Quality assurance (QA) department involves in all activities that contribute to defining, designing, assessing, monitoring, and improving the quality of healthcare in Moi Teaching and Referral Hospital. These activities are performed as part of the accreditation of the facility, supervision of health workers, or other efforts to improve the performance of health workers and the quality of health services.

Quality Assurance department focuses on four core principles
1.Focus on the Client
2.Focus on Systems and Processes
3.Focus on Measurement
4.Focus on Teamwork

Focus on the Client
Health services exist to meet the health needs of clients, so the delivery of health services in MTRH is designed to meet those needs. A focus on the client examines how and whether each step in a process is relevant to meeting client needs and eliminates steps that do not ultimately lead to client satisfaction or desired client outcomes. This focus on the client is achieved by gathering information about clients and then designing services to cater to the needs that are discovered. A focus on clients not only involves people that come to the facility to receive services (referred to as external customers), but also addresses the work-related needs of personnel (referred to as internal customers) involved in the delivery of care. External customers include patients, suppliers and media whereas internal customers are hospital staff e.g. clinical and administrative personnel and each are important in achieving the overall goal of quality care.

Focus on Systems and Processes
MTRH management views all work in the form of processes and systems. Systems are arrangements of organizations, people, materials, and procedures that together are associated with a particular function or outcome. A system consists of inputs, processes, and outputs/outcomes. All processes are directed at achieving one goal or output from the system that encompasses the processes.
The Hospital has employed different types of processes. These include:

• Clinical algorithms: The processes by which clinical decisions are made
• Information flow processes: The processes by which information is shared across the different persons involved in the care
• Material flow processes: The processes by which materials (e.g., drugs, supplies, food) are passed through the system
• Patient flow processes: The processes by which patients move through the hospital they seek and receive care
• Multiple flow processes: Most processes are actually multiple flow processes, whereby patients, materials, information, and others are involved simultaneously in the same process of care.

Focus on Measurement
We use data to analyze processes, identify problems, test solutions, and measure performance. Data are important to us because they ensure objectivity.  The collection and analysis of data

allow us to develop and test hypotheses. Comparing data from before and after a change allow us to verify that the changes have actually led to improvements.
We use measurement and data to:

• Identify opportunities for improvement to initiate quality assurance efforts
• Detect and assess problems
• Verify possible causes of problems
• Inform decision making
• Show if a quality intervention yielded improvement and by how much
• Monitor processes over time to see if the change or improvement is maintained

Quality Assurance department uses both quantitative data, such as service statistics, and qualitative, such as customer feedback or comments from staff.
TRH believes that participation of major stakeholders improves the ideas generated, builds consensus about changes, and reduces resistance to change. Moreover, mutual support and cooperation arise from working together on a project, leading to increased commitment to improvement. Such an atmosphere of support discourages blaming others for problems. The accomplishment of a team often increases the members’ self-confidence. This empowers staff to work towards the goal of quality by motivating them to contribute their knowledge and skills to improve not only institutional but also individual performance.