lect qa study
TRANSCRIPT
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QU LITY SSUR NCE
STUDY
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Methodology of QA Study
1. Problem / Opportunity Statement
2. Literature Review / Situational Analysis
3. Objectives of the study
4. Type of Study
5. Variables
6. Sampling7. Data Collection Techniques
8. Mapping the Proposal
9. References
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Methodology of QA Study
1. Problem / Opportunity Statement
A complete opportunity/ problem statementshould describe :
* the problem or area of concern and itssignificance for the quality of care
* possible causes and contributory factors
* rationale of the study* scope of the study
* intention to use the results to improve the
quality of care
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PROBLEM
Other QUALITY
PRACTICAL DAILY LIFEScientific / academic interest
Do nothing CAN DO SOMETHING
Severity
Benefit
ABNA
Problem
prioritisation
BIG MAGNITUDE Small magnitude
? Feasible ? Possible
? Cost benefit ? Study module
DO QA STUDYDo nothing
yes
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2. Literature Review / Situational Analysis
Source of literature;
* text books* scientific journals
* proceedings of conferences
* local, state and national statistics
* reports on QA studies
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Literature review will help us in;
clarify our problemstate the study objectives
know what has happen elsewhere
check the implicit standards
set explicit criteria and standards
suggest suitable study methodsfind appropriate remedial actions
avoid duplication of works
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3. Objectives of the study
Objectivesof study summarise what isfinally to be achieved by the study
If an objective is planning what is to be
accomplished by the study in general term,it is called a general objective
It is possible to be down general objectives
into smaller logically connected partswhich are normally referred to asspecific
objectives
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Objectives should be closely related tothe statement of the problem.
For example; if the problem identified
is high defaulter rate amongst TBpatients, the objectives will be to identifyreasons for this high defaulters and to
find means to improve it.
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Objectives should..
be phrased in such a way that they focus onwhat the study is attempting to solve, indifferent parts of the problem in a logicalway
be clear, phrased in operational termspecifying exactly what one is going to do
keep in mind that when the study / poject isevaluated , the result will be compared to theobjectives
be realistic to be achieved
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Phrasing of objectives
Thegeneral objectivewill mention the overallfinal aim to be achieved in the study
The specific objectivesshould be stated using
action verbs that specific enough to
measures:
To determine - To compareTo verify - To establishTo calculate - To describe
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Avoid the use of vague non-action verbssuch as;
To appreciate
To understand
To believe.
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Specific objectives for QA study
1. To verify the existence of the qualityproblem
2. To measure the magnitude of the
problem3. To identify/describe the actual causes or
contributory factors involved
4. To formulate the remedial orimprovement measures
5. To evaluate the effectiveness of the
measures taken.
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4. Type of StudySTUDY
NON-EXPERIMENTAL EXPERIMENTAL
DESCRIPTIVE ANALYTICAL
QUANTITATIVE
QUALITATIVE
CASE-CONTROL
( retrospective)
COHORT
(prospective )
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Descriptive study:
Systematic collection and presentationof data to give a clear picture of aparticular situation within a particular
period ( cross-sectional)
describe in term of qualitativemeasure or quantitativemeasure
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Analytical study( or; comparative study )
Aims at determining and testing therelationshipbetween several variables to suggestpossible causes of problemCase-control/Retrospective: Check the present
outcome and examine the past possibleexposure factorsCohort/Prospective: Expose different factors to
different group of study samples ( of similarcharacteristic ) and measure their outcomes aftercertain time period
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Experimental study
Strongest possible type of study to provecausation
Individuals are randomly allocated to at least
two groups; one group is subject to anintervention or experiment while the othergroup is not
The outcome of the intervention ( effect ofintervention of the dependent variable) isobtained by comparing the two groups
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Time perspective
PASTRETROSPECTIVE
Looks for past exposureto a factor ordescribe
the past event
NOWCROSS-SECTIONAL
Looks at the presentsituation
FUTUREPROSPECTIVE
Looks at development of acondition over time
Descriptive study; can be retrospective, prospective orcross-sectional
Analytical study; can be either retrospective or prospective
Experimental study is always prospective
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5. Variables
A characteristic of a person, object orphenomenon that is measureable and
can take on different values
Examples;Variable: Height value: tall , short
variable: Sex value: male , female
variable: Knowledge value:Good, poorvariable: Socioeconomic status
value: High income, middle-income,
low income group
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Key Word Definition
To describe the definition of certain/selective key words and terminology usedin this study
The terminology probably applied only forthis study including application of certainvariables, situation, standard.
Must be sound valid, acceptable, reliable,clear and not ambiguous.
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Proposed Indicator and
Standard Describe the indicator proposed to be
applied in the study.
If rate based, what numerator and
denominator will you use.
Proposed the most acceptable standard.
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6. Sampling
Better to get intended information froma certain population ( all ), but limitedwith problems of logistics, costs, time &
other resources.
Thus, we have to do sampling; arepresentative sample with all importantcharacteristics of the drawn population
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Sampling procedures
1. Non-probablility
- Convenience & Non-convenience
2. Probability sampling- simple randomized
- systematic random
3. Stratified sampling4. Cluster sampling
5. Multi-stage sampling
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7. Data Collection Techniques
Review of recorded sources
Observation Interview
Written questionaires
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Plan for Data Collection
WHAT data to collect
WHERE to get the data
HOW to collect them WHO will collect
WHEN will the data be collected
HOW LONG will it takes
QUALITY CONTROL of the data
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Plan for Data Analysis
The plan includes;
Data handling andstoring
Data processing Data analysis
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8. Mapping the Proposal
Construct the Gantts Chart
List down the the plan of processes to be
undertaken in conducting the study Chart the appropriate time frame for each
process
To mark the plan and actual task carriedout
Gantts Chart
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Responsibility Oct
1stwk 2ndwk 3rdwk 4thwk
Nov
1stwk
2nd
wk
3rd
wk
4th
wk
Prepare
Proposal
Group
members
Prepare
Checklist
Group
members
Staff
Briefing
Group
members
QA Study SN ED/ward
Data
collection
SN ED/ward
Data
Analysis
Group
members
Remedial
Action
Group
members
Evaluation Group
members
Report
Writing
Group
Members
Gantt s Chart
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9. References
List down all references quoted or referredin the study
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References
1. Clinical Practice Guidelines on The
Management of HPT
( Academy of Medicine; 2002 )
2. Standard Operating Procedure for MA
( Ministry of Health; 2000 )
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References
1. McCarty D., Zimmet P. 1997. Diabetes 1994 to 2010: Globalestimates and Projection- Interact in Internationaldiabetes. Melbourne, Australia, 1997 ISBN 0640.2448.10.
2. Langer D et al, Pregestational diabetic: Insulin requirementthroughout pregnancy. Am J Obstet Gynae 1988; 159:616-621
3. Life-style changes linked to global rise in diabetes- Expertssay, Press Release ; WHO/59 14 July 1994.12.
4. King H. Revers M. Diabetes in adults is now a third worldproblem. Bulletin of WHO 1991. 69 (b):643 648.14
5. Diabetes facts and figures. 1997. Persatuan DiabetesMalaysia homepage, page 15.
6. America Diabetes Association. Screening for Diabetes,Diabetes Care, 1989; 12: 588 590.5.