)‫أوجه الجودة (تقييم االداء‬Aspects of Quality (MAP)

Compliance with/ adherence to standards.

According to the judgment of peer review bodies.

‫زميل له نفس التخصص والخبرة‬

‫احساس العميل بالخدمة المقدمة‬ As perceived by the recipient of care.

• The ideal organizationwide healthcare quality
strategy is effective in tracking measurable quality
while understanding the value and necessity of
appreciative quality and actively fostering perceptive
quality.
• But the ideal healthcare quality strategy is also well-
supported by the governing body, by physicians and
other independent clinical practitioners, by the chief
executive officer, by senior and middle management,
and by all employees.
A customer is anyone who receives our service Or
dependent on me as a supplier.
• Identifying customers:

- "Wheel and spoke" or "sundial“.

- Customer lists by type: Internal and external.

• Identifying customer needs:

- Surveys and interviews.

- Research.

- Brainstorming.
within the organization / outside the organization
• Admitting/reception/front office • Patients/families
staff • Physicians
• Administrative staff
• Administrative services staff • Purchasers
• Ancillary staff/technicians • Insurance companies and
• Care coordination/social health plans
services staff • Employers
• Communications staff
• Government agencies
• Human resource staff
• Facilities staff • Regulators and
• Finance staff accrediting agencies
• Medical/clinical record staff • Vendors/suppliers )goods
• Nurses, aides, medical and services)
assistants
• Performance improvement, QM
• Other providers
• Pharmacists • Educational institutions
•Physicians, med. directors
 Product Service
Tangible Intangible ‫غير ملموسة‬

Measure Output “objects” Measure Outcome

"performances"
Homogenous Heterogeneous ‫غير متجانسة‬

Can be stored or resold Perishable ‫ ضائع‬/ ‫فاني‬

cannot be stored or resold
Can be patented ‫براءة اإلختراع‬ Very difficult to patent
 ‫ خدمة مناسبة لحالة المريض‬Appropriateness
• The degree to which the care and services
provided are:
1. Relevant to an individual's clinical needs.

2. Correct: Doing the right things in accordance

with the purpose (Medical necessity).
3. Suitable resource utilization as judged by
peers.
 Timeliness ‫تقديم الخدمة بوقت مناسب بدون تأخير‬
• The degree to which care is provided to the
individual at the most beneficial or necessary time.
 Availability ‫الخدمة متاحة‬
• The degree to which appropriate care and services
are accessible and obtainable to meet an individual's
needs.
 Competency ‫كفاءة‬

• The degree to which the practitioner adheres to

professional and/or organizational standards of care
and practice.
 Continuity ‫استمرارية الخدمة‬

• The coordination of needed healthcare services for

a patient among all practitioners and across all
involved organizations over time.
• The delivery of needed healthcare as a coherent
unbroken succession of services.
 Effectiveness

• The degree to which care is provided in the correct

manner, given the current state of knowledge, to
achieve the desired or projected outcome(s) for the
individual"
 Efficacy

• The potential capacity, or capability of the care to

produce the desired effect or outcome, as already
shown, e.g., through scientific research (evidence-
based) findings.
• The power of a procedure or treatment to improve
health status.
 Efficiency

• The relationship between the outcomes (results of

care) and the resources used to deliver care.

• "The relationship of outputs (services produced) to

inputs (resources used to produce the services)"
 Prevention/Early Detection

• The degree to which interventions, including the

identification of risk factors, promote health and
prevent disease.
 Respect and Caring
• The degree to which those providing services do so
with sensitivity for the individual's needs,
expectations, and individual differences.

• The degree to which the individual or a designee is

involved in his or her own care and service decisions
 Safety

• The degree to which the healthcare intervention

minimizes risks of adverse outcome for both patient
and provider.
Comparison Between Traditional Monitoring and Evaluation
utilizing the three aspects of quality (Quality Assurance) and
Continuous Quality Improvement (CQI)

QA TQM / CQI
Objective Outcome. Process and outcome.

Entire group.
Statistical tail.
(Continuous
Problem-focused methods
Focus improvement process)
(Actions are initiated when
trying to improve the
a problem is identified).
process itself.

