Fourcade A, Vinceneux P, Hay JM, Olivier M, Blum-Boisgard C; International Society of Technology Assessment in Health Care. Meeting.
Abstr Int Soc Technol Assess Health Care Meet. 1993; 9: 144.
Hopitaux de Paris, France.
BACKGROUND. Development of quality assurance programs in acute care hospitals in Europe is being achieved in various ways: some countries have developed a management approach to quality assurance by developing explicit organizational standards and an accreditation-like process (King's Fund, United Kingdom); others have developed an approach focused on specific activities (accreditation for emergency care services in Italy). In France, although there is no accreditation process in our health-care system, the context of the new Hospital Reform law (July 1991) and the acute competition between public and private hospitals provide a good opportunity to develop research on quality standards. The aim of this project is to develop a quality assurance program in an acute care hospital using the experience acquired with ISO 9000 standards for quality assurance in manufacturing and service industries. Louis Mourier, one of the forty-seven public hospitals of the Assistance Publique-H$opitaux de Paris (AP-HP) is the pilot site for testing the applicability of ISO 9000 standards to an hospital organization. It is a teaching hospital of 517 beds of acute care located in Colombes, in the north west of Paris suburb. METHOD. Initially, we established a multidisciplinary steering group of 15 senior medical, paramedical, technical and administrative staff. A general practitioner and an ambulatory care nurse are steering group advisers. The responsibility of the steering group is to provide information on the process in order to get the staff involved and to pilot the different steps of the project. First step: Definition of the quality of the service provided was based on information coming from three sources: (1) results of the reflexions of the steering group using the method of brain-storming and cause-effect diagram, (2) analysis of 20 semi-directive interviews of staff members not represented in the steering group, (3) a survey of patients representative of the local catchment population. An ultimate validation of the criteria of the quality definition is a general survey of the entire hospital staff. Second step: Translation of this definition into quantifiable standards. The ISO 9000 is used as a guide for the implementation of the standards once the definition is available. It provides guide-lines for writing policies and procedures for each of the criteria of the quality definition. This second step will lead to a written manual of the quality assurance program. Third step: Measurement of performance against the standards as established in the manual. At this stage we will have to decide whether to apply the standards to the whole hospital, one department or one activity. CONCLUSION. The success of this experience is based on the relevance of industrial ISO 9000 standards for the implementation of a quality assurance program in a complex organization as an acute care hospital, on the appropriation of the standards as locally established by the professionals themselves and on the motivation of the staff during the whole process. It is a great opportunity to mobilise all staff, medical, nursing and management on one aim: providing a high standard of quality care to patients.
Publication Types:
Keywords:
- Accreditation
- Ambulatory Care
- Behavior
- Data Collection
- Delivery of Health Care
- Europe
- France
- Great Britain
- Hospital Administration
- Hospitalization
- Hospitals
- Hospitals, Public
- Human Development
- Humans
- Italy
- Learning
- Motivation
- Organizations
- Paris
- Quality Control
- standards
- hsrmtgs
Other ID:
UI: 102211528
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