Fundamentals of Quality (QI & QC)

FUNDAMENTALS OF QUALITY (QI & QC)

Quality Improvement (QI)

·       Quality Improvement is a systematic, formal approach to the analysis of practice performance and efforts to improve performance.

·       It involves ongoing efforts to make incremental improvements in processes, systems, and outcomes.

Objectives of Quality Improvement

• Improve patient safety and care outcomes
• Reduce errors and inefficiencies
• Enhance staff satisfaction and productivity
• Ensure compliance with standards and regulations
• Promote continuous learning and innovation

Key Principles of QI

Principle	Description
Customer Focus	Patient-centered care is the primary goal.
Teamwork	QI requires the collaboration of all staff members.
Process Orientation	Focuses on improving processes rather than blaming individuals.
Data-Driven Decision Making	Uses data to identify problems and monitor improvements.
Continuous Improvement	Ongoing effort to improve systems and processes.

Models and Tools of Quality Improvement

a. PDSA Cycle (Plan-Do-Study-Act)

A cyclical model for testing and implementing changes:

• Plan – Identify a problem and plan a change
• Do – Implement the change on a small scale
• Study – Analyze the results
• Act – Adopt, adapt, or abandon the change based on results

b. Six Sigma

• A method that aims to reduce variation and defects using statistical tools.
• Uses the DMAIC process: Define, Measure, Analyze, Improve, Control

c. Lean Management

• Focuses on eliminating waste, improving workflow, and adding value.

d. Root Cause Analysis (RCA)

• Identifies the underlying causes of a problem to prevent recurrence.

e. Benchmarking

• Comparing internal performance with industry best practices.

Benefits of Quality Improvement

• Better patient outcomes
• Improved staff morale
• Cost-efficiency
• Increased compliance with regulatory bodies (e.g., NABH, JCI)
• Enhanced patient satisfaction

Quality Assurance (QA)

·       Quality Assurance is a planned and systematic activity implemented to ensure that quality requirements for a product or service are fulfilled.

·       In healthcare, QA ensures that medical and non-medical services meet accepted standards.

Objectives of QA

• Ensure consistency and reliability in healthcare services
• Maintain standardized practices
• Detect and correct deficiencies
• Promote patient safety and trust

Components of Quality Assurance

Component	Description
Standards	Benchmarks for quality (clinical protocols, SOPs)
Assessment	Periodic review and audit of services
Feedback Mechanism	Patient feedback, grievance redressal
Monitoring	Ongoing tracking of performance metrics
Corrective Actions	Implementing changes to meet quality standards

QA Activities in Healthcare

• Internal and external audits
• Credentialing and privileging of medical staff
• Patient satisfaction surveys
• Medical record reviews
• Accreditation (e.g., NABH, ISO, JCI)

Differences Between QA and QI

Aspect	Quality Assurance (QA)	Quality Improvement (QI)
Focus	Meeting predefined standards	Continuous performance enhancement
Approach	Reactive (detects errors)	Proactive (prevents errors)
Nature	Periodic and evaluative	Continuous and developmental
Outcome	Conformance with rules	Innovation and better outcomes

Tools Used in QA

• Checklists
• Audit forms
• Performance indicators
• Standard Operating Procedures (SOPs)
• Compliance reports

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