Dear Readers,
Today quality is the single defining factor which distinguishes one service provider from another. This issue of Sitenews explores the multi dimensional concept of quality assurance. From the introductory set of articles which provides overview of quality in healthcare and particularly in eyecare, it moves to set of articles which provide a deeper understanding of the multidimensional construct of quality. To ensure the standards are always high the concept of benchmarking evolved. Measuring and monitoring are other important concepts to make sure one is always improving. Patient centered care is another important consideration which will show impact of continuous focus on quality. Quality is all about being current hence information and technology are other important considerations. This also necessitates need for use for appropriate resources. It also is about changing the organization process including leadership issues. Counselling is seen as a strategy to improve patient centred care. Questionnaires are viewed as instruments to collect information to enhance quality.
Our partner this time is Toyota famous for their quality management strategies especially the lean management techniques.
Happy Reading!
Regards,
Vision 2020 e-resource team
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The quality of health care is of universal concern. Communities and governments around the world strive to improve health care standards in order to provide a happier and more productive future for their citizens.
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QUALITY OF CARE IN OPHTHALMOLOGY
Abstract:
This article details the development of quality of eye care services in ophthalmology.
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QUALITY EYE CARE: WHAT DOES IT MEAN?
Abstract:
This article clearly defines the meaning of quality in eye care. It provides, in detail, the efficacy of surgical performance to improve the quality of eye care.
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QUALITY OF CARE
Abstract:
This article emphasizes how the quality of the healthcare services has improved through the ages. This article also provides different learning and training methodologies to attain improved quality health care service.
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QUALITY IMPROVEMENT IN EYE CARE
Abstract:
This article focuses on quality, steps to set up a quality improvement system, its monitoring process and implementing changes in eye care.
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QUALITY CARE AND PRACTICE VARIATION: THE ROLES OF PRACTICE GUIDELINES AND PUBLIC PROFILES
Abstract:
Goals of the quality-of-care initiative are to improve the structure, process, and outcome of health care. The effectiveness of methods to improve quality has been largely unverified. Most methods are too costly to implement and time-consuming to perform; some threaten professional autonomy. The characteristic feature of modern medicine that fuels the debate over quality is the variation in the delivery of health care. This review examines the variation phenomenon in medicine and the roles that practice guidelines and physician profiling have in improving health care, in general, and for adult cataract, in particular.
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It is well-known that service quality is also multidimensional. It is harder to find one set of quality dimensions which apply equally well to many types of services. Classifying the dimensions of service quality is often more challenging than to classify the dimensions of product quality. Yet some of the dimensions for Health Care setup are Access to services, Effectiveness of care, Efficiency of service delivery, Interpersonal relations, Continuity of services, Safety, Physical infrastructure and comfort, personal interaction with staff, degree of two-way understanding between patient and caregiver, level of patient participation in decision making etc.
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COMMUNITY OPHTHALMOLOGY DIMENSIONS
Abstract:
This article introduces the concept of community ophthalmology and its application to the changing scenario in eye care services. It focuses on the shift from individualised care to community based eye care services and highlights the broad spectrum of conditions and circumstances that make community based services relevant today.
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QUALITY CATARACT SERIES - COMMUNITY OUTREACH
Abstract:
Community Outreach Initiatives details the purposes of community outreach, community outreach activities in various fields, challenges in community outreach and methods to overcome it for improving patient awareness and increasing the uptake of cataract services.
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QUALITY IMPROVEMENT AND PERFORMANCE IMPROVEMENT DIFFERENT MEANS TO THE SAME END?
Abstract:
This article describes the similarities and differences between the two methodologies-quality improvement and the performance improvement in eye care. This article also describes in detail the performance improvement process.
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Benchmarking is a process designed to asses the competition in comparison to the organizations own performance. It is a search for those best practices that will lead to superior performance of the company (Camp 1990). Xerox Corporation initiated competitive bench marking in 1979 and has defined it as a continuous process of measuring our products, services, and practices against our toughest competition or those companies who are the leaders (Camp 1990). The key to successful benchmarking is that it requires the organization to know its own products and processes and also forces it to compare itself against the best. This information defines the gap that the organization must close, and it encourages the organization to learn from the best. Benchmarking is a good way to set realistic objectives. Many times when internal people believe that something cannot be accomplished, a visit to a leading organization often sparks the motivation to accomplish higher objectives.
