Title is self explanatory However: Evolution of Quality Assurance (QA) Quality definitions Objectives of QA, Principles, components difference bet QA n QC MODELS of QA SPO PDCA ANA

1. Q U A L I T Y
A S S U R A N C E
U N I T - 1 , 2
SRISHTI BHARDWAJ

2. EVOLUTION
From inspection to total quality
During the early days of manufacturing, an operative’s work was inspected and a
decision made whether to accept or reject it. As businesses became larger, so too
this role, and full time inspection jobs were created.
Accompanying the creation of inspection functions, other problems arose:
• More technical problems occurred, requiring specialised skills, often not
by production workers
• The inspectors lacked training
• Inspectors were ordered to accept defective goods, to increase output
• Skilled workers were promoted into other roles, leaving less skilled workers to
perform the operational jobs, such as manufacturing
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3. • These changes led to the birth of the separate inspection
department with a “chief inspector”, reporting to either the
person in charge of manufacturing or the works manager.
• Hence the quality control department evolved, in charge of
which was a “quality control manager”, with responsibility
for the inspection services and quality control engineering.
• In the 1920’s statistical theory began to be applied
effectively to quality control, and in 1924 Shewhart made
the first sketch of a modern control chart.
– His work was later developed by Deming and the early work of
Shewhart, Deming, Dodge and Romig constitutes much of what
today comprises the theory of statistical process control (SPC).
However, there was little use of these techniques in manufacturing
companies until the late 1940’s.
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4. • At that time, Japan’s industrial system was virtually destroyed, and it
had a reputation for cheap imitation products and an illiterate
workforce.
– The Japanese recognised these problems and set about solving them with
the help of some notable quality gurus – Juran, Deming and Feigenbaum.
• In the early 1950’s, quality management practices developed rapidly
in Japanese plants, and become a major theme in Japanese
management philosophy, such that, by 1960, quality control and
management had become a national preoccupation.
• By the late 1960’s/early 1970’s Japan’s imports into the USA and
Europe increased significantly, due to its cheaper, higher quality
products, compared to the Western counterparts.
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5. • In 1969 the first international conference on quality control,
sponsored by Japan, America and Europe, was held in Tokyo.
– In a paper given by Feigenbaum, the term “total quality” was used for the first
time, and referred to wider issues such as planning, organisation and
management responsibility.
– Ishikawa gave a paper explaining how “total quality control” in Japan was
different, it meaning “company wide quality control”, and describing how all
employees, from top management to the workers, must study and participate
in quality control.
• Company wide quality management was common in Japanese
companies by the late 1970’s.
• The quality revolution in the West was slow to follow, and did not
begin until the early 1980’s, when companies introduced their own
quality programs and initiatives to counter the Japanese success.
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6. • In a Department of Trade & Industry publication in 1982 it was stated that
Britain’s world trade share was declining and this was having a dramatic
effect on the standard of living in the country.
– There was intense global competition and any country’s economic
performance and reputation for quality was made up of the reputations
and performances of its individual companies and products/services.
• Since then the International Standardization Organization (ISO) 9000 has
become the internationally recognized standard for quality management
systems. It comprises a number of standards that specify the requirements
for the documentation, implementation and maintenance of a quality
system.
• As we move into the 21st century, TQM has developed in many countries
into holistic frameworks, aimed at helping organizations achieve excellent
performance, particularly in customer and business results.
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8. DEFINITIONS
QUALITY
• “Quality is defined as the degree to which health services for the
individuals and populations increase the likelihood of the desired
health outcomes and are consistent with current professional
knowledge”.
-Joint Commission on Accreditation of Healthcare
Organizations (2002)
• “Quality of a service is defined as the totality of features and
characteristics of a service that bear on its ability to satisfy the
stated and implied needs of the patients.”
-International Organization for Standardization (ISO 8402)
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9. DEFINITIONS
QUALITY ASSURANCE
• “Quality Assurance is an on-going, systematic comprehensive evaluation of
health care services and the impact of those services on health care services.
- Kozier.
• Quality assurance is defined as all activities undertaken to predate and prevent poor
quality.
-Neetvert(1992)
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10. KEY TERMS RELATED TO QUALITY
ASSURANCE
• Quality improvement
• Total Quality Management/
Continuous Quality Improvement
• Quality Control
• Quality circles
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11. OBJECTIVES OF QUALITY ASSURANCE
According to Jonas (2000), the two main objectives are;
• To ensure the delivery of quality client care
• To demonstrate the efforts of the health care providers to provide
the best possible results
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12. Other specific objectives are:
• Formulate plan of care
• Attend the patients physical and non-physical needs
• Evaluate achievement of nursing care
• Support delivery of nursing care with administrative and managerial
services
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13. PRINCIPLES OF QUALITY ASSURANCE
• Customer focus
• Leadership
• Involvement of people
• Process approach
• System approach to management
• Continual improvement
• Factual approach to decision making
• Mutually beneficial supplier relationship
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14. COMPONENTS OF QUALITY ASSURANCE
• STRUCTURE EVALUATION
• PROCESS EVALUATION
• OUTCOME EVALUATION
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15. QUALITY ASSURANCE PROCESS
1. Establishment of standards or criteria
2. Identify the information relevant to criteria
3. Determine ways to collect information
4. Collect and analyze the information
5. Compare collected information with established criteria
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16. CONT..
6. Make a judgment about quality
7. Provide information and if necessary, take corrective action regarding findings of
appropriate sources
8. Determine ways to collect the information
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18. DIFFERENCE BETWEEN QA & QC
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24. THANK YOU
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25. M O D E L S O F
Q U A L I T Y
A S S U R A N C E
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26. 1. SYSTEM MODEL
1. Input
2. Throughput
3. Output
4. Feedback
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27. DONABEDIAN MODEL
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28. ANA QUALITY ASSURANCE
MODEL
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29. PLAN, DO, STUDY, ACT CYCLE
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30. LEVELS OF EVALUATION OF
QUALITY OF CARE
• National Level
• Trust or organization level
• Local Level
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31. APPROACHES OF QUALITY
IMPROVEMENT
General Approaches
• Credentialing
• Licensure
• Accreditation
• Certification
• Charter
• Academic Degrees
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32. CONT…
Specific Approaches
• Peer Review Committees (Staff Review Committees)
• Standard as a device for quality assurance
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33. THANK YOU
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