ALIPURDUAR LIONS EYE HOSPITAL

QUALITY ASSURANCE & MONITORING IN OPD & OUTREACH SERVICES

PRESENTED BY ALIPURDUAR LIONS EYE HOSPITAL

WHAT IS QUALITY QUALITY: A piece of work done with perfection. it is the basic

need to survive in today's world. 100% or more. It has become the integral part of any organization. Quality is the level of Patient Satisfaction.

Quality has become the KEY DRIVER with the increase in awareness, and paying capacity.

It is the perception and expectation of the patients to which extend the service provider can provide quality establishments.

The process of building quality starts with the understanding of patients expectations and translating this understanding into improved treatment, facilities etc.

DIMENSIONS OF QUALITY

- Quality of surgery - Basically abstract

- It is quantifiable & tangible - Not quantifiable, intangible

- Diagnostics and treatment - treatment process

e.g. post operation complication, e.g. communication,

Visual acuity, ambience

Safe medicine and appropriate staff behavior

prescription etc.,

QUALITY

PRODUCTWHAT is delivered

SERVICEHOW it is delivered

QUALITY ASSURANCE

Quality Assurance: Is a systematic process of checking to see whether a product /service is meeting specified requirements

Quality assurance focuses on enhancing and improving the process that is used to create the end result.

QA is a continuous process, it is not something that is to be done only once or construed as additional burden. It is the continuous quality improvement

PLAN

MEASURE

MONITORREVIEW

ACT UPON

IMPORTANCE OF MONITORING o Helps an organization to understand oneself better.

o Monitoring increases the effectiveness as well as the cost effectiveness can be measured and better plans can be chalked out through proper decision making.

Are we doing the right things? How well are we doing? Whether the work done actually has

the intended impact? Does it make any difference?

NEED TO MONITORReview our workKeep a track of statistical data.Measure achievements and progress Detect challenges and hindrances so that

corrective action can be takenImprove outcomes and enhance the impactsTrack the rise or dip in number of patients, has

the organization developed over the years.Optimal utilization of resources and cost

efficiency Improve staff performanceStimulate learning and motivationBetter decision making through feedback

HOW TO ENSURE QA Regular monitoring: Regular monitoring brings out short comings.

Monitoring of surgical complications, waiting time analysis etc. post camps meetings to analyze what went wrong and what went right.

Regular Meeting: helps to assess and discuss performance and to plan further strategies helps a programme evolve with the demand.

Set Targets: Standards must be set

Performance Appraisal : set standards and then the staff has to be evaluated based on these targets or standards.

Training: Educating staff in quality improvement, not just in job function as “Quality staff can provide quality service”

Benchmarking: compare with the best practices and thereby improve

QA IN OPD Monitor waiting time: Total time to complete the entire process can be

tracked randomly once a quarter.

Drop Out Rate: is the rate at which patients do not come back for follow up or do not respond for surgery after they have been asked to come for surgery, this can be checked through medical records. Follow up visits can be assessed and analyzed.

Patients comfort: check the cleanliness and comfort of the patients

Track numerical data: The daily OPD patients, new, review must be checked on a daily basis to track the rise or dip in number of patients.

Review of records: From the Medical record patients details can be tracked. Well maintained medical records

Track patients: Data must be maintained to ascertain how many patients have got refractive errors, cataract, glaucoma etc. Tracking the visual outcome and improvement

Spectacles: Pre and post vision must be recorded.

MONITORING IN OUTREACH In order to conduct successful outreach camps it is

essential to have a proper planning and monitoring system without which there is

no accountability cost increases 2-3 timesDrop outsMisuse of medicinesMisplacement of equipments, banners etc.If camps are not conducted in a proper way it may

hamper the hospital image as a huge number of population is involved.

No co-ordination amongst the team members.

An outreach programme needs proper planning.

OUTREACH ACTIVITY

PRE CAMP ACTIVITY

• Identify locations• Ascertain Sponsors• Agree upon suitable

date &time• Estimate camp size• Plan site• Select camp Venue• Proper medium of

publicity• Gather necessary

equipment, medicines

• Plan travel & catering arrangements

• Schedule surgery date, discharge etc.

CAMP DAY ACTIVITY

• Ensure task is completed

• Relevant team meet at base hospital

• Set up camp• Patients registered• Refraction &

examination• Selected patients

given time to leave for base hospital

• Patients start for the hospital

• Actual number of patients have come or not

• Inpatients are checked into the hospital

POST CAMP ACTIVITY

• Inform doctors & paramedical staff about patients admitted

• Follow up surgery & discharge schedule

• Counsel patients about how take medicines, what is to be done etc.

• Plan and arrange return journey

• Take camp records and data to base hospital administration team for record keeping

• Prepare data for weekly meetings.

• Meeting with sponsors & coordinators

TOOLS TO MONITORPrior to the execution of a tool it is necessary to

DETERMINE the objective, and then accordingly select the tools to have a monitoring system in place. Quality cannot be measured without a clear definition or standard

Monitoring tool has to be simple so that it is easily understood by everybody. Methods are:

Regular Meetings Diaries/Logbooks Progress reports Questionnaires Feedback forms Observation Discussion with staff Review system Communication with clients and community

QUESTIONNAIREName: Age: Address:Sex: Room No:Please encircle the appropriate numbers.Excellent =1, Good =2, Fair =3, Poor =41.How is our medical care?

2. How was the responsiveness to your complains?

3. How do you feel about quality of nursing staff?

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1 2 3 4

1 2 3 4

Parameter

People involved

Indicator Set Standard

Actual

Variance

Registration

Counter Incharge

Number of patients

1000 800 200

Refraction unit

optometrists. Room Attendant

Number of patients

800 500 300

Premises Cleaners, supervisor

Cleanliness Yes Partial Not upto the mark

Camps Sponsors, camp coordinator

No of patients

200 150 50