be measured and better plans
can be chalked out through proper decision making.
 Are we doing the right things?
 How well are we doing?
 Whether the work done actually has
the intended impact?
 Does it make any difference?

7. NEED TO MONITOR
Review our work
Keep a track of statistical data.
Measure achievements and progress
Detect challenges and hindrances so that
corrective action can be taken
Improve outcomes and enhance the impacts
Track the rise or dip in number of patients, has
the organization developed over the years.
Optimal utilization of resources and cost
efficiency
Improve staff performance
Stimulate learning and motivation
Better decision making through feedback

8. HOW TO ENSURE QA
Regular monitoring: Regular monitoring brings out short comings.
Monitoring of surgical complications, waiting time analysis etc. post
camps meetings to analyze what went wrong and what went right.
Regular Meeting: helps to assess and discuss performance and to
plan further strategies helps a programme evolve with the demand.
Set Targets: Standards must be set
Performance Appraisal : set standards and then the staff has to
be evaluated based on these targets or standards.
Training: Educating staff in quality improvement, not just in job
function as “Quality staff can provide quality service”
Benchmarking: compare with the best practices and thereby
improve

9. QA IN OPD
Monitor waiting time: Total time to complete the entire process can be
tracked randomly once a quarter.
Drop Out Rate: is the rate at which patients do not come back for follow
up or do not respond for surgery after they have been asked to come for
surgery, this can be checked through medical records. Follow up visits can
be assessed and analyzed.
Patients comfort: check the cleanliness and comfort of the patients
Track numerical data: The daily OPD patients, new, review must be
checked on a daily basis to track the rise or dip in number of patients.
Review of records: From the Medical record patients details can be
tracked.Well maintained medical records
Track patients: Data must be maintained to ascertain how many patients
have got refractive errors, cataract, glaucoma etc. Tracking the visual
outcome and improvement
Spectacles: Pre and post vision must be recorded.

10. MONITORING IN
OUTREACH In order to conduct successful outreach camps it is
essential to have a proper planning and monitoring
system without which there is
no accountability
cost increases 2-3 times
Drop outs
Misuse of medicines
Misplacement of equipments, banners etc.
If camps are not conducted in a proper way it may
hamper the hospital image as a huge number of
population is involved.
No co-ordination amongst the team members.
An outreach programme needs proper planning.

11. OUTREACH ACTIVITY
PRE CAMP ACTIVITY
• Identify locations
• Ascertain Sponsors
• Agree upon suitable
date &time
• Estimate camp size
• Plan site
• Select camp Venue
• Proper medium of
publicity
• Gather necessary
equipment,
medicines
• Plan travel &
catering
arrangements
• Schedule surgery
date, discharge etc.
CAMP DAY ACTIVITY
• Ensure task is
completed
• Relevant team meet
at base hospital
• Set up camp
• Patients registered
• Refraction &
examination
• Selected patients
given time to leave
for base hospital
• Patients start for the
hospital
• Actual number of
patients have come
or not
• Inpatients are
checked into the
hospital
POST CAMP ACTIVITY
• Inform doctors &
paramedical staff
about patients
admitted
• Follow up surgery &
discharge schedule
• Counsel patients
about how take
medicines, what is
to be done etc.
• Plan and arrange
return journey
• Take camp records
and data to base
hospital
administration team
for record keeping
• Prepare data for
weekly meetings.
• Meeting with
sponsors &
coordinators

12. TOOLS TO MONITOR
Prior to the execution of a tool it is necessary to
DETERMINE the objective, and then accordingly
select the tools to have a monitoring system in place.
Quality cannot be measured without a clear definition
or standard
Monitoring tool has to be simple so that it is easily
understood by everybody. Methods are:
 Regular Meetings
 Diaries/Logbooks
 Progress reports
 Questionnaires
 Feedback forms
 Observation
 Discussion with staff
 Review system
 Communication with clients and community

13. QUESTIONNAIRE
Name: Age: Address:
Sex: Room No:
Please encircle the appropriate numbers.
Excellent =1, Good =2, Fair =3, Poor =4
1.How is our medical care?
1 2 3 4
2. How was the responsiveness to your
complains?
1 2 3 4
3. How do you feel about quality of nursing
staff?
1 2 3 4

14. Parameter People
involved
Indicator Set
Standard
Actual Variance
Registratio
n
Counter
Incharge
Number of
patients
1000 800 200
Refraction
unit
optometrists
. Room
Attendant
Number of
patients
800 500 300
Premises Cleaners,
supervisor
Cleanliness Yes Partial Not
upto the
mark
Camps Sponsors,
camp
coordinator
No of
patients
200 150 50