American Nurses Association (ANA) Model of quality assurance.ppt.

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Here, presentation on- American Nurses Association (ANA) Model of quality assurance. pptx. including the model and the description of the components of ANA model.

1. American Nurses Association (ANA) Model of Quality Assurance (QA) Presented by: Rabeya Sultana R eta MSN (WHMN) BSMMU 1

2. Quality Assurance (QA) Quality management (QM) and quality i mprovement (QI) are the basic concepts derived from the philosophy of total quality management (TQM). Now it is preferred to use the term continuous quality improvement (CQI). The method of monitoring of health care foe CQI is done with quality assurance (QA). 2

3. Definition of Quality Assurance (QA) According to Joint Commission , QA was initially defined as- “the process objectively and systematically monitoring and evaluating the quality and appropriateness of patient care and for resolving defined problems”. Quality assurance is a judgment concerning the process of care based on the extent to which that care contributes to valued outcomes. -Donabedian 1982 3

4. Objectives of Quality Assurance (QA) Whether in health or education QA has two main objectives: To provide technical assistance in designing and implementing effective strategies for monitoring quality and correcting systemic deficiencies. To refine existing methods for ensuring optimal quality health care through an applied research programme. (Decker, 1985 and Schroeder, 1984) 4

5. Models of QA American Nurses Association (ANA) model Donabedian model (1985) Wilson’s model Quality health outcome model Quality management model FOCUS-PDCA model Joint Commission 10 step process model Performance management system paradigm Quality caring model Marker’s umbrella model 5

6. ANA Model This first proposed and accepted model of quality assurance was given by Long and Black in 1975. It was meant for nursing profession but used by other professional in health care. It helps in self-determination, patient, and family, nursing health orientation, patient’s right to quality care and nursing contributions. This is a cyclic model. The basic components of the ANA model can be summarized as follows. 6

7. Components of ANA model 7

8. Identify values In this model, value identification looks as such issue as patient, philosophy needs and rights from an economic, social, psychology and spiritual perspective and values philosophy of the health care organization and the provider of nursing services. 8

9. Identify standards and criteria Identify structure, process and outcome standards and criteria: this step begins with writing of philosophy and objectives of organization, which serves to define the structural standards of an agency . Standards of structure are defined by licensing or accrediting agency. Another standard of structure includes the organizational chart, which shows supervisory methods, communication patterns, staff patterns and sometimes staff assignments. A group internal or external to the agency does evaluation of the standards of structure. 9

10. Identify standards and criteria cont’d . The evaluation of process standards is a more specific appraisal of the quality of care. An agency can chose to use the standards of care set such as ANA nursing standards or nursing process. Agency also apply it to the activities of the nurses and correspond to the procedure of care defined by the agency. The process evaluation include peer review committee and the client satisfaction survey. The techniques included are direct observation, questionnaire, interview, written audit and videotape of client and provide encounter. 10

11. Identify standards and criteria cont’d. The evaluation of outcome standards reveals the end results of nursing care. To be able to identify the net changes clients health status as a result of nursing care as contribution to the health care delivery system. Research studies using the trace or the sentinel method to identify client outcomes and satisfaction surveys used to evaluate outcome standards. Technique used to compare admission data with the discharge data to show changes in the level of dependence. 11

12. Secure management Select measurement needed to determine degree of attainment of criteria and standards: Measurements are those tools used to gather information or data, determined by the selections of standards and criteria. The approaches and techniques used to evaluate structural standards and criteria are nursing audit, utilization’s review, review of agency documents, self studies, and review of physical facilities. 12

13. Secure management cont’d. For the evaluation of process standards and criteria are peer review, client satisfactions, surveys, direct observation, questionnaires, interviews, written audits and videotapes . The evaluation approaches for outcome standards and criteria include research studies, client satisfaction surveys, client classification, admission, readmission, discharge data and morbidity data. 13

14. Make i nterpretations The degree to which the predetermined criteria are met is the basis for interpolation about the strengths and weakness of the program. The rate of compliance is compared against the expected level of criteria accomplishment. 14

15. Identify course of action If the compliance level is above the normal or the expected level, there is great value in conveying positive feedback and reinforcement. If the compliance level is below the expected level, it is essential to improve the solution to the problems. 15

16. Choose action Usually various alternative course of action are available to remedy a deficiency. It is vital to weight pros and cons of each alternative while considering the environmental context and availability of resources. More than one cause is identified, action needed to deal with each contributing factor. 16

17. Take action It is important to firmly establish accountability for the action to be taken. Essential to answer the questions of who will do? What? By when? this step then concludes with the actual implementation of the proposed courses of action. 17

18. Re-evaluation The final step of QA process involves an evaluation of the results of the action. The reassessment is in the same way as the original assessment and begins the QA cycle again. Careful interpretation is essential to determine whether the course of action has the deficiency was remedied or improve. Positive reinforcement is offered to those who participated and the decision is made. If the deficiency is not remedied, the problem solving process is repeated. 18

19. Conclusion According to the ANA model, all the quality assurance systems involve appraisal of quality standards followed by action for quality improvement. The ANA cycle of QA is an elaboration of the sequence. At each stage in the cycle the observation and events of the previous stage influence the decision to be made and action to be undertaken in the next. This cycle is also known as “open” system. This openness is necessary to allow for the idea of continuous quality improvements. 19

20. 20 THANKS TO ALL