Module 3. Session 2 Introduction to quality in health care

How is quality assured? “It is the duty of each health care body to put and keep in place arrangements for the purpose of monitoring and improving the quality of health care provided by and for that body.”

What is quality assurance? Process of measuring quality, analysing the deficiencies discovered and taking action to improve performance, followed by measuring quality again to determine whether improvement has taken place. A systematic process for closing the gap between actual performance and desirable outcomes.

Defining quality in health care

Quality can be defined in various ways Quality is getting the best results possible within the available resources (Policy on Quality in Health Care for South Africa, National Department of Health, April 2007 Quality is the level of attainment of health systems’ intrinsic goals for health improvement and responsiveness to legitimate expectations of the population (World Health Organization)

In other words Quality is the extent to which health services provided to individuals and patient populations improve desired health outcomes. The care should be based on the strongest clinical evidence and provided in a technically and culturally competent manner with good communication and shared decision making.

Why does quality matter ?

Better for patient Good health outcome Client satisfaction Value for money Less frustrating

In the US, only 55% of chronically ill patients receive the proper diagnosis and treatment.

Better for health care providers

Better for the institution Patients more satisfied with services More patients will use the service The environment will improve Facility will have a good reputation

And - poor quality of care costs money Costs of wrong diagnosis and wrong treatment - repeated visits to clinic, prolonged illness, death Wasted time to patient and health worker Patients do not comply to treatment Unnecessary laboratory tests and reagents Low staff morale – absenteeism etc. Studies show that additional hospitalization, litigation costs, infections acquired in hospitals, lost income, disability and medical expenses have cost some countries between US$ 6 billion and US$ 29 billion a year.

Dimensions of quality - Maxwell

What do health care managers want ? Provide for needs of the health care providers and patients. Equity, access and effectiveness Efficient use of funds Appropriate use of resources Accountable to politically set goals and targets

What do health care providers want He / she has the skills, resources and conditions necessary to improve the health status of the patient Technical competence, effectiveness and safety Degree to which health care meets the current technical state of the art Freedom to act in the full interest of the patient Accountable to professional standards Safe and clean workplace