QUALITY IMPROVEMENT AND PATIENT SAFETY

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QUALITY IMPROVEMENT AND PATIENT SAFETY
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WHAT IS QUALITY ?
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• Appropriate application of medical knowledge with
  due regard to the balance between the hazard
  inherent in every medical intervention and the
  benefits expected from it
• It is, however more complex than this.

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WHAT IS QUALITY ASSURANCE

• Quality assurance as making sure that the
  services provided by thehospital are the best
  possible given existing resources and current
  medical knowledge.

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QUALITY FROM WHOSE POINT OF VIEW ?
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• Provider of Health care Services
• Recipient of the Health care services
• Organizer of the Health care services

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PROVIDERS CONCERNS

• To provide care as per established norms
• Adequate resources
• Self satisfaction with the final outcome
• Should contribute to enhancement of skills,
  competence and add to experience

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RECIPIENTS CONCERNS

• Accessibility
• Affordability
• Prompt attention
• Less waiting time
• Early diagnosis and cure
• Return to Productivity as early as possible
• Humane Treatment ie to be treated with empathy ,
  respect and concern

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ORGANISERS CONCERNS

• Responsible to the Society for the funds spent on
  health care
• To ensure safety of public and prevent
  inappropriate or suboptimal care
• To meet the requirements of the recipient and
  provider of the health care services at
  Acceptable costs

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QUALITY IMPROVEMENT APPROACHES

• Credentialing
• Licensure
• Accreditation
• Certification
• Chart recognition

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QUALITY ASSURANCE CYCLE
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NEW TRENDS IN QUALITY ASSURANCE

• Quality council
• Concurrent monitoring
• High volume case assessment
• High risk assessment
• Standard of quality care
• Inter disciplinary quality assurance
• Automation of data sources
• Performance of the staff

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WHAT IS ACCREDITATION
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Accreditation is an external review of quality
with four principal components

• It is based on written and published standards
• Reviews are conducted by professional peers
• The accreditation process is administered by an
  independent body
• The aim of accreditation is to encourage
  organizational development.

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Focus of standards

• Patient Safety
• Staff and employee safety
• Environment and community safety
• Information Education and Communication

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Accreditation Process

• Applications
• Screening of the Applications
• Pre-assessment survey
• Assessment Survey
• Review of the recommendations of the assessing
  body by the Accreditation Committee
• Recommendations to the board
• Accreditation decision

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DOCUMENT REVIEW

• Quality Manual
• Various Policies and Procedures
• Minutes of Meetings of various committees
• Medical Records
• Medical / Nursing Audit
• Adverse Events
• HAI
• Action Taken Reports
• Personal Records of Staff

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OBSERVATIONS

• Facility Safety
• Level of compliance with laid down policies and
  procedures
• BMW Management
• Standard Precautions
• Patient care
• Fire Safety
• Equipment Management

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PROBLEMS AND CHALLENGES

• HCOs are very enthusiastic
• Ill prepared
• Initial preparation is shoddy
• Resources required initially
• Benefits have a longer gestation period

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PROBLEMS AND CHALLENGES

• Quality Consciousness at all levels will take
  time
• Sustenance and consistency of efforts will be
  required
• Commitment on a consistent basis
• High rates of attrition will require repeated and
  continual training
• Public Sector will take a longer time to get into
  the process
• Quality and consistency of assessors and
  assessments

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These May Look Difficult Initially, But the First
steps are Never easy.
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Also Nothing Is ImpossibleFor,
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ImpossibleMeansI M Possible
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Quality Norms and Accreditation??
Response of Medical Fraternity
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Expected Response
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THE CURRENT STATUS OF ACCREDITATION IN INDIA

• Initializing phase is over.
• Phase of consolidation.
• The initial steps have been difficult but the
  journey has begun.
• The journey has to continue.
• Especially since ---------------------------

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• ACCREDITATION IS A JOURNEY
• AND
• NOT A DESTINATION.

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• BON VOYAGE !!!!!

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THANK YOU FOR YOUR PATIENCE