Focus Clinical and non clinical

Clinical aspects of care only.
on aspects.
Comparison Between Traditional Monitoring and Evaluation
utilizing the three aspects of quality (Quality Assurance) and
Continuous Quality Improvement (CQI)

QA TQM / CQI
Objective Outcome. Process and outcome.

Entire group.
Statistical tail.
(Continuous
Problem-focused methods
Focus improvement process)
(Actions are initiated when
trying to improve the
a problem is identified).
process itself.

Focus Clinical and non clinical

Clinical aspects of care only.
on aspects.
Comparison Between Traditional Monitoring and Evaluation
utilizing the three aspects of quality (Quality Assurance) and
Continuous Quality Improvement

QA TQM / CQI
Cross-departmental acc. to
Departmental.
patient flow.
Frequently separating the
Integrating all efforts to improve
dimensions of quality care—
both patient outcomes and
review of appropriateness
efficiency of care delivery
separate from effectiveness
(improving value).
and/or efficiency.

Errors are due to individual Errors are due to system failure

performance. (85%).
Comparison Between Traditional Monitoring and Evaluation
utilizing the three aspects of quality (Quality Assurance) and
Continuous Quality Improvement
QA TQM / CQI
Also, focuses to the previous
ones:
WHAT of care Patient care
HOW of care Patient care
given.
processes.
The right service to the right
Systems and their key
patient at the right time and
processes, Policies,
Focus place.
procedures, and regulatory
on WHO of care Patient care
compliance, Relationships
giver.
and communications; Clinical
Competent and qualified staff
pathways, practice guidelines,
who is doing the rights things
and protocols.
right.
RESULT of care Patient
care outcome.
It is the involvement of the entire organization in a
process of quality improvement to provide value.

All functions and all employees have to participate.

Focusing on meeting customer needs and
organizational objectives.

Continuous improvement in all work, from high level

strategic planning and decision-making, to detailed
execution of work elements on the shop floor.
The key principles are:
- Management Commitment.
- Employee Empowerment.
- Fact Based Decision Making.
- Continuous Improvement.
- Customer Focus.
- Organizational Culture.
- Continuous learning.
 key concepts of TQM
• Top management leadership.
• Creating corporate framework for quality.
• Transformation of corporate culture.
• Customer focus.
• Process focus.
• Collaborative approach to process improvement.
• Employee education and training.
• Learning by practice and teaching.
• Benchmarking.
• Quality measurement and statistics.
• Recognition and reward.
• Management integration.
 QUALITY MANAGEMENT PRINCIPLES
1. "Productive work is accomplished

through processes." Each person in the

organization is a part of one or more

processes.

2. "Sound customer-supplier

relationships are absolutely necessary for

sound quality management.“

3. "The main source of quality defects is

problems in the process."

 QUALITY MANAGEMENT PRINCIPLES
4. Poor quality is costly.

5. Understanding the variability of

processes is a key to improving quality.

6. Quality control should focus on the

most vital processes.

7. The modern approach to quality is

thoroughly grounded in scientific and

statistical thinking.
 QUALITY MANAGEMENT PRINCIPLES
8. Total employee involvement is critical.

9. New organizational structures can help

achieve quality improvement.

10. Quality management employs three

basic, closely interrelated activities:

• Quality planning, quality control [quality

measurement], and quality

improvement.
The Joint Commission Principles of Organization and
Management Effectiveness
1. The organizational
mission statement clearly
expresses a commitment.
2. The organizational
culture.
3. Opportunities for
organizational change.
4. The role of governing
board, managerial, and
clinical leaders.
The Joint Commission Principles of Organization and
Management Effectiveness
5. The governing board, managerial,
and clinical leadership
qualifications.

6. The qualifications, evaluation,

and development of independent
practitioners.

7. Human resources recruitment and

retention policies and practices.
The Joint Commission Principles of Organization and
Management Effectiveness
8. Sufficient support resources.

9. The monitoring, evaluation,

and continuous improvement
of patient care.

10. Organizational integration

and coordination.

11. Continuity and

comprehensiveness of care.
The ISO 9000:2005 Quality Management
Principles
A central principle of TQM is that mistakes may be
made by people, but most of them are caused, or at
least permitted, by faulty systems and processes.
- Mistakes can be avoided and defects can be
prevented.

- Improving capabilities to produce better results in

the future.