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Quality Assurance

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"Quality" has, in the last few years, become a popular buzzword in the American economy. Discussion of quality often reflects the view that the Japanese, in particular, take quality more seriously, and take more active steps to ensure quality, than does American industry. Ironically, though, the concept of Quality Assurance was largely developed by Americans. J. M. Juran, one of the pioneers in Quality Assurance, is an example of an American whose work on quality was awarded with the Second Class of the Order of the Sacred Treasure, given by the Emperor of Japan  the highest award given to nonJapanese citizens (Juran, 1989, jacket note).

What do the principles of industrial Quality Assurance have to say about the practice of nursing? We intuitively think of nursing as a profession, comparable to teaching or the practice of law, rather than as an "industrial" activity. Yet the provision of medical care is one of the fastestgrowing sectors in the American economy. The problems of providing quality in nursing care are different in almost every detail from those of building safer and more reliable automobiles, but many of the basic principles of Quality Assurance are applicable to both endeavors.

Developments in recent years have tended to accentuate the need to consider Quality Assurance in nursing care. Medical care and practice are in general more complex, which means that there are more possibilities for error. Specialization and subspeci

. . .
has also become a "complex system," and the old customerbased and craftsmanshipbased approach to the assurance of quality care is no longer sufficient. It is thus necessary to apply modern concepts of Quality Assurance to nursing care. We know intuitively what we mean by "quality," but in order to analyse and measure quality we must define it more specifically. The basic measure of quality in Quality Assurance is frequency of deficiencies quality =  opportunities for deficiencies (Juran, 1989: 18) There is a natural tendency to say that we can never devote too much effort to providing quality. However, this cannot be literally true. If we never stopped working to ensure the quality of a given operation  whether it be a medical procedure or the manufacture of a car  we would be endlessly checking and rechecking our work, and we would never get the job done. The quality of care would be ensured, though the patient died because the procedure was never completed. Instead, the goal of Quality Assurance is first, to check and recheck work thoroughly enough, within the time and eff
. . .

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Approximate Word count = 1379
Approximate Pages = 6 (250 words per page)

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