With the increasing threats of health hazards, the health services are expected to maintain the quality in providing healthcare. In recent times, it is well proven that any person can fall prey to any health issue regardless of belonging to any section of society.
Before diving into details about the quality assurance process in healthcare, it should be clear that ‘ what does Quality of service means? ‘.
Quality is the measure in which a product or service is regarded as free from defects, deficiencies and considered good enough to meet consumer satisfaction.
There are various dimensions on which the quality of service is analysed:
- Technical Performance
- Access to Services
- Effectiveness of Standards
- Interpersonal relations
- The efficiency of Service Delivery
- Continuity of Services
- Practical infrastructure and comfort
- Choice of Services
What is Quality Assurance?
Quality Assurance is the process of setting and making efforts to meet the standards to ensure that the product succeeds in providing quality service to the consumer.
Likewise, Quality Assurance definition in healthcare is the process of following the standards and practices to deliver quality services to the patient at a healthcare organization.
Quality Assurance consists of three components:
- Defining Quality
- Improving Quality
- Measuring Quality
International Organisation for Standardization (ISO) provides the quality certification to a product which follows all its guidelines.
According to ISO 900 standard, clause 3.2.11, Quality Assurance is the part of quality maintenance that provides the confidence to a consumer that the product meets quality standards and is safe to use.
According to ISO 900 standard, clause 3.2.10, Quality Control is the part of quality management that is done to check a product or service fulfil all quality guidelines.
Why Quality Assurance is Important in Healthcare?
1. As mentioned earlier, with increasing health threats consumer are expecting to get better and quality health services.
2. It is beneficial for patients if the quality of healthcare is improved.
3. Continuous check-up of the quality of medical services tempts the staff to remain up to date and be cautious to prevent mistakes.
4. It also exposes the weaknesses of the hospital administration and provides the solution to fix them as soon as possible.
5. It also amends the regulations for delivering better healthcare services.
6. It also helps in determining the practices to be unfollowed.
7. To eliminate the medical errors.
Important Aspects of the Quality Assurance process in healthcare
1. QA is a continuous process that works in the cycle to keep on updating the technological support and medical skills for improving healthcare services.
2. It tries to develop professional behaviour in medical staff and patient’s satisfaction at an efficient price.
3. It should be noted that just including very expensive technology does not ensure the quality of service.
4. Decision should be taken based on data generated through surveys and research.
5. Since the patient will receive the services, so the definition of quality should be defined by his consent.
Quality Assurance: Methods
There are two methods followed while assuring the quality of service:
1. Retrospective Quality Assurance
This method involves the analysis of the data received by documenting the reports of the patients already discharged and check whether the quality is improving or degrading and corresponding changes are made in the practices to prevent the mistakes.
2. Concurrent Quality Assurance
This method involves the analysis of the data generated by documenting the reports of the patients whose treatment is under progress. It is done by interviewing patients and observing reports of them. It improves the quality of services provided to the patients under observation.
Components of Quality Assurance
1. Organization Level
At this level, the strategies to deliver quality services are prepared. A quality manual is prepared to contain a quality policy, objective and management.
2. Functional Level
At this level, it is decided that what general practices will be carried out to improve the quality of healthcare services like training and facilities.
3. Operational Level
This level deals with ‘ how the quality will be assured in day to day practice? ‘. For this, the Standard Operating Procedures are prepared.
Quality Assurance Cycle in Healthcare
1. Plan the Quality Assurance Strategy
2. Set the standards which will be used to check the quality of services and will be tried to accomplish.
3. Communicate these standards with the organisation and patient to check if they need some modifications.
4. Then monitor the current service quality.
5. Compare the current status with the targetted one. The team will be able to identify the areas that need improvement.
6. Prioritise the improvements to decide ‘on which weakness they should work first?’.
7. Define the problem in a detailed way.
8. Then a team should be built to work on that problem and will be responsible for fixing it.
9. The team will analyze and study the problem carefully and will come with some observations like ‘what is the reason of the problem? who is affected by the problem? and who is responsible for the problem?’.
10. Then a solution would have to be figured out to solve the problem and design a system to implement the same.
11. The last step is the execution of the solution of the problem.
As mentioned earlier QA is a continuous process, so the cycle starts again another problem is identified and tried to resolve.
Quality Assurance in Healthcare in India
In India, National Quality Assurance Standards have been developed by considering public health requirements and global best practices.
These standards are currently followed in District hospitals, CHCs, PHCs and Urban PHCs.
NQAS: Areas of Concern
- Service Provision
- Patient Rights
- Support Services
- Clinical Care
- Infection Control
- Quality Management
ISQUA has accredited these standards.
Problems: Quality Assurance of Healthcare
1. Many hospital administrations do not possess enough resources to have confidence in their services.
2. Even the maintenance is also ignored many times.
3. Medical service providers fail in providing quality healthcare to a large number of patients.
4. Weakness in the services is rarely reported.
5. The population is also unaware that healthcare services are uncompromisable.
6. Absence of strong laws that guard quality assurance.
7. It’s very rare when any patient is asked ‘if he/she is satisfied with the services or not?’.
The Medical Service Providers and the patients need to understand that quality assurance in healthcare is not a privilege even it’s a necessity in the current world of multiple health threats.