PS58 2018: Quality Assurance and Quality Improvement

 

N.B. I have made many modifications to this document for the sake of simplicity and coherence

 

List:

·        Premise

·        Definitions

·        Examples

·        Evaluation

 

Premise:

Triple aim

1.      ↑Quality of care

2.      ↑Health of people

3.      ↓Cost

 

What does ‘quality’ mean?

·        Effective (getting it right)

·        Efficient (getting it right the first time)

·        Evidence-based

·        Safe

·        Timely

·        Patient-centred

 

What are QA and QI?

Definitions:

·        QA: programme for maintaining good practice

·        QI: programme for improving practice

 

QA process:

·        Identify risks

·        Plan for data collection

·        Collect data

·        Review data

·        Set standards

 

QI process:

·        Identify problem

·        Plan changes

·        Implement changes

·        Review changes

·        Revise standards

 

What do QA and QI programmes look like?

Navel gazing:

·        M&M meetings

·        Adverse reactions committees

·        Sentinel and serious adverse event reporting and root cause analysis

·        Critical incident review

Feedback:

·        Mechanism for receiving and managing patient complaints

·        Patient experience survey

·        Staff experience survey

Other:

·        CPD

·        Research

·        Teaching

 

How do we evaluate the programmes?

 

(1) Measure progress

·        Structure (easy to measure)

o   Number and qualification of staff

o   Equipment

o   Service space

o   Facilities for teaching education, research

o   Risk register

o   Process for managing complaints

·        Process (easy to measure)

o   Risk analysis

o   Equipment maintenance

o   Appointment criteria for new staff

o   Allocation of work and supervision

o   Participation in CBD

o   Participation in QA and QI

o   Audits

o   Administration e.g. budgets

·        Outcome (hard to measure and influences vary wildly)

o   Hours actually worked

o   Exam results

o   Mortality rates

o   PACU clinical indicators

o   Publications and conference presentations

o   Financial position

o   Staff recruitment and retention

 

(2) Audit

·        Ensure relevant

·        Ensure cost-effective

 

(3) Expert opinion

 

 

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