Total Quality Management
Chemistry, Clinical
Quality Control
Quality Assurance, Health Care
Management Quality Circles
Quality circles in ambulatory care: state of development and future perspective in Germany. (1/573)
OBJECTIVE: To survey the quantitative development of quality circles (peer review groups; QC) and their moderators in ambulatory care in Germany, to describe approaches to documentation and evaluation, to establish what types of facilities and support is available and to assess opinions on the future importance of QC. DESIGN: Cross-sectional survey using a standardized questionnaire and supplementary telephone interviews. SETTING: All 23 German regional Associations of Statutory Health Insurance Physicians (ASHIP) were surveyed. RESULTS: The total number of QC in ambulatory care in Germany increased rapidly from 16 in 1993 to 1633 in June 1996, with about 17% (range 1.0-52.1%) of all practicing physicians (112 158) currently involved. Throughout Germany, 2403 moderators were trained in 168 training courses by the qualifying date. Follow-up meetings were held or being planned in 20 ASHIP, with approximately 39% (23-95%) of the moderators participating. Systematic documentation of QC work was undertaken or planned in all 23 ASHIIP, and 10 ASHIP carried out comparative evaluation, with at least five others planning to start it. The ASHIP promoted the work of QC by providing organizational (22) or financial (20) support, materials (20) or mediation of resource persons (16). Eleven ASHIP received grants from drug companies. ASHIP rated the future importance of QC as increasing (18) or stable (four), but in no case as decreasing. CONCLUSIONS AND RECOMMENDATIONS: The quantitative growth of QC in Germany is encouraging, but the extent of support and evaluation appears insufficient. Increased methodological support and facilitation, follow-up meetings on a more regular basis, improved documentation and evaluation of individual QC, and problem oriented evaluation of their impact on health care are essential for further successful development. Principles, problems and solutions discussed may be relevant for similar QI activities in other countries. (+info)An assessment of the operation of an external quality assessment (EQA) scheme in histopathology in the South Thames (West) region: 1995-1998. (2/573)
AIMS: To describe the design and organisation of a voluntary regional external quality assessment (EQA) scheme in histopathology, and to record the results obtained over a three year period. METHODS: A protocol is presented in which circulation of EQA slides alternated with teaching sessions. Procedures for the choice of suitable cases, evaluation of submitted diagnoses, and feedback of results to participants are described. The use of teaching sessions, complementary to the slide circulations, and dealing with current diagnostic problems is also outlined. RESULTS: Participation rates in the nine slide circulations varied between 66% and 89%, mean 85%. Overall scores were predictably high but 4% of returns, from 10 pathologists, were unsatisfactory. These low scores were typically isolated or intermittent and none of the participants fulfilled agreed criteria for chronic poor performers. CONCLUSIONS: This scheme has been well supported and overall performances have been satisfactory. The design was sufficiently discriminatory to reveal a few low scores which are analysed in detail. Prompt feedback of results to participants with identification of all "incomplete" and "wrong" diagnoses is essential. Involvement of local histopathologists in designing, running, and monitoring such schemes is important. (+info)Adapting total quality management for general practice: evaluation of a programme. (3/573)
OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. (+info)Practitioner based quality improvement: a review of the Royal College of Nursing's dynamic standard setting system. (4/573)
OBJECTIVE: To explore and describe the implementation of the Royal College of Nursing's approach to audit--the dynamic standard setting system--within the current context of health care, in particular to focus on how the system has developed since its inception in the 1980s as a method for uniprofessional and multiprofessional audit. DESIGN: Qualitative design with semistructure interviews and field visits. SETTING: 28 sites throughout the United Kingdom that use the dynamic standard setting system. SUBJECTS: Quality and audit coordinators with a responsibility for implementing the system; clinical staff who practice the system. MAIN MEASURES: Experiences of the dynamic standard setting system, including reasons for selection, methods of implementation, and observed outcomes. RESULTS: Issues relating to four themes emerged from the data: practical experiences of the system as a method for improving patient care; issues of facilitation and training; strategic issues of implementation; and the use of the system as a method for multiprofessional audit. The development of clinical practice was described as a major benefit of the system and evidence of improved patient care was apparent. However, difficulties were experienced in motivating staff and finding time for audit, which in part related to the current format of the system and the level of training and support available for clinical staff. Diverse experiences were reported in the extent to which the system had been integrated at a strategic level of quality improvement and its successful application to multiprofessional clinical audit. CONCLUSIONS: The Royal College of Nursing's dynamic standard setting system can successfully be used as a method for clinical audit at both a uniprofessional and multiprofessional level. However, to capitalise on the strengths of the system, several issues need to be considered further. These include modifications to the system itself, as well as a more strategic focus on resources and support for audit, better integration of quality initiatives in health care, and a continuing focus on ways to achieve true multiprofessional collaboration and involvement of patients in clinical audit. (+info)Essential dataset for ambulatory ear, nose, and throat care in general practice: an aid for quality assessment. (5/573)
