Summary

In study session VI you have learnt

• Quality is the degree to which a set of inherent characteristics of something comply with a set of expectations (ISO 9004)
• Quality is also defined as proper performance (according to standards) of interventions that are known to be safe, that are affordable to the society in question, and that have the ability to produce an impact on mortality, morbidity, disability, and malnutrition.(WHO 1983)
• Health care quality is also defined 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. (IOM, National Academy of Sciences)
• According to Donabedian, quality of healthcare has seven pillars/components. These are : efficacy, effectiveness, efficiency, optimality, acceptability, legitimacy, equity
• Efficacy: is the ability of the science and technology of healthcare to achieve desired outcomes under best circumstances.
• Effectiveness: is the degree to which attainable outcomes are attained in reality.
• Efficiency is the ability to achieve attainable outcomes of care at a lower cost.
• Optimality is the balancing of improvements in health against the cost and other negative consequences of such improvements. It also means optimizing benefits.
• Acceptability is the level of conformity to the wishes, desires and expectations of patients.
• Legitimacy is the conformity of healthcare to social preferences as expressed in ethical principles, values, norms, laws and regulations.
• Equity is conformity to a principle that determines what is just and fair in the distribution of healthcare and its benefits among members of the population.
• Quality management includes all the activities that organizations use to direct, control or coordinate quality.
• There are different models of quality management in healthcare including: licensing, certification, accreditation and continuous quality improvement
• Licensing is a process by which a governmental authority grants permission to an individual practitioner or health care organization to operate or engage in an occupation or profession.
• Certification is a process by which an authorized body, either a government or non-governmental organization, evaluates and recognizes either an individual or an organization as meeting pre-determined requirements.
• Accreditation is s a formal process by which a recognized body usually a non-governmental organization, assesses and recognizes that a health care organization meets applicable pre-determined and published standards.
• Continuous Quality Improvement is an ongoing, organization wide framework in which health service organizations and their employees are committed to and involved in monitoring and evaluating all aspects of the health serve organizations' activities and outputs in order to continuously improve them
• Continuous quality improvement includes two important components (Quality Measurement and Quality Improvement) and a supporting infrastructure for Quality Management
• Donabedian's framework for measurement of healthcare quality consist of three components measures. These are; structure, process and outcome.
• Structure is the setup in which care is being provided. Structure includes: people, resource and knowledge and technology
• Process is the set of interrelated activities that constitute what healthcare is
• Outcome is the change observed on beneficiaries of healthcare (individuals or population) that is attributable to healthcare. It may include intermediate or longer term outcomes.
• Steps to measure quality include: identify priority areas for improvement, select quality of care indicators related to priority areas of improvement, collect data, analyze data, expected results and opportunities for quality improvement identified
• Quality Improvement is the step during which series of actions will be taken to: plan and implement potential solutions to address underlying root causes of problems, study if changes bring improvement and expand those changes that are found effective and modify those found ineffective
• The quality improvement steps are explained by the Deming's Cycle; which consists of four steps: Plan, Do, Study and Act
• Quality management in the Ethiopian health sector consists of external quality control and internal quality improvement process