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QA in Healthcare

Improvement Collaboratives

Dimensions of Quality

QA Model

Defining Quality

Measuring Quality

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Institutionalizing QA

QA Resources

   
 
 
   
 

 

Methods & Tools

QA Resources

QAP has developed a number of reference tools and resource materials on QA methods and approaches, emphasizing those that have proven useful in developing country settings. This section provides highlights of technical resources for doing QA, including Quality and Performance Learning Series products, monographs, and other QA Project products. More information about related CD-ROM products and print and electronic publications may be found in the Publications & Products section of this website.

Job Aids Symposium

Cosponsored by the Quality Assurance Project and the Child Survival Collaborations and Resource (CORE) Group, the purpose of the symposium was to exchange views and evidence about the state-of-the-art in job aids, to share particular job aids that have been successfully used in international health, and to identify future developments that will make job aids more useful in field applications for child survival and international health. View transcripts and presentations from the Symposium.

Quality Assurance Tools and Methods

View descriptions of the key analytical tools and methods that have proven useful in QA Project field activities:

Further information and interactive examples of how these tools can be applied are found in The Quality Assurance Theory and Tools Kit.

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The Quality Assurance Theory and Tools Kit

The Quality Assurance Theory and Tools Kit (QA Kit) is a computerized learning application that provides references and tools for quality assurance in healthcare. An interactive, easy-to-use CD-ROM, the QA Kit was designed to give healthcare providers and teams a blueprint to evaluate and improve healthcare delivery in low and middle-income countries.

The CD-ROM provides a step-by-step guide for process and program analysis, redesign, and evaluation to strengthen competencies and improve organizational performance. Its learning-by-doing approach teaches users how to define standards, analyze problems, and take steps to improve program performance and effectiveness.

Features of the QA Kit include:

  • Audio narration
  • Computer tutorial
  • Cause-and-effect diagram tool, budget tool, survey tool, flowchart tool, system modeling tool, time line and Gantt chart tool, and several specialized tools
  • Large collection of publications and training materials
  • Instructional video in every section
  • Colorful graphic icons
  • Built-in e-mail interface and direct links to key websites on quality
  • Glossary of quality assurance terms

To order the QA Kit, link to the Quality Performance Learning Series in Products.

Taxonomy of Health System Standards

Many types of standards exist in healthcare. Determining what type of standard is needed can be confusing. The QA Project has developed a taxonomy (or classification) of health system standards to assist in the understanding and development of standards in healthcare. The taxonomy proposes a systematic way of organizing standards and provides consistent terminology.

As shown in the table below, the taxonomy is divided into system components: input, process, and outcome standards. Inputs refer to the resources needed to provide care or services (staff, equipment, and supplies), processes refer to a series of activities or tasks (e.g., admission processes or patient care management) that lead toward a particular result, and outcomes are the results of the processes. The taxonomy is further divided into two main categories: administrative standards and technical standards. Some types of standards can be found in either category.

 

System Components

Categories

 

Administrative

Technical

INPUT

Administrative policies

Rules and regulations

Qualifications

Job descriptions

Specifications

PROCESS

Standard operating procedures

Algorithms

Clinical pathways

Clinical practice guidelines

Procedures

Protocols

Standing orders

OUTCOME

Expected results

Health outcomes

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As suggested by the different categories in the taxonomy, standards take a wide variety of written forms. Each type of standard serves a different purpose, but all aim to improve services and healthcare. Facilities typically use a variety of these formats based on the user and the application. Thus, it is not a matter of selecting a single format for developing standards.

The group designated to develop standards will want to consider who will be using the standards, in what setting, and for what purpose in order to decide which are the appropriate formats for presenting standards. For instance, clinical practice guidelines have been developed primarily by physicians to guide their practice, whereas, protocols and procedures have been designed for more general use by healthcare professionals. A clinical pathway is a multidisciplinary approach to writing and implementing standards. Clinical pathways were originally designed for use in hospitals but are now being applied to other settings.

The formats used for technical process standards are possibly the most difficult to differentiate. The table below identifies the most common formats for technical standards and their respective uses.

Technical Process Standards: Description and Use

Standard Format

Description

Use

Clinical practice guidelines

Recommendations for medical care based on current research

Physician’s reference in management of specific situations or conditions

Clinical pathways

Expected, multidisciplinary daily plan of treatment primarily used in hospitals

Nurses, physicians, and others use daily plan to progress the care of the patient

Algorithms

Flowcharts or decision grid

Quick, visual, and helps make decisions

Procedures

How-to, step-by-step instructions

Directions on how to perform a technical skill, e.g., insert a urinary catheter

Protocols

Management of patient care

Patient care management for specific situations, care of the patient with a urinary catheter or specific conditions, e.g., post operative patients

Standing orders

A pre-established set of medical orders

Permits nurses and/or other professionals to initiate medical orders in the absence of a physician, e.g., care for a patient with a cardiac arrhythmia in a critical care unit


QA Glossary

Link to a brief glossary of terms related to quality assurance in healthcare  that the QA Project has found to be helpful in explaining QA concepts and approaches.

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The Quality Assurance Project (QAP) is funded by the U.S. Agency for International Development (USAID) under Contract Number GPH-C-00-02-00004-00.