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APPLYING BENCHMARKING IN HEALTH
Abstract:
This article provides as a guide for learning the Benchmarking technique in Health Care. This article mainly focus on the benchmarking done after the Quality Assurance project handled by the Health Care Managers of Center for Human Resources.
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Quality of eye care has become an important concern in developing countries. However, when one observes the systems of eye care delivery, questions arise about the definition of quality eye care, Quality is often mistakenly linked with high-cost modalities. While expensive, sophisticated technological tools undoubtedly add to the quality of eye care, equally critical are many inexpensive measures to improve the outcome. Another critical component of quality eye care is the surgical technique itself, which can be achieved through proper training. Also utmost concentration has to be given for pre as well as postoperative care.
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QUALITY ASSURANCE IN HEALTH CARE
Abstract:
This article mainly focus on the Quality assurance in Health Care. This article also tells in detail how to access, improve and monitor the quality of Healthcare. This article also tells in detail how to meet the client needs by framing an effective team to process the systems and to provide high quality service in healthcare.
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QUALITY CATARACT SERIES - CLINICAL STRATEGIES
Abstract:
Clinical Strategies deals with benchmarks for monitoring quality volume and sustainability, evolution of cataract surgical techniques, clinical strategies, IOL microsurgery training course, and manual phaco extraction training course. Apart from this there are appendices on preoperative evaluation, preoperative preparation and anesthesia, intraoperative considerations, postoperative management and pediatric cataract.
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QUALITY ASSURANCE IN CATARACT SURGERY
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This book details the diagnosis of cataract, describes how the cataract surgery, is done, preoperative medication, anesthesia, surgery procedure, phacoemulsification technique, and postoperative care with the IOL In-patient Record. Apart from this there are appendices on preoperaparative evaluation, preoperative preparation and anesthesia, intraoperative considerations, postoperative management and pediatric cataract.
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QUALITY ASSURANCE IN REFRACTION
Abstract:
This book deals with the epidemiology, impact, diagnosis, role of school screening camps, and contact lenses.
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QUALITY ASSURANCE IN MANAGEMENT OF PRIMARY ANGLE CLOSURE GLAUCOMA
Abstract:
This book deals with the different types of glaucoma like acute angle, sub acute angle glaucoma, its epidemiology, history, diagnosis and the counselling and referral services.
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QUALITY ASSURANCE IN PRIMARY OPEN ANGLE GLAUCOMA
Abstract:
This book deals with the epidemiology, history, diagnosis, clinical evaluation, complications and counselling in primary open angle glaucoma.
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QUALITY ASSURANCE IN MANAGEMENT OF MICROBIAL KERATITIS
Abstract:
This book deals with the epidemiology and magnitude of the problem, its prevention and history, diagnostic tests performed, medical records and counselling and referral services.
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QUALITY CATARACT SERIES INTRODUCTION
Abstract:
Introduction consists of cataract The big picture, cataract and vision 2020-The Right to Sight, about the entire series, the Aravind model etc.
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HOW TO IMPROVE THE OUTCOME OF CATARACT SURGERY
Abstract:
This article discusses the reasons for poor outcome of cataract surgery and ways to overcome the same.
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QUALITY ASSURANCE IN VISION CENTER
Abstract:
This article focuses on ways to maintain quality in a Vision Center.
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TREATMENT AND VISION-RELATED QUALITY OF LIFE IN THE EARLY MANIFEST GLAUCOMA TRIAL
Abstract:
This article with the randomized clinical study conducted to evaluate the effect of treatment, visual function, and other factors of vision-targeted health related quality of life (HRQOL) of patients with early glaucoma. This article provides the detailed sketch of the survey population and the data analysis of the study.
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Constant monitoring and assessment of various functions helps maintain quality control. There should be a formal system of evaluation in place. For example, at Aravind Eye Hospital, quality checks on surgery are maintained by a detailed computerized record that includes details of a surgeons hourly surgical output and intraoperative complications.
Regular staff meetings to assess and discuss performance and to plan further strategies helps a programme evolve with the demand. For example, at Aravind, monthly infection control meetings are arranged by the Chief Medical Officer in coordination with the nursing supervisor. The meetings, attended by all doctors and paramedical staff, serve as checks to ensure that intraoperative and post operative complications and infections that arise are within internationally acceptable limits. Each infection is discussed in detail with the nursing supervisor.
