PAHS 423

PRINCIPLES OF HEALTHCARE
QUALITY ASSURANCE
STUDY GUIDE
Session 1 – Understanding ‘quality’
Lecturer: Nana Nimo Appiah-Agyekum (PhD), UGBS
Contact Information: nnappiah-agyekum@ug.edu.gh

College of Education
School of Continuing and Distance Education
2014/2015 – 2016/2017
 Session Overview
This session provides a general background of quality and
related concepts. It also builds the foundation for
subsequent sessions on meaning and scope of quality as
a general concept and with specific reference to
healthcare .
At the end of the session, the student will
• Understand the definition and scope of quality
• Become familiar with the key concepts of quality
• Appreciate the relevance of quality

Slide 2
 Session Outline
The key topics to be covered in the session are :
• Topic One : Overview of Quality
• Topic Two : Conceptualisations of quality
• Topic Three : Definition of quality

Slide 3
 Reading List
• Newton, J. (2007). What is quality. Embedding quality culture in
higher education, 14-20.
http://www.qualityresearchinternational.com/Harvey%20papers/Har
vey%202006%20Understanding%20quality.pdf

Slide 4
Topic One

OVERVIEW OF QUALITY

Slide 5
 What is Quality (1)
• Quality is a very complex and contentious term
• Yet, everyone understands what is meant by
“quality”
• It is perceived differently by different people
• Individuals, organizations, regulators and the
general public have different meanings of quality
• The differing meanings leads to different
priorities, expectations and goals, depending on
the perspective of the constituent
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 What is Quality (2)
• For products, quality may relate to the fit, finish,
appearance, function and performance
• For services, quality may relate to the degree of
satisfaction by the recipient of the service.
• Though they are often confused with each other
‘quality’ is distinct in meaning and application
form ‘standards’
- Quality relates to process
- Standards relates to intended or actual outcome
Slide 7
 Why focus on quality
• Quality provides the basis for continuous
improvement in product or service.
• Aims to ensure that the customer will be satisfied
to pay for the product or service.
• Results in a reasonable profit for the producer or
the service provider.
• Builds and sustains a lasting relationship between
customers and manufacturers/providers.
• Enhances the reliability of product/services
PAHS 423: lecture 1 Slide 8
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Topic two

CONCEPTUALISATIONS OF QUALITY

Slide 9
 The concept of quality
Quality is non-unitary concept. It is
• stakeholder-relative
• Multi-perspective
• Subjective
• Both output and process oriented
• Draws inspiration from public perceptions and
opinions
• Discipline specific
PAHS 423: lecture 1 Slide 10
UGBS, GBS9, nananimo0@gmail.com
 Meaning of Quality (1)
Quality may mean or is associated with
• Exceptional or as excellence
• perfection or consistency
• fitness for purpose
• value for money
• transformation (Harvey and Knight, 1996)
• a mechanism
• Functionality
• Accomplishments
PAHS 423: lecture 1 Slide 11
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 Meaning of Quality (2)
• Equality, equity and uniformity
• Exclusivity
• Discrimination
• End or means to an end
• Standards/ standardization
• Legislation
• Costly/ expensiveness
• Long-lasting/ durability
• Reputation
PAHS 423: lecture 1 Slide 12
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Topic three

DEFINITION OF QUALITY

Slide 13
 Definitional challenges with quality (1)
Quality is difficult to define because it is
• a creature of political fashion (Becher, 1999)
• multi-faceted (Frazer, 1992)
• elusive (Neave, 1994)
• slippery and value-laden (Harvey and Green,
1993)
• Continuously evolving
• driven by the general public’s understanding
and expectations
PAHS 423: lecture 1
Slide 14

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 Definitional challenges with quality (2)
Consequently,
• No authoritative definition of quality is possible
(Scott & Palmer, 1994)
• there is a lack of theory of quality
(Westerheijden, 1999)
• there is no definition but you will know it when
you find it! (McConville, 2000)
• In the last resort, quality is a philosophical
concept (Green, 1994)
PAHS 423: lecture 1 Slide 15
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 Quality defined (1)
Quality has been defined as
• standards and high achievement (Garvin, 1998)
• fitness for use (Juran, 1988)
• value (Feigenbaum, 1951)
• excellence (Peters and Waterman, 1982)
• conformance to specifications (Gilmore, 1974)
• conformance to requirements (Crosby, 1992)
• predictable degree of uniformity and
dependability (Deming Slide 16
PAHS 423: lecture 1
 Quality defined (2)
• meeting and/or exceeding customers
expectations’ (Parasuraman, Zeithaml and Berry,
1985)
• ‘consistently delighting the customer by
providing products and services according to the
latest functional specifications which meet and
exceed the customer’s explicit and implicit
needs and satisfy producer/provider’
(Mosadeghrad, 2013).
PAHS 423: lecture 1 Slide 17
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 Sample Question
Several definitions of quality have been provided
from several authors across several decades
emphasizing different components
• From your understanding of the definitions
provided above, how will you define quality in
your own words?
• What will be the key elements in your
definition and why?

Slide 18
 References
• Becher, T. (1999). Quality in the professions. Studies in Higher Education, 24(2),
225-235.
• Crosby, P. B. (1992). Completeness: Quality for the 21st century. Penguin.
• Deming, W. E., & Edwards, D. W. (1982). Quality, productivity, and competitive
position (Vol. 183). Cambridge, MA: Massachusetts Institute of Technology, Center
for advanced engineering study.
• Feigenbaum, A. V. (1951). Quality control: Principles, practice and administration:
An industrial management tool for improving product quality and design and for
reducing operating costs and losses. McGraw-Hill.
• Frazer, M. (1992). Quality assurance in higher education. Quality assurance in
higher education, 9-25.
• Garvin, D. A. (1988). Managing quality: The strategic and competitive edge. Simon
and Schuster.
• Gilmore, H. L. (1974). Product conformance cost. Quality progress, 7(5), 16-19.
• Green, D. (1994). What Is Quality in Higher Education?. Taylor & Francis, 1900 Frost
Road, Bristol, PA 19007-1598.
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 References
• Harvey, L., & Green, D. (1993). Defining quality. Assessment & evaluation in higher
education, 18(1), 9-34.
• Harvey, L., & Knight, P. T. (1996). Transforming Higher Education. Open University
Press, Taylor & Francis, 1900 Frost Road, Suite 101, Bristol, PA 19007-1598.
• Juran, J. M. (1988). Juran on planning for quality. New York: Free Press.
• McConville, G. (1999). Everybody wants quality education: but what does it
mean?. Australian Universities' Review, The, 42(1999-2000), 2.
• Neave, G. (1994). The politics of quality: Developments in higher education in
western Europe 1992-1994. European journal of education, 29(2), 115-134.
• Newton, J. (2007). What is quality. Embedding quality culture in higher education,
14-20.
• Peters T. J., Waterman R. H. (1982) In search of excellence. New York: Harper and
Row
• Scott, M. J., & Palmer, J. (1994). Eight principles for 'total quality'
schools. Education, 115(1), 139-144.
• Westerheijden, D. F. (1999). Where are the quantum jumps in quality
assurance?. Higher education, 38(2), 233-254.
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