OBJECTIVE: To describe the documentation of care for the usual range of ear, nose, and throat (ENT) problems seen in primary care as a basis for developing a computerised information system to aid quality assessment. DESIGN: Descriptive study of the pattern of ENT problems and diagnoses and treatment as recorded in individual case notes. SETTING: The primary health care centre in Mjolby, Sweden. PATIENTS: Consultations for ENT problems from a 10% sample randomly selected from all consultations (n = 22,600) in one year. From this sample 375 consultations for ENT problems (16% of all consultations) by 272 patients were identified. MAIN MEASURES: The detailed documentation of each consultation was retrieved from the individual records and compared with the data required for a computer based information system designed to help in quality management. RESULTS: Although the overall picture gained from the data retrieved from the notes suggested that ENT care was probably adequate, the recorded details were limited. The written case notes were insufficient when compared with the details required for a computerised system based on an essential dataset designed to allow assessment of diagnostic accuracy and appropriateness of treatment of ENT problems in primary care. CONCLUSION: There is a gap between the amount and the type of information needed for accurate and useful quality assessment and that which is normally included in case notes. More detailed information is needed if general practitioners' notes are to be used for regular quality assessment of ENT problems but that would mean more time spent on keeping notes. This would be difficult to justify. IMPLICATIONS: The routine information systems used at this primary healthcare centre did not produce sufficient documentation for quality assessment of ENT care. This dilemma might be resolved by specially designed desktop computer software accessed through an essential dataset. (+info)Developments in total quality management in the United States: the Intermountain Health Care perspective. (6/573)
In summary our purpose has been to evaluate quality in the following terms. Best process of care--narrowing the variation of care decisions, working towards the best method. Best clinical outcome--decreased morbidity ond mortality. Best patient satisfaction--both for clinical outcome and the process of care. Best value--best value at the lowest cost. At Intermountain Health Care we believe that the best way to achieve the best quality improvement in a health care system is to involve all of the participants--patients, providers, and systems--in employing the principles of total quality management. Patient involvement--in prevention; participating in best care process through education and utilisation; in evaluating functional status before, during, and after intervention; in satisfaction; in clinical outcome and follow up with providers. Provider involvement--in planning, implementing, analysing, and educating; in defining guidelines; in reassessing and defining guidelines; in reassessing and continually modifying the care map, always striving for "best care." System involvement--in providing structure and mechanisms, support staff, and information systems and being willing to focus on quality as a part of its mission. An American philosopher, George Santayana, once said: "What we call the contagious force of an idea is really the force of the people who have embraced it." It will be up to all of us collectively to become the force behind moving quality management principles into the forefront of patient care methodology and ensuring that quality remains as the guiding principle of health care delivery in the future. (+info)Continuous quality improvement decreases length of stay and adverse events: a case study in an interventional cardiology program. (7/573)
A study was performed to assess the effectiveness of continuous quality improvement in achieving a better quality of care for patients undergoing coronary interventions. Increasing utilization of new coronary interventional devices has incurred a higher incidence of complications, prolonged hospital stay, and related costs. Using a clinical information system, we adopted continuous quality improvement to control the incidence of complications and postprocedural length of stay. Multiple regression analysis and a matched case-control study were performed to detect complications related to postprocedural length of stay and their causes among 342 patients. The results led to the modification of the postprocedural heparin anticoagulation protocol, which was followed by the introduction of a ticlopidine-based poststent anticoagulation regimen. Two sequential groups of patients (n = 261, n = 266) were selected to compare postprocedural length of stay and frequency of complications with those for the first group. Adjustments were made for patients and procedural characteristics through stratification