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To grow and prosper, health care providers must satisfy their patients; offering superior customer service is a prerequisite. Satisfied patients are more likely to return to the practice for goods and services. They are more likely to refer their friends and relatives to the practice, and they are more likely to follow treatment recommendations. Patients who will probably return are considered loyal, and they are a valuable resource for any practice. Providing quality services to them is also efficient because tasks needn't be redone or modified to fulfill patient expectations.
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The importance of information to quality is vast therefore the need to manage it well, is growing rapidly. Now more than ever, we need to understand the critical role information plays in so many aspects of business and life. It drives our communication, our decision making, and our reactions to the entire environment. We have listed various articles which explain importance of information for quality purpose.
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INFORMATION SYSTEM FOR EFFECTIVE MANAGEMENT, MONITORING AND EVALUATION
Abstract:
This article lists the ways information systems helps in effective management, monitoring and evaluation of ophthalmic services.
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MANAGING INFORMATION SYSTEM KEY TOOLS FOR CEOS
Abstract:
This article tells in detail how the MIS plays a vital role in planning, designing and monitoring the statistical analysis of the organizational performance. It provides hands-on tools for the CEOs of the organization. This article also tells in detail about the key areas the CEOs have to follow in managing the organizational performance.
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Technology in health care does not have to be expensive to be effective. Commercial ophthalmic equipment and expendable supplies are often scarce or unavailable in developing countries. Monetary resources are limited and the demand for quality services is high. Appropriate technology or intermediate technology in ophthalmology, local manufacture of inexpensive but effective supplies, and application of simple yet practical ideas all extend basic eye care services where resources are frequently very limited.
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TECHNOLOGY FOR EYE CARE TRAINING IN THE CARE OF EQUIPMENT AND INSTRUMENTS
Abstract:
This article tells in detail how to maintain the Ophthalmic instruments to provide effective eye care service. This article also tells in detail how to train the technicians to effectively use and maintain the instrument s with proper care. This article also tells in detail about the Ophthalmic Technician course offered by Aravind Eye System, Madurai.
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HIGH VOLUME, HIGH QUALITY CATARACT SURGERY
Abstract:
This article explores the factors that contribute to high volume, high quality cataract surgery and details the processes, systems and procedures involved.
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Ensuring an adequate supply of resources is vital in a high quality surgery programme. A large volume of clinical work is made possible when diagnostic and surgical equipment and microsurgical instruments are available in the required quantity and at the required time. Buying high quality instruments, maintaining a high uptime of equipment through good spare parts planning, and providing continual maintenance help in achieving high quality.
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QUALITY CATARACT SERIES - ARCHITECTURAL DESIGN MODULE
Abstract:
Architectural Design consists of examples and models, design principles such as hygiene, technology, function, community design, beauty, economic issues, and development process. This module is useful for several different architectural projects such as building anew facility on a new site, adding another building to the current site , acquiring an existing building and renovating it, renting an existing bilding and negotiating with the landlord to make changes to and redesigning and renovating the current building.
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QUALITY CATARACT SERIES - FINANCIAL SUSTAINABILITY
Abstract:
Financial Sustainability consists of examples and models, cost recovery issues, and cost recovery principles such as pricing, accountability etc. and also a cost recovery exercise to record lessons learned in the achievement of cost recovery in eye care programmes, to describe the factors and principles to consider when implementing cost recfovery measures for financial sustainability, and to remind those responsible for economic development, costing decisions and financial decisions to ask the right questions to the right people at the right time in the planning process.
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The adoption of appropriate quality-improvement strategies will, if done right, result in increased patient and physician satisfaction. Here we describe Aravinds quality practices. We believe through collaboration and consensus, we can help ensure that quality eye care is delivered to patients. Do share with us your organizational practices to ensure quality is maintained.
Patient care at Aravind Eye Care System
- Patients must be discharged with full satisfaction.
- All staff must attend duty punctually
- All staff must be conscious of the importance of patients attending the hospital and the care given to them.
- The staff should not quarrel among themselves in front of the patients. Similarly senior staff should not scold junior staff in front of patients.
- There must be full co-operation and team spirit among the staff while doing their work.
- Staff must extend the same treatment and respect to both the paying patients and the free patients. There should not be any discrimination.
- All staff must work hard to improve the prestige, efficiency and dedication of the hospital.
