بسم الله الرحمن الرحيمبسم الله الرحمن الرحيم

و قل رب زدنى و قل رب زدنى ﴿﴾علمًا�علمًا�

صدق الله العظيمصدق الله العظيم

Health Services Health Services AdministrationAdministration

Dr. Ahmed Al Far, M.D.Professor of Radiation Oncology

CHS 242CHS 242

Quality ManagementQuality Management

Quality Management Systems

Quality control (QC) Quality assurance (QA) Quality improvement (QI) Total Quality Management (TQM)

√ The focus is moving from static control to dynamic improvement

√ Each system included previous system

√ Quality must be both assured and improved

Quality control A procedure or set of procedures intended to

ensure that a manufactured product or manufactured product or performed serviceperformed service adheres to a defined set of quality criteria or meets the requirements of the client or customer.

Subset of QA process, it comprises of activities employed in detection and measurement of the variability in the characteristics of output output attributable to the production system, and includes corrective responses.

Quality Assurance A procedure or set of procedures intended

to ensure that a product or service under product or service under developmentdevelopment (before work is complete, as opposed to afterwards) meets specified requirements.

Any systematic process of checking to see whether a product or service being being developeddeveloped is meeting specified requirements.

CharacteristicQAQIPhilosophyPoor performance

must be detected and remedied

Improvement is always possible

GoalControl error rateMove to higher level

Types of flaws studied

SpecialCommon and special

Performance referent

A standardCapability/need

Source of knowledge

Peer in professionAll staff

Review methodSummativeFormative, analytic

Patient needsNot assessedIncluded

Worker involvedSpecialized staffAll staff

Use of statisticsLimitedPervasive

Leads to actionOnly if deficiency is detected

Always

Plan

Do

Check(Analyze)

Act(As Needed)

CQI Cycle

CQI Cycle PLAN

Plan for CQI and build team to do the following.

Set standards Monitor current quality level and

identify problem/s Analyze root causes of problem/s Generate solution/s

DO Implement chosen solution/s

CHECK Monitor success of solution

ACT Adjust solution/s to ensure success Standardize effective solution/s

Total quality management (TQM) TQM is a overall philosophy and

management system that seeks to integrate all organizational functions to focus on meeting customer needs and organizational objectives.

It is a total system approach which works horizontally across functions and departments, involves all employees from top to bottom, and everyone in the quality chain from suppliers to customers.

Elements of TQM

Customer Focus

Teamwork

Continuous Improvement

Data-Based Decision Making

Integrated Planning

Importance of Quality in Radiology Department?

Accurate diagnosis accurate treatment (medical errors death cost).

17 % of preventable medical errors are errors in diagnosis (Institute of Medicine, USA).

Diagnostic errors may be attributed to poorly performed medical imaging examinations, and the diagnostic quality of these examinations is operator-dependent (ASRT, 2000).

Radiology Department QA Program

Goal: accurate diagnosis of patients Objectives:

1. To maintain quality of diagnostic images;2. To minimize radiation exposure to patient

and staff; and3. To be cost effective.

QA committee QA manual: handout ? QA personnel training

Quality Indicators: Radiology department

General (no. of exams/year, no. of full time employee).  

Productivity (exams volume/modality). Reporting (report turn around time). Access to examinations (waiting times). Customer satisfaction (patient, referring

physician, employee). Finance (cost/exam).