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Chapter 23Chapter 23

Quality Management Quality Management

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Definitions and GoalsDefinitions and Goals

QualityQuality Quality assurance/improvementQuality assurance/improvement GoalsGoals

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Historical Development of Quality Historical Development of Quality Improvement in Nursing and Health CareImprovement in Nursing and Health Care

1892—licensure of nurses introduced1892—licensure of nurses introduced ANA quality assurance modelANA quality assurance model ANA study of nurse credentialsANA study of nurse credentials NLN study of accreditationNLN study of accreditation

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Approaches for Quality ImprovementApproaches for Quality Improvement

General approachesGeneral approaches CredentialingCredentialing LicensureLicensure AccreditationAccreditation CertificationCertification OtherOther

• CharterCharter• RecognitionRecognition• Academic degreeAcademic degree

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Approaches for Quality ImprovementApproaches for Quality Improvement

Specific approachesSpecific approaches Total quality management/continual quality improvementTotal quality management/continual quality improvement Staff review committeeStaff review committee Utilization reviewUtilization review Risk managementRisk management Professional standards review organizations (PSROs)Professional standards review organizations (PSROs) Evaluative studiesEvaluative studies Client satisfaction assessment Client satisfaction assessment Malpractice litigationMalpractice litigation

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TQM/CQI in Community and Public TQM/CQI in Community and Public Health SettingsHealth Settings

Using QA/UI in TQM/CQUUsing QA/UI in TQM/CQU Traditional quality assuranceTraditional quality assurance

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Client SatisfactionClient Satisfaction

Malpractice litigationMalpractice litigation

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Model QA/QI ProgramModel QA/QI Program

StructureStructure ProcessProcess OutcomeOutcome Evaluation, interpretation, and actionEvaluation, interpretation, and action

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Model Quality Assurance ProgramModel Quality Assurance Program

Basic componentsBasic components Identifying valuesIdentifying values Identifying standards and criteriaIdentifying standards and criteria Selecting measures to assess attainment of standards Selecting measures to assess attainment of standards

and criteriaand criteria Interpreting strengths/weaknesses of care givenInterpreting strengths/weaknesses of care given Identifying alternative courses of actionIdentifying alternative courses of action Choosing courses of actionChoosing courses of action Taking actionTaking action

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RecordsRecords

Purposes of recordsPurposes of records Community and public health agency Community and public health agency

recordsrecords