Dokuz Eylul University, Turkey Department of Quality Improvement and Accreditation in Health Care

1. Evaluating the Effects of Quality Assurance: A Comparative Analysis between ISO 9001 Certified and Non-certified Hospitals in Turkey Dokuz Eylul University, Turkey Department of Quality Improvement and Accreditation in Health Care Assoc. Prof. Dr. Ozkan TUTUNCU Dr. Deniz KUCUKUSTA Ahmet AKMAN

2. Presentation Plan • Introduction • Objective • Methodology • Findings • Conclusion

3. Introduction • Quality assurance aims • to ensure that the product or service • is fit for its purpose and • meets customer expectations

4. Introduction • Quality assurance (QA) in health care • all activities that contribute to defining, • designing, • assessing, • monitoring, • and improving the quality of healthcare.

5. Introduction • Certification and Accreditation • an important factor in continuous quality improvement and TQM, • promotes integration, • promotes patient safety and error reduction in health care organizations.

6. Objective • to determine which dimensions of quality management system differs significantly • in ISO certified and non-certified hospitals • within the perceptions of healthcare employees in Turkey.

7. Methodology • structured-questionnaire survey consisting three parts. • QMS 39 questions • 3 overall statements representing general perceptions about the quality management system, service quality and patient safety • demographic and nominal questions

8. Methodology • Five-point Likert Scale • 3 certified and 3 non-certified, middle scale hospitals in Izmir, Turkey • 803 of 1000 questionnaires were returned, with a usable response rate of 80,3%

9. Methodology • Data analysis consisted of • frequency distribution, • correlation analysis, • factor analysis • and regression analysis at the base of derivative and inferential statistics.

10. Findings • According to the frequency distribution • 82 % of them were women and 18% were men. • 75% of the respondents have minimum university degree. • 47% have ISO certification where the others have none. • 60 % were nurses and • 15 % were medical doctors where the rest of them were other medical staff.

11. Findings • General Reliability ,98 (Cronbach’s alpha) • In accordance with Cronbach’s alpha result obtained, the factor analysis has been implemented on data.

12. Factor Analysis and Correlation Results

13. Regression Analysis of the Factors Affecting the Overall QMS

14. Regression Analysis of the Factors Affecting the Overall Service Quality

15. Regression Analysis of the Factors Affecting the Overall Patient Safety

16. Findings • In order to compare the difference between ISO certified and non-certified hospitals, T-test was used. • According to the T-test, the mean values of all the dimensions in both hospital types differ significantly (p=0,000).

17. Descriptive statistics of T-test

18. Conclusion • The results of this study supports that • the main and the most important factor of the quality system was named as KAIZEN (measurement, analysis continuous improvement and service actualization) • This core dimension has a very strong effect in overall quality management system, service quality and patient safety.

19. Conclusion • Resource management and management responsibility also strongly affect quality system. • All the dimensions are strongly and positively correlated with each other, meaning that the quality system and its parts are perceived almost unique. • All the dimensions of the quality management system differ significantly between certified and non certified hospitals.

20. Conclusion • In ISO certified hospitals, • continuous improvement, • management responsibility and • resource management dimensions are perceived positively and more important. This result also shows how the quality management system leads to positive approach in healthcare staff towards management and patient safety culture.

21. ozkan.tutuncu@deu.edu.tr Thank you…