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Even with the best infrastructure and perfect systems in place, positive staff attitudes are necessary for achieving excellent results. In a dynamic environment such as a hospital, it is impossible to predict every single activity and to specify every single procedure. Therefore, positive attitudes must be developed and nurtured in all staff to keep them striving for high quality standards and constantly improving upon them. The leader must develop and exhibit these attitudes in the day-to-day activities and must believe that high quality and large volume do go together.
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A CULTURE OF COMMITMENT
Abstract:
What's the secret to building a great organization? How do you sustain consistent growth, profits, and service in an industry that can literally change overnight? And how do you build a culture of commitment and performance when the notion of loyalty -- on the part of customers, employees, and employers -- seems like a quaint anachronism? I can answer basically in two words: be yourself.
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LEADERSHIP AND MANAGEMENT IN THE VOLUNTARY SECTOR A PRACTICAL GUIDE
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This article describes how the leaders can get started with the voluntary organization, how to work with the trustees, managers and staff, service users, volunteers to provide effective participation for the upliftment of the organization.
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GRADUATING DEVELOPMENT PROFESSIONALS TO LEADERSHIP
Abstract:
This article discusses about the difference between managers and leaders and also highlights how to identify leadership potential in individuals, nurture them and develop them to assume the leadership role.
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Effective Counselling and informed consent play an important role in patient satisfaction. As the patient undergoes screening and treatment through medication and/or surgery, it becomes imperative for the service providers to communicate and educate the patient on the same. As the medical staffs are often hard pressed for time to communicate the same in detail and clarify the doubts raised by the patients, the concept of introducing patient counselling to increase the level of patient satisfaction and educate them while ensuring optimum utilization of manpower assumes great significance
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QUALITY CATARACT SERIES - PARAMEDICAL CONTRIBUTIONS
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Paramedical contributions lists the objectives of the paramedical module, examples, ophthalmic paramedical training, the Aravind model of paramedical staffing, etc.
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PATIENT COUNSELLING AT ARAVIND EYE HOSPITAL
Abstract:
This article details counselling department activities at Aravind Eye Hospital. It covers the counsellors selection process, training, specific functions in different departments, coordination, and performance assessment.
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PATIENT COUNSELLORS: THE ROLE OF PATIENT COUNSELLORS IN INCREASING THE UPTAKE OF CATARACT SURGERIES AND IOLS
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This article focuses on selecting, training and working skill of counsellors with some common questions asked by patients which a counsellor needs to answer.
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COUNSELLING - A SUCCESS STORY
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This article focuses on importance of counselling and shares the experience of counselling at Netra Niramoy Niketan, Vivekananda Mission Ashram, Chaitanyapur.
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Questionnaires are an instrumental component in monitoring a hospital's quality of care in relation to patient satisfaction, costs and services. In the dynamic healthcare industry, many eye care providers are cutting costs while maintaining high quality services. Patients, employers, employees and insurers are scrutinizing the delivery of care from both a quality and cost perspective. We have listed some of the questionnaires like Inpatient Questionnaires, Outpatient Questionnaires, to understand patients' perceptions, thus initiating positive outcomes that meet or exceed patients highest expectations.
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TOYOTA :
Kiichiro Toyoda, founder of the Toyota Motor Corporation, was born in 1894, His father Sakichi Toyoda became famous as the inventor of the automatic loom. Inheriting the spirit of research and creation from his father, Kiichior devoted his entire life to the manufacturing of cars, which was an unknown frontier at that time. After years of hard work, he finally succeeded in completing the A1 prototype vehicle in 1935. That was the beginning of the history of the Toyota Motor Corporation.
Toyota Quality
Toyota's commitment to a world class, quality automobile is entrenched in the entire manufacturing philosophy. From the development stages to manufacturing a product, the quest for superior quality is evident.
PHILOSOPHY
The cornerstone of Toyota's quality control system is the role of the team members in the production process.
Toyota involves its team members by:
- encouraging an active role in quality control,
- utilizing employee ideas and opinions in production processes,
- and practicing "kaizen" striving for constant improvement.
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 | Archives |
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Introduction
Quality Dimensions
Bench Marking
Quality Assurance in Eye Care
Measuring Quality/Outcome Monitoring
Patient Centred Care
Quality and Information 
Quality and Technology
Appropriate Resources for Quality
Organization Process for Quality Improvement
Leadership
Counselling and Patient Communication
Questionnaires
Collaborating Partner