Posted: May 12th, 2022

Quality Assurance In Government Hospitals Nursing Essay

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Quality Assurance is necessity in Medicare as with out it might be justifiably inconceivable to treatment sufferers and their given diseases. Lohr (1990) defines Quality Assurance as a methodically designed perspective that insures high quality programs to take care of the particular high quality necessities relevant for a services or products. It’s measured with customary requirements achieved both by way of private selection or optimum benchmarking and the given suggestions ensures the extent of high quality achieved. Contemplating the suggestions falls to a unfavourable cycle, Quality Assurance helps acknowledge the researched high quality illnesses after which helps in fixing the weak point to create optimum service and product.

Standardization could be very essential in offering very best options. This turns into more and more vital in providers sectors (Grimshaw, 1993). Hospitals around the globe try to fulfill world requirements the place they supply very best service, the character of labor in hospital is extraordinarily essential and it entails coping with lives of people (Laffel & Blumenthal, 1989). Due to this fact utmost precautions have to be taken in order that the very best and correct resolution is offered to the affected person.

Based on Restuccia (1982) the most important cause for hospital high quality assurance malfunction is the unfavourable Assessment required to provoke a conduct in doctor’s determination making ideology that might assure their ordering and using important and compulsory services. The prime motive for that is insufficient acknowledgment of the “intensive” experience used to deal with delicate sufferers, a data exemplified by the reliance of healing providers and the affected person’s response to those providers.

1.2. Assertion of the issue

Medical services are important to human survival however they aren’t standardized in every nation. Developed and flourishing nations have budgetary allocations to their public well being care sector and their public hospitals and embellished with astounding cutting-edge know-how and docs which are able to diagnose and repair any attainable sickness. This nonetheless isn’t true for all nations around the globe; these within the stance of growth need to suffice on the given personal hospitals as they’re the one glimmer of hope contemplating their public well being establishments are failing.

“Quality Assurance in Government Hospitals of Saudi Arabia: Case of Hospital in Qassem” will Help assessing the diversion of public well being care services within the Kingdom of Saudi Arabia and examine it with flourishing public well being establishments of the West.

1.three Objective of the examine

The report will develop the parity between high quality requirements and precise observe in hospitals of KSA. The final norm of the Center East and the African Peninsula considers public hospitals as ineffective and inefficient, the thesis paper will purpose to generalize this conference and see if the final perception is right concerning medical practices.

The analysis paper will Help bridge the hole between medical services offered by KSA and therefore evaluating the standard requirements of these medical associations with Western requirements. It is going to Help us test if the general public hospital providers in KSA are disadvantaged of worldwide well being necessities and medical advantages and standardization.

1.four Analysis Goals

The dissertation will purpose to

Direct the well being sector of the Kingdom of Saudi Arabia and therefore develop an inventory of high quality requirements that can be used as comparability benchmarks with Western nations and their public hospitals identified for his or her utmost advantageous medical practices.

It will Help in evaluating the offered medical services by KSA after which utilizing them as variables for additional reference and intense descriptive examine.

The analysis will additional purpose to deliver a factual potion between observe and idea and goals to bridge the hole between any disparities by figuring out greatest worldwide normal practices.

1.5. Analysis Questions

To perform the analysis goals and targets we are going to take the Helpance of outlined analysis questions that can give base and basis to the dissertation. The analysis questions are as adopted:

Can high quality requirements efficiently obtain enchancment in efficiency or they’re simply there for the paper work?

What high quality requirements are maintained by Hospitals of (UK/USA/Germany)

How completely different are these requirements to high quality requirements of hospitals in KSA

What relationship exist between written requirements and precise observe of high quality requirements in KSA

What areas of enchancment exist in elevating present high quality requirements

What are obstacles to greater high quality assurance and requirements

How can KSA hospitals study from greatest worldwide observe?

1.6 Analysis Speculation

H1: Hospitals in Qassem: Saudi Arabia follows standardized qc.

H2: Hospitals in Qassem: Saudi Arabia benchmarks their high quality assurance with Western medical establishments.

H3: There’s a discrepancy between public well being establishments of Qassem: Saudi Arabia and people in Europe and America.

1.7 Limitations, Assumptions and Design Controls

The confinement of a examine pertains to these traits of plans or ways that collide or manipulate the relevance or elucidation of the implications of a examine. They’re the constrictions on simplification and the comfort of pronouncement which are consequential to the tactic during which the chosen structure of the examine is acquired to institute inside and peripheral legitimacy (Lambert, 1992).

