Paradigm Shift in Health Care: From Quality Assurance to Continuous Quality Improvement
AIR FORCE INST OF TECH WRIGHT-PATTERSON AFB OH
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The concept of quality in health care is discussed throughout this paper, within an historical perspective, including key forces influencing quality assurance QA. The Joint Commission on Accreditation of Healthcare Organizations JCAHO has been identified by Schroeder 1991a as probably the most significant influence on QA structures and approaches in the United States. The revised nursing care standards delineated by JCAHO in the 1991 Accreditation Manual for Hospitals AMH will be discussed in this paper. A Systematic Internal Review SIR program to be utilized as a self assessment of compliance with the new standards is introduced. In addition, the monitoring and evaluation M and E process used to measure the quality of care as set forth by JCAHO is described. The concept of quality and the shift from a traditional QA philosophy to a continuous quality improvement CQI philosophy is explored with implications for health care and nursing presented. The importance of nursing staff as well as an organizationwide commitment to and involvement with CQI activities is emphasized.
- Personnel Management and Labor Relations
- Medicine and Medical Research