An Introduction to Quality Assurance in Health Care

✍ Scribed by Avedis Donabedian

• Publisher: Oxford University Press, USA
• Year: 2002
• Tongue: English
• Leaves: 233
• Edition: 1
• Category: Library

✦ Synopsis

Avedis Donabedian's name is synonymous with quality of medical care. He unraveled the mystery behind the concept by defining it in clear operational terms and provided detailed blueprints for both its measurement(known as quality assessment) and its improvement(known as quality assurance). Many before him claimed that quality couldn't be defined in concrete objective terms. He demonstrated that quality is an attribte of a system which he called structure, a set of organized activities whihc he called process, and an outcome which results from both. In this book Donabedian tells the full story of quality assessment and assurance in simple, clear terms. He defines the meaning of quality, explicates its components, and provides clear and systematic guides to its assessment and enhancement. His style is lucid, succinct, systematic and yet personal, almost conversational.

✦ Table of Contents

CONTENTS......Page 18
LIST OF APPENDICES......Page 22
The Meaning of Quality Assurance......Page 24
The Targets of Quality Assurance......Page 25
The Components of Quality Assurance......Page 26
The Quality Monitoring Cycle......Page 28
Formal and Informal Monitoring......Page 29
Some Foundations of Quality Assurance Through Monitoring......Page 30
The Meaning of Quality in Health Care......Page 32
1. THE COMPONENTS OF QUALITY IN HEALTH CARE......Page 36
Efficacy......Page 37
Effectiveness......Page 38
Efficiency......Page 42
Optimality......Page 44
Acceptability......Page 51
Choosing a Definition of Quality......Page 57
Steps in Monitoring and Improving Clinical Performance......Page 59
2. DETERMINING WHAT TO MONITOR......Page 62
Internally Motivated Monitoring Activities......Page 63
3. DETERMINING PRIORITIES IN MONITORING......Page 72
Additional Institutional Interests......Page 73
Feasibility......Page 75
4. SELECTING APPROACHES TO ASSESSING PERFORMANCE......Page 78
Definitions of Structure, Process, and Outcome......Page 79
Comments on the Structure-Process-Outcome Model......Page 80
Relative Usefulness of the Three Approaches......Page 82
Conclusions About the Choice of an Approach......Page 89
5. FORMULATING CRITERIA AND STANDARDS......Page 92
Definitions of Terms......Page 93
Some Attributes of Criteria and Standards......Page 94
6. OBTAINING THE NECESSARY INFORMATION......Page 110
Medical Records......Page 111
Surveys......Page 117
Financial Records......Page 119
Direct Observation......Page 120
Test Situations......Page 122
7. CHOOSING WHEN AND HOW TO MONITOR......Page 124
When to Monitor......Page 125
How to Monitor......Page 126
8. CONSTRUCTING A MONITORING SYSTEM......Page 150
Key Elements......Page 151
9. BRINGING ABOUT BEHAVIOR CHANGE......Page 156
Readjustments in the System......Page 157
Educational and Motivational Activities......Page 159
10. THE EFFECTIVENESS OF QUALITY MONITORING......Page 166
Contextual Factors......Page 167
Operational Factors......Page 169
Some Concluding Remarks......Page 170
REFFERENCES......Page 172
APPENDICES......Page 178
C......Page 230
M......Page 231
R......Page 232
W......Page 233