In this paper there have been numerous attainable limitations. Many hospitals and their related workers don’t speak concerning the faults within the hierarchal construction and the know-how development. Medical establishments are a wholesome placebo for sufferers and the given inside employees didn’t wish to shatter that phantasm in any attainable method. Accumulating completely dependable knowledge based mostly on this was fairly problematic for the validity of the analysis.

1.9 Abstract

The dissertation goals to determine the diversion of medical utilities and services out there for the general public of Kingdom of Saudi Arabia. It is going to Help acknowledge the important thing benefits and attainable developments in medical know-how in KSA and in addition determine any attainable issues which are skilled in offering optimum medical expertise within the public hospitals of KSA.

This dissertation can be achieved by using varied major and secondary sources and the chapters after this can be categorized in response to their vital and their recognition within the analysis. The literature critiques in Chapter 2 will Help determine the given associations and norms with medical services around the globe and their growth and standardization. The literature Assessment will Help us perceive the fundamentals of the analysis and why high quality assurance is important for the success of medical services.

Literature Assessment

2.1 Introduction

Rowley (2004) examined the importance of a literature Assessment by assessing its significance in supporting and guiding content material in a analysis. Based on Rowley (2004) a literature Assessment is a synopsis of various literature concerning a topic area. Literature might be taken from completely different dependable sources to higher perceive the content material of the analysis and different work finished on the subject.

Completely different research present that small priority is consigned on affected person’s expectations of service high quality (Baldwin, 2002). In contrast to merchandise, service differs and never everybody can reap the very same advantages as the opposite round. Based on Carson (1998) the principle cause behind a distinction in judgment concerning the effectiveness of well being care establishments is as a result of problem of measuring the success fee in addition to the efficiency and methods of these offering the service.

Quality in well being providers might be signified because the service that’s wanted by both a person or a inhabitants (Morgan, 1990). Assessment of high quality in healthcare is kind of troublesome because the outcomes aren’t secure and fixed however shifting. The success fee and the failure fee fluctuate continually however morality fee is a variable that can be utilized to evaluate the efficiency of a well being service (Renwick, 1992).

Based on Tang (1999) there are three sides of high quality administration in hospitals, the primary is recognizing efficiency and computing efficiency. The second step is deciding if the given requirements match with the scenario and eventually the third thought talks about recovering esentation when requirements should not met. Based on Schaaf (1989) high quality assurance and administration is vital as medical services are just for the advantage of sufferers and the sick therefore the requirements have to be written and designed that might significantly profit those that they’re supposed for. Figuring out and measuring high quality is troublesome and in response to Hammer (1993) high quality assurance is kind of vital and Hammer’s (1993) analysis on 20 hospitals in Singapore confirmed the completely different high quality administration actions prevalent in these hospitals. The conclusion lastly confirmed that there have been three primary arenas of high quality that needed to be developed; a brand new service high quality program for workers, high quality orientation and suggestions from sufferers concerning the service they acquired.

Design and conformance is a crucial side of high quality assurance with regard to hospitals (Borys, 1996). Based on Palmer and Dunford (2002), retaining the hierarchy of a medical group small helps in sustaining efficient high quality requirements as de-layering the hierarchy shortens the design and above each subordinate there’s a watchful eye that helps enhance motivation and withhold high quality requirements.

Quality in well being care isn’t outlined by requirements solely however by assembly buyer calls for. Based on Garwin (1984) the mere points of high quality in well being care was round affected person satisfaction, components reminiscent of retaining appointments with sufferers and treating them professionally and checking their outcomes continually in addition to their earlier historical past confirmed high quality and marked it. Aside from this docs and physicians in private and non-private hospitals had been informed to stick to carefulness and safety, saying that these had been two main high quality assurance variables.

2.2. Completely different notions about high quality assurance in well being care

Bij (1998) means that high quality in well being care is quite a bit like that in a corporation or one other generic service. Quality in well being care must be adopted similar to that in a corporation or there could possibly be lives misplaced, similar to losses gone and clients misplaced. Based on Vries analysis (1992) high quality requirements in well being establishments have to be managed, monitored and improved. Requirements have to be set and managed after which the given high quality assurance methodologies have to be monitored to test in the event that they’re adopted and eventually if there are any issues then they have to be improved or else the failure of high quality assurance would result in issues within the well being establishment when it comes to medical efficiency and treating sufferers.

The essential motive behind high quality enchancment in well being group is to current sufferers with excellent service by incessantly bettering providers (Balding, 2007). Organizations all around the globe are actually attempting their greatest to enhance affected person security and that is attainable solely with the Helpance of high quality assurance requirements (Carool, 2007).