and multiple regression methods. Blood transfusion was the most important predictor of prolonged hospital stay (partial R2 = 0.26, P < 0.01). A high level of postprocedural anticoagulation and intracoronary stent use were significantly associated with blood transfusion (P = 0.01, P = 0.02, respectively). The comparison among the three groups showed that heparin protocol change reduced only postprocedural length of stay (P < 0.001) for patients without stents, whereas the stent change in anticoagulation protocol significantly reduced both transfusion and hospital stay for patients with stents (P < 0.001, P < 0.05, respectively). Continuous quality improvement based on clinical information is promising to control both complications and hospital costs. Physician involvement is necessary throughout the process. (+info)Putting continuous quality improvement into accreditation: improving approaches to quality assessment. (8/573)
The accreditation systems of the United States, Canada, and Australia have been restructured to reflect the adoption by health services of the industrial model of continuous quality improvement. The industrial model of quality makes assumptions about management structures and the relation of process to outcome which are not readily transferable to the assessment of quality in health care. The accreditation systems have therefore had to adapt the principles of continuous quality improvement to reflect the complex nature of health service organisations and the often untested assumptions about the relation between process and outcome. (+info)Total Quality Management (TQM) is not a medical term per se, but rather a management approach that has been adopted in various industries, including healthcare. Here's a general definition:
Total Quality Management (TQM) is a customer-focused management framework that involves all employees in an organization in continuous improvement efforts to meet or exceed customer expectations. It is based on the principles of quality control, continuous process improvement, and customer satisfaction. TQM aims to create a culture where all members of the organization are responsible for quality, with the goal of providing defect-free products or services to customers consistently.
In healthcare, TQM can be used to improve patient care, reduce medical errors, increase efficiency, and enhance patient satisfaction. It involves the use of data-driven decision-making, process improvement techniques such as Lean and Six Sigma, and a focus on evidence-based practices. The ultimate goal of TQM in healthcare is to provide high-quality, safe, and cost-effective care to patients.
Clinical chemistry is a branch of medical laboratory science that deals with the chemical analysis of biological specimens such as blood, urine, and tissue samples to provide information about the health status of a patient. It involves the use of various analytical techniques and instruments to measure different chemicals, enzymes, hormones, and other substances in the body. The results of these tests help healthcare professionals diagnose and monitor diseases, evaluate therapy effectiveness, and make informed decisions about patient care. Clinical chemists work closely with physicians, nurses, and other healthcare providers to ensure accurate and timely test results, which are crucial for proper medical diagnosis and treatment.
"Quality control" is a term that is used in many industries, including healthcare and medicine, to describe the systematic process of ensuring that products or services meet certain standards and regulations. In the context of healthcare, quality control often refers to the measures taken to ensure that the care provided to patients is safe, effective, and consistent. This can include processes such as:
1. Implementing standardized protocols and guidelines for care
2. Training and educating staff to follow these protocols
3. Regularly monitoring and evaluating the outcomes of care
4. Making improvements to processes and systems based on data and feedback
5. Ensuring that equipment and supplies are maintained and functioning properly
6. Implementing systems for reporting and addressing safety concerns or errors.
The goal of quality control in healthcare is to provide high-quality, patient-centered care that meets the needs and expectations of patients, while also protecting their safety and well-being.
A laboratory (often abbreviated as lab) is a facility that provides controlled conditions in which scientific or technological research, experiments, and measurements may be performed. In the medical field, laboratories are specialized spaces for conducting diagnostic tests and analyzing samples of bodily fluids, tissues, or other substances to gain insights into patients' health status.
There are various types of medical laboratories, including:
1. Clinical Laboratories: These labs perform tests on patient specimens to assist in the diagnosis, treatment, and prevention of diseases. They analyze blood, urine, stool, CSF (cerebrospinal fluid), and other samples for chemical components, cell counts, microorganisms, and genetic material.
2. Pathology Laboratories: These labs focus on the study of disease processes, causes, and effects. Histopathology involves examining tissue samples under a microscope to identify abnormalities or signs of diseases, while cytopathology deals with individual cells.
3. Microbiology Laboratories: In these labs, microorganisms like bacteria, viruses, fungi, and parasites are cultured, identified, and studied to help diagnose infections and determine appropriate treatments.
