QUALITY ASSURANCE

OBJECTIVES
Define the term quality
Identify the quality,volume and cost of
healthcare
Discuss the perspectives of quality in
healthcare
Discuss the philosophy for a quality
service;Maxwell,Donabedian.

The Quality,Volume and Cost of

Healthcare
What will be the quality of the care
purchased/provided?
What volume is to be purchased/provided?
What is the cost of purchasing/providing
this volume?

PERSPECTIVES OF QUALITY
IN HEALTHCARE

Users of services
Providers of healthcare
Purchasers of healthcare
The public

USERS OF SERVICES
Central to the delivery of high quality care
Influenced by prior expectations of care
Issues;outcome of treatment and
care,attitudes of staff,time available to
them,nature of the environment
Self help groups,voluntary organisations

PROVIDERS OF SERVICES
Influenced by professional outlook.
concerned with;staffing levels,safe
practices,confidentiality,efficacy of
treatment,nutrition of food
provided,availability of support services
Accountability
UKCC Code of Professional Conduct

PURCHASERS OF SERVICES
As users concerns will also be concerned
with cost,and to what standard these
services will be provided.
Access to services
Level of quality in provision
Government policy

OBJECTIVES
Define Total quality management and
benchmarking.
Discuss the development of standards
Discuss the steps in auditing of quality
control
Discuss methods of measurement ie
Nursing care,educational provision.

QUALITY ASSURANCE
Quality is a type of
controlling,refers to
activities that
evaluate,monitor, or
regulate services
rendered to consumers
Marquis and Huston
1998

PROCESS
If nursing is to strive toward excellence,
then criteria in development should be
pushed to optimium standards rather than be
set at minimum acceptable levels. Marquis
and Huston1998

PHILOSOPHY
Two of the philosophies that underpin many
of the issues related to quality.
Maxwells dimensions of quality
Donabedian approach

MAXWELL

Six dimensions of quality:

Appropriateness
Equity
Accessibility
Effectiveness
Acceptability
Efficiency

DONABEDIAN
STRUCTURE
PROCESS
OUTCOME

TOTAL QUALITY
MANAGEMENT
A philosophy developed by Deming and
considered the hallmark of japanese
management.
Based on the premise that the individual is
the focus of production and service,the
environment must be customer responsive.
Everyone is subject to continous
improvement efforts.Kirk 1992.

BENCHMARKING
Best practice research occurs when an
organisation identifies a weakness and then
goes about identifying other organisations
who excel in that area.
The deficient organisation following
development then tries to implement best
practice.

STANDARD
An agreed level of
performance
negotiated within
available resources.
Each standard reflects
an element of the
quality of care
provided

STEPS IN AUDITING OF
QUALITY CONTROL
Identify the information relevant to the
criteria
Determine ways to collect the information
Collect and analyse the information
Compare collected informaton with the
established criteria
Make a judgement about the quality

 Provide information and if necessary

corrective action regarding findings to
appropriate sources
Determine when there is a need for re
evaluation.

METHODS OF
MEASUREMENT
Educational provision;subject
review,professional bodies quality
standards,audit of clinical areas.
Nursing
careprovision;Monitor,Qualpacs,Slater
Nursing Competencies,Phaneufs Nursing
Audit,Clinical Audit.

SUBJECT REVIEW
Quality Assurance
Agency for Higher
Education.

AIMS
To secure value from
public investment ;by
ensuring that all
education is of
approved quality.
To encourage
improvements in
quality of education.

SUBJECT REVIEW
SELF ASSESSMENT; an evaluation by the
subject provider of the quality of the student
learning experience and student
achievement measured against aims and
objectives.

ASPECTS OF PROVISION

Curriculum design ,content and organisation

Teaching ,learning and assessment
Student progression and achievement
Student support and guidance
Learning resources
Quality management and enhancement

GATHERING EVIDENCE
T he review is focused on the extent to
which the students learning experience and
student achievement demonstrate that the
aims and objectives are being met.
Sampling of student work;each level and
year of study,core modules,option
modules,range of marks,assessment
methods,marking and feedback
sheets,criteria.

MEETING WITH STUDENTS

Curriculum content and organisation;
reason for choosing
course/institution;expectationns re
flexibility,choice and content.;
appropriateness of curricular content to the
development of knowledge and skills;
relevance to prospective career/further
study student timetable,workload

 TEACHING AND LEARNING AND

ASSESSMENT;
range of teaching and learning methods,
student views on quality of teaching,
guidance and support for independent study
students understanding of asssessment
methods and criteria;
feedback on assessed work.

 STUDENT PROGRESSION AND

ACHIEVEMENT;
Advice on progression;
attainment of intended learning outcomes;
awareness of qualities and skills acquired.
preceptions of added value;
career aspirations.

 STUDENT SUPPORT AND GUIDANCE;

Admission and induction procedures;
quality of written guidance;
arrangements for academic and personal
support including personal tutorial support;
support during periods of practice,study
abroad,work experience.
availability and use of welfare
support,counselling and finicial advice

 LEARNING RESOURCES;
library services;
course materials, including learning packs;
information techology;
specialist equipment;
teaching accommodation;
space for study;
common rooms,social areas.

 QUALITY MANAGEMENT AND

ENHANCEMENT;
ways in which student views are sought;
representation on courses/department
committees;
degree to which students views are
influential and examples;
students contribution to self assessment.

NURSING PROVISION

Audit tools
Monitor
Qualpacs
Quality Assurance ward audit
Slater Nursing Competencies rating scale
Phaneufs Nursing Audit
Other contemporary methods

 I keep six honest

serving men...they
taught me everything i
know;their names are;
what and why and
when and how and
who and where.
Rudyard Kipling