To take a step additional, Eboch (1998) talks about completely different high quality components that have to be current and are vital in the case of high quality assurance. In Eboch’s view high quality assurance applications ought to apply to all medical establishments, from private and non-private hospitals to private clinics, high quality strategies have to be measured and a few primary variables must be assessed concerning high quality, these might be the standard of remedy that’s given to sufferers and the an infection or dying charges prevalent within the hospital. Aside from that high quality assurance in hospital shouldn’t keep on with medical services solely but additionally must be regarded upon in depth concerning affected person and “household” satisfaction, which means ready space and good meals out there to not solely the affected person however to those that stick with them.

Jackson (2004) talks concerning the begin of high quality administration and assurance in america and the way it has developed in time contemplating know-how and client necessities. The primary medical requirements that had been set had been by the American Faculty of Surgeon’s. They determined to implement sure requirements in the case of high quality assurance in medical remedy and tried to observe these tips; organizing the hospital and its employees, hiring employees that was skilled and well-learnt, medical information wanted to be saved and insured in order that in case a affected person returns his/her historical past can be already out there to lock time and reduce down prices. As soon as these bases for medical high quality had been acknowledged quickly others adopted; in 1996 newer medical requirements had been constructed and these required medical trainers and docs to coordinate work with welfare, present good remedy to each private and non-private hospitals and in addition require clever and double checks on affected person historical past and present scenario earlier than advising operations or severe measures. A lot of the requirements set by the American union within the 20th century present foundation for as we speak’s requirements in medical well being.

Kilo, (1998) revolutionized the way in which of high quality assurance in medical care within the American peninsula. He developed a steady high quality enchancment and assurance plan that really useful all medical establishments to develop a separate high quality assurance division and never contain medical physicians in them immediately, other than this Kilo talked about emphasizing the affected person and physician relationship and in addition investing in fixed enchancment in regard to high quality. Docs had been additionally suggested to keep away from jargon language in hospital administration and with sufferers and in addition coaching all hospital employees and administration to know the requirements arrange by the hospital administration and cling to them.

Aside from Kilo, Dalley (1990) performed a examine with the Division of Well being in York College and tries to asses the standard requirements arrange by the well being authorities there in addition to different locations affiliated with York. It was seen that almost all medical establishments, each private and non-private took high quality administration fairly significantly and recognized completely different high quality assurance strategies to improvise high quality of their establishments. It was seen that the majority establishments had employed particular managers who ignored high quality assurance they usually had been particularly employed as a result of their earlier background in medication. Aside from this these managers performed high quality critiques twice in a month and in addition tried to determine high quality enchancment strategies after high quality assurance was finished.

2.three Significance of high quality assurance

In his examine, Ronen (1995) described the significance of high quality assurance and why it needed to be carried out in well being care. Based on his observational analysis on hospitals in Israel it was seen that with out high quality assurance there was no common management or normal out there to which actions needed to be finished. Docs and nurses acted on their very own accord, treating once they favored and utilizing non-methodological methods. From 10 hospitals, 6 got high quality management manuals to observe and the remainder four might do no matter they wished to on their accord. The analysis led to the validity and proof of the assertion that with out high quality assurance and management, medical well being and health-care couldn’t prosper as there wasn’t any rule or legislation to be adopted which brought about misery.

2.four. Assessment of high quality

Hill (1991) assessed alternative ways of assessing high quality management in well being care establishments. Based on him remark was the primary greatest analysis method nevertheless it had its drawback as docs and nurses had important thought about their Assessment and carried out higher than they’d on regular days. Technological gadgets reminiscent of cameras can be utilized however this raises the moral notion of consent.

Vuori (1988) examined the state of high quality assurance in medical establishments in the course of the 20th century. Based on her analysis on hospitals round America and Europe it was seen that docs within the 20th century considered themselves as overconfident and therefore didn’t want any controls or manuals to help them on how work wanted to be finished. Earlier than high quality assurance requirements had been designed for well being care services completely different instruments had been used to evaluate the conformity of well being care providers (Steven, 1996). An instrument referred to as the SERVQUAL decided the tangibility, reliability, responsiveness, assurance and empathy in buyer discernment and this was later relevant in medicinal organizations as effectively (Scardina, 1994).

Understanding the flexibility of a phrase with regard to its area and context is kind of important (Shaw, 1986). Healy (1988) examined completely different terminologies in high quality assurance on the subject of well being care and contemplating high quality assurance refers to actions and features involved with the attainment of high quality, it must be understood on the subject of well being care.

Robinson (1995) assesses high quality assurance and its significance in well being care. In his analysis he carried out high quality assurance applications in each public hospitals and personal hospitals to evaluate the change in employees and medical efficiency. His outcomes confirmed that the implementation of high quality assurance manuals and high quality management checks elevated employees efficiency in each kinds of hospitals.

