Quality indicators: a tool for quality monitoring and improvement

Quality indicators are one of the quality management system (QMS) tools to monitor and control efficiency of the system key segments, while the results collected serve as a basis for implementation of corrective measures and continuous quality improvement. There are several classifications of quality indicators. According to the objectives of their establishment and utilization, they can be internal and external. In line with the tripartite quality model, quality indicators can be classified as structural indicators, process indicators and outcome indicators. Quality indicators should ideally possess a number of attributes. Besides objectivity (measurability), the most common requirements are as follows: importance and potential for use, reliability and validity. Quality indicators offer the possibility of fast and simple insight into the level of product and service quality and their pattern over time to the interested parties within and outside the institution. Although quality management has long been recognized as being of utmost importance in transfusion medicine, quality indicators as a QMS tool did not receive due attention until recently. Implementation of quality indicators is a complex process which requires scientific approach as well as testing and verification before routine usage. Quality indicators are defined on the basis of scientific concepts, own experiences, results of literature searches, discussion with experts within and outside the institution, etc. On setting quality indicators, the numerator and denominator should first be strictly defined. Quality indicators should be monitored continuously, including trend monitoring and detection of deviations. Whenever considered necessary, appropriate corrective measures have to be undertaken.