Chapter 23: Quality Control

� : Fifth and Final step of Management Process

Quality Control

who develops the quality control?

� ANA develops standards

� The greatest challenge in consensus building is time, � Good leaders have consensus-building skills

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page 38 and 39

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Hallmarks of Effective Quality Control Programs [4]

� 1. Support from top-level administration
� 2. Commitment by the organization in terms of fiscal and human resources
� 3. Quality goals reflect search for excellence rather than minimums
� 4. Process is ongoing (continuous)

Audits Frequently Used in Quality Control

structure, process, outcome

structure

� monitor the structure or setting in which patient care occurs

process

� measure the process of care or how the care was carried out

Outcome

determine what results, if any, followed from specific nursing interventions for patients

Audits Frequently Used in Quality Control
� Structure�monitor the structure or setting in which patient care occurs-to ensure a safe and effective environment, i.e., ER wait times, availability of fire extinguishers, ratio of providers to patients
� Proce

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Quality Gap

difference in performance between top-performing health-care organizations and the national average

Benchmarking

The process of measuring products, practices, or services against best-performing organizations.

� Organizations can determine how and why their organization differs from these exemplars and then use the exemplars as role models for standard development and performance improvement

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Standards
� A predetermined level of excellence that serves as a guide for practice
� Used as measurement tools and must be objective, measurable, and achievable and guide individual practitioners in performing safe and effective care
� First standards ne

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Three Steps of the Quality Control Process

The criterion or standard is determined
Information is collected to determine whether the standard has been met
Educational or corrective action is taken if the criterion has not been met

IOM (1994)- defines health care quality as

the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge

Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options

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Total quality management (TQM) is the continual process of detecting and reducing or eliminating errors in manufacturing, streamlining supply chain management, improving the customer experience, and ensuring that employees are up to speed with training.

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QA models target

currently existing quality

QI models target

� QI models target ongoing and continually improving quality
� Identifying and doing the right things
� The right way
� The first time
� Problem-prevention planning

Quality assurance models seek to ensure that quality currently exists, whereas quality improvement models assume that the process is ongoing and that quality can always be improved

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Total Quality Management

Based on the premise that the individual is the focal element on which production and service depend
-Focus is on doing the right things, the right way, the first time, and problem-prevention planning, not inspective and reactive problem solving

Professional Standards Review Organizations-1972
- Mandated certification of need for patient's readmission and continued review of care; evaluation of medical care; and analysis of the patient profile, the hospital, and the practitioners

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