A framework for institutionalizing quality assurance
A framework for institutionalizing quality assurance
复制标题
DOI：
10.1093/intqhc/14.suppl_1.67
复制
发表时间：
2002-12-01
影响因子：
2.6
通讯作者：
Macaulay, C
中科院分区：
文献类型：
--
作者：
Silimperi, DR;Franco, LM;Macaulay, C
目标。制定支持质量保证(QA)制度化的框架。质量保证制度化的框架由八个基本要素组成的模式和制度化进程的“路线图”组成。基本要素是实施和维持质量保证活动所需的基本要素。核心质量保证活动包括定义、测量和改进质量。基本要素分为三类：内部支持环境(组织或系统内部)、质量组织和支持职能。有利的环境包含领导力、政策、核心价值观和资源的基本要素。质量组织包括实施QA的结构。三个基本要素主要是支助职能：能力建设、通信和信息以及奖励质量。该模式可应用于组织或系统一级。文章还描述了质量保证制度化的过程，从预先意识状态开始，经历了四个阶段(意识阶段、经验阶段、扩展阶段和巩固阶段)，最终达到成熟状态。这个过程不是线性的；一个组织可能会倒退，在各个阶段之间摇摆不定，甚至保持停滞。某些阶段(如意识阶段和经验阶段)可能同时发生。该框架已在拉丁美洲和非洲的近12个国家推出。概念模型被用于支持战略规划和指导卫生部的工作计划，也被用作确定加强和维持质量保证的必要要素的资源。下一步将是开发和评价评估工具，以监测质量保证制度化方面的发展进展。
Objective. To develop a framework to support the institutionalization of quality assurance (QA).Design. The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously.Conclusion. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.