PS58 2018: Quality Assurance and Quality Improvement


(I’ve modified this one a fair bit)





·         Premise

·         Definitions

·         Examples

·         Evaluation



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?


·         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

·         Mechanism for receiving and managing patient complaints

·         Patient experience survey

·         Staff experience survey


·         CPD

·         Research

·         Teaching


How do we evaluate the programmes?


(1)Expert opinion


(2)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


(3) Audit

·         Ensure relevant

·         Ensure cost-effective


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