Resources: Quality Improvement

Quality Basics
Quality Assurance vs. Quality Improvement

Quality Assurance (QA) is designed to evaluate whether or not certain established standards were met. It is a process designed to identify and evaluate the quality of patient care and other services to ensure that the established standards are being met. The ongoing audits are meant to identify deficiencies, and make sure that steps are taken to correct the deficiencies, i.e. process improvement. This is a key feature of QA.

Quality Improvement (QI) is based on the theory that quality can not always be assured and that ongoing efforts to identify opportunities for improvement is necessary. The QI approach is a process of improving the whole system, whereas QA is designed to identify and correct deficiencies. QI is proactive while QA is reactive.

Root Cause Analysis: When standards are not met, or an adverse event has occurred, it is necessary to conduct a root cause analysis. What does that mean exactly? It means taking a look back at the sequence of events that led to the discrepancy or error.
Identify the processes involved and keep asking the question why did this happen? (Ask 5 times).
Analyze each step in the process using a process map, or flow chart to show what happened and compare that to the established protocol or policy, then keep asking why protocol was not followed
Once problem solving has taken place, make the necessary change in the system using Plan-Do-Study-Act (PDSA) methodology.

Failure Mode, Effects and Criticality Analysis: is a risk management technique that looks at current systems to identify any area/process that could potentiality cause an adverse event. It is a pro-active risk management activity that works by:

• Identifying the patient care processes that make up the system
• Identifying the risk in each process
• Ask, what are we doing to reduce the risk? And taking action when gaps are identified. Involve all involved.

» The RHQN endorses the Model for Improvement
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