An introduction to quality assurance in health care / Avedis Donabedian ; edited by Rashid Bashshur.

Format:

Book

Author/Creator:

Donabedian, Avedis.

Contributor:

Bashshur, Rashid, 1933-

Language:

English

Subjects (All):

Medical care--Quality control.

Medical care.

Quality Assurance, Health Care.

Delivery of Health Care.

Medical Subjects:

Quality Assurance, Health Care.

Delivery of Health Care.

Physical Description:

xxxii, 200 pages : illustrations ; 22 cm

Other Title:

Quality assurance in health care.

Place of Publication:

New York : Oxford University Press, 2003.

Summary:

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.

Contents:

What This Book Is About xxiii

The Meaning of Quality Assurance xxiii

The Targets of Quality Assurance xxiv

The Components of Quality Assurance xxv

The Quality Monitoring Cycle xxvii

Formal and Informal Monitoring xxviii

Some Foundations of Quality Assurance Through Monitoring xxix

The Meaning of Quality in Health Care xxxi

1. The Components of Quality in Health Care 3

Efficacy 4

Effectiveness 5

Efficiency 9

Optimality 11

Acceptability 18

Choosing a Definition of Quality 24

Steps in Monitoring and Improving Clinical Performance 26

2. Determining What to Monitor 29

Externally Required Monitoring Activities 30

Internally Motivated Monitoring Activities 30

3. Determining Priorities in Monitoring 39

Importance to Patient Welfare 40

Additional Institutional Interests 40

Feasibility 42

4. Selecting Approaches to Assessing Performance 45

Definitions of Structure, Process, and Outcome 46

Comments on the Structure-Process-Outcome Model 47

Relative Usefulness of the Three Approaches 49

Conclusions About the Choice of an Approach 56

5. Formulating Criteria and Standards 59

Importance of Criteria and Standards 61

Some Attributes of Criteria and Standards 61

6. Obtaining the Necessary Information 77

Medical Records 78

Surveys 84

Financial Records 86

Statistical Reports 87

Direct Observation 87

Test Situations 89

7. Choosing When and How to Monitor 91

When to Monitor 92

How to Monitor 93

8. Constructing a Monitoring System 117

Key Elements 118

9. Bringing About Behavior Change 123

Readjustments in the System 124

Educational and Motivational Activities 126

10. The Effectiveness of Quality Monitoring 133

Contextual Factors 134

Operational Factors 136.

Notes:

Includes bibliographical references and index.

ISBN:

0195158091

OCLC:

49711799