QUALITY ASSURANCE

                                                    

                      Quality assurance in client care in PHC is a management concepts that stresses the need to direct all the efforts of PHC workers towards patient satisfaction by continuous improvement of patient care.
                                               PURPOSE OF QUALITY IN PHC

·               To ensure that clients have access to quality health care because PHC is the bed rock of the Nigerian health care system.

·               To ensure an effect PHC Service. delivery to the people in . Nigeria To achieve a high level of compliance to treatment by the client and client satisfaction.

·               To enhance continuous utilization of primary health centres, by community member; and their continuous willingness to participate and contribute to sustain PHC programmes.

                                             DIMENSIONS OF QUALITY

·               Technical (Professional) Competence: This refers to the skills, capability and performance of PHC providers e.g. clinical I skills in patients care.

·               Client’s Satisfaction: This expresses Clients perception of the response to the health service to his/her felt need opinions are usually based on the outcome of care e.g. 

Patients waiting time/hours.

·               Timeliness i.e. attention to patients in goad time of within reasonable time, interpersonal relationships, amenities of care.

·               Accessibility: of care in term absence of barriers to healthcare i.e. geographic economic social, cultural barriers i e availability a acceptability of care etc.

·               Coverage: Refers to percentage of the community who should actually receive the services.

·               Effectiveness: refers to if the desired results actually obtained i.e. is the treatment given the most appropriate for the given situation.

·            Interpersonal relationships: this refers to the level of the interaction between primary health care workersand the clients between the health Lean and community members.This interpersonal relationship is expressed through.

·            Courtesy: this refers to how patient are treated all patients should be treated personally and professional. This most important factor here is staff attitude. The attitude of staff from (Vltho CIIOS) is the single most important factor determining satisfaction of client. Staff should have positive attitude to be able to make client feel welcome, accepted, and respected determines their compliance with treatment and other aspects of management PHC staff should exhibit a positive attitude to all clients.

                                           POSITIVE ATTITUDE IMPLIES

·            Acceptance: Ability to accept clients irrespective of their health problems. All clients deserve attention assistance and concern.

·            Empathy: The realization that many clients face problem and pressures which are difficult to surmount and deserve understanding and compassion.

·            Assurance of Confidentiality: Any important aspect of quality services in primary health cafe is assurance of confidentially for the client. No client likes the details of his/her health problem to become public knowledge. Unless health worker give fill assurance to keep patient's problem secret. Client will not seek medical treatment. Confidentiality which involves:

…..Keeping information private: never gossips about a client inside or outside the health facility and never disclose any information about a client history or condition for any reason e.g. HIV positive patient or STD client.
……Privacy i.e. ensuring that client have privacy during history during taking examination conation treatment.

·            Continuity of Care: Is the complete range of promotive, preventive curative and rehabilitative care available on an en-going basis without under interruption e.g. ensure timely referral of clients from one level to the other.

·            Safety: This refers to avoidance of infection risks, including side-effects of medication to clients.

·            Amenities: This refers to the physical appearance of facilities, cleanliness, comfort and privacy for patient etc. amenities should be such that encourage client to return for a follow-up visit.
i. Client organization for adequate patient flow
ii. Efficiency and completeness of service or care.
iii. Consistency and convenience in terms of:
a. Service (10 component of PHC) b. Use of standing orders for uniformity of care c. Performance of client skills without error.

                                      PERSPECTIVES ON QUALITY

Quality means different Things to different people for example:

1, To the PHC service consumers i.e. the client patients and community members it means services that:                   a. Focus on patient’s felt 0r perceived needs.
b. Are delivered courteously and timely.

c. Are consistent d. Accessible, afford

e. Accurate effective.

2. To the care providers: quality focus on:
a. Professional skills, effectiveness

b. Availability of resources.

c. Safely of work environment
d. Effective referral system

e. Opportunities for continuing education etc. .

3. To the members/heads of facilities, quality will focus on two previous factors. able and convenient.