4. Molecular Biology Laboratories: These labs deal with the study of biological molecules, such as DNA, RNA, and proteins, to understand their structure, function, and interactions. They often use techniques like PCR (polymerase chain reaction) and gene sequencing for diagnostic purposes.
5. Immunology Laboratories: These labs specialize in the study of the immune system and its responses to various stimuli, including infectious agents and allergens. They perform tests to diagnose immunological disorders, monitor immune function, and assess vaccine effectiveness.
6. Toxicology Laboratories: These labs analyze biological samples for the presence and concentration of chemicals, drugs, or toxins that may be harmful to human health. They help identify potential causes of poisoning, drug interactions, and substance abuse.
7. Blood Banks: Although not traditionally considered laboratories, blood banks are specialized facilities that collect, test, store, and distribute blood and its components for transfusion purposes.
Medical laboratories play a crucial role in diagnosing diseases, monitoring disease progression, guiding treatment decisions, and assessing patient outcomes. They must adhere to strict quality control measures and regulatory guidelines to ensure accurate and reliable results.
Quality Assurance in the context of healthcare refers to a systematic approach and set of activities designed to ensure that health care services and products consistently meet predetermined standards of quality and safety. It includes all the policies, procedures, and processes that are put in place to monitor, assess, and improve the quality of healthcare delivery.
The goal of quality assurance is to minimize variability in clinical practice, reduce medical errors, and ensure that patients receive evidence-based care that is safe, effective, timely, patient-centered, and equitable. Quality assurance activities may include:
1. Establishing standards of care based on best practices and clinical guidelines.
2. Developing and implementing policies and procedures to ensure compliance with these standards.
3. Providing education and training to healthcare professionals to improve their knowledge and skills.
4. Conducting audits, reviews, and evaluations of healthcare services and processes to identify areas for improvement.
5. Implementing corrective actions to address identified issues and prevent their recurrence.
6. Monitoring and measuring outcomes to evaluate the effectiveness of quality improvement initiatives.
Quality assurance is an ongoing process that requires continuous evaluation and improvement to ensure that healthcare delivery remains safe, effective, and patient-centered.
I'm sorry for any confusion, but "Management Quality Circles" is not a recognized medical term or concept in healthcare management. It appears to be a term that combines the general business concept of "Quality Circles" with "Management," which may refer to a specific approach used in management and continuous improvement.
In the context of business and management, Quality Circles are small groups of employees who meet regularly to identify, analyze, and solve work-related problems and issues, with an aim to improve quality and productivity. The concept is often associated with Total Quality Management (TQM) and Continuous Quality Improvement (CQI).
However, if you're looking for a term related to healthcare management or medical definitions, please provide more context so I can give you a more accurate answer.
Hospital administration is a field of study and profession that deals with the management and leadership of hospitals and other healthcare facilities. It involves overseeing various aspects such as finance, human resources, operations, strategic planning, policy development, patient care services, and quality improvement. The main goal of hospital administration is to ensure that the organization runs smoothly, efficiently, and effectively while meeting its mission, vision, and values. Hospital administrators work closely with medical staff, board members, patients, and other stakeholders to make informed decisions that promote high-quality care, patient safety, and organizational growth. They may hold various titles such as CEO, COO, CFO, Director of Nursing, or Department Manager, depending on the size and structure of the healthcare facility.
Accreditation is a process in which a healthcare organization, facility, or program is evaluated and certified as meeting certain standards and criteria established by a recognized accrediting body. The purpose of accreditation is to ensure that the organization, facility, or program provides safe, high-quality care and services to its patients or clients.
Accreditation typically involves a thorough review of an organization's policies, procedures, practices, and outcomes, as well as an on-site survey by a team of experts from the accrediting body. The evaluation focuses on various aspects of the organization's operations, such as leadership and management, patient safety, infection control, clinical services, quality improvement, and staff competence.
Accreditation is voluntary, but many healthcare organizations seek it as a way to demonstrate their commitment to excellence and continuous improvement. Accreditation can also be a requirement for licensure, reimbursement, or participation in certain programs or initiatives.
Examples of accrediting bodies in the healthcare field include The Joint Commission, the Accreditation Council for Graduate Medical Education (ACGME), the Commission on Accreditation of Rehabilitation Facilities (CARF), and the National Committee for Quality Assurance (NCQA).