In her examine, Rachel Fleishman (1996) designed a sensible construction for the Assessment of intervention applications to increase and advance the standard assurance strategies in public hospitals. Her design examined three components in high quality assurance, course of analysis, impression analysis and summative analysis. Her analysis confirmed that though the standard assurance design was carried out, the brand new change wasn’t fortunately adopted by the hospital administration. Conclusively the standard assurance design didn’t Help enhance the efficiency in hospitals and the design failed in regard to high quality assurance.

Naveh (2005) examined the consequence of high quality enhancement applications on hospital presentation. His analysis carried out on hospitals in Israel confirmed that high quality implementation finished on eight out of 14 hospitals labored fairly effectively, displaying outcomes of elevated efficiency in each medical services offered in addition to within the organizational hierarchy.

Quality assurance is a major route however provided that it’s paired with high quality administration (McKee, 2000). Based on Hore (1994) high quality assurance is nothing with out high quality administration as in response to her analysis she assessed six hospitals within the state of New Jersey and instigated each high quality administration and assurance in three and solely high quality assurance within the different three. Conclusively it was seen that hospitals with out high quality administration didn’t care a lot about high quality assurance and though adopted the standard manuals and controls within the begin, they quickly fell to their very own methods as their was nobody to Question Assignment or assess their motivation.

2.5. Quality variations in personal and public hospitals

All through literature and other people’s perceptions we discover that almost everybody believes personal providers to be extra environment friendly, productive and promising than these offered within the public sector (Tian, 2000). Chaker (2003) compares the variations in high quality assurance and rules in personal and public hospitals utilizing Parasuraman’s SERVQUAL instrument for measuring high quality, Anderson (1995) used this instrument to measure the providers given by a well being clinic that resided within the College of Houston Well being Middle. Anderson’s examine confirmed that folks weren’t absolutely glad when it comes to high quality as there was much less empathy in hospital employees they usually didn’t give a lot significance to sufferers when it comes to fixed checks and visits. . Based on Chaker, this instrument is each dependable and legitimate in the case of testing and has been used many occasions in measuring high quality by hospital managers and administrators. Chaker’s examine was performed within the Center Japanese nation UAE and 400 questionnaires had been distributed in each private and non-private hospitals based mostly on the SERQUAL instrument and the conclusion once more confirmed that sufferers in public hospitals weren’t very happy with the remedy they acquired and rated high quality low in public hospitals saying that they may have acquired significantly better remedy in a non-public hospital.

Based on Evans (1999) high quality assurance is extraordinarily vital in the case of measuring high quality and requirements however high quality must be improved as effectively and that’s finished by way of fixed high quality enchancment, a component that tries to measure the variations in high quality and enchancment in know-how and perceptions after which implementing new modifications in high quality. Costin (1999) talks concerning the completely different objects that Help in figuring out high quality after which later enhance it; these components comprise a top quality committee that works in a particular division donated just for the aim of high quality, a top quality enchancment plan and a funds that must be allotted to seek advice from high quality enhancements that have to be acknowledged.

Overtveit, (2001) talks about high quality assurance and completely different high quality strategies in Japan. Based on him high quality assurance wasn’t carried out very significantly in Japanese healthcare however as occasions modified and because the world flourished the Japanese needed to observe the Western tips of high quality assurance. The Japanese began utilizing well being care reforms to implement high quality requirements in well being care and this pushed each private and non-private hospitals to begin designing strategies for high quality assurance and administration.

Ishikawa (1990) recognized the initiation of high quality assurance in Japan. Based on him high quality assurance strategies began within the early 80’s however quickly fell as these designing high quality assurance requirements had been utilizing strategies these utilized in enterprise administration. Whole high quality administration and high quality circles had been good concepts to implement however these didn’t attain a excessive level in Japanese high quality assurance design as they realized that well being care was a special job as in comparison with enterprise actions and manufacturing.

As Ishikawa talks about high quality assurance strategies in Japan, Hazilah (2009) helped describe the standard administration and assurance relevant in Malaysian public hospitals. Our examine talks about high quality assurance strategies within the Kingdom of Saudi Arabia and it’ll help our examine to know the standard assurance strategies of one other Muslim nation with an economic system reminiscent of that of Saudi Arabia. Hazilah (2009) performed a analysis to know the standard assurance strategies in public hospitals on all ranges; from metropolis to state to nationwide, greater than twenty hospitals had been assessed to supply a sound reasoning to his examine. Often publicly working medical establishments attempt to benchmark the standard requirements set by the personal hospitals disposed within the personal sector (Manaf, 2006).

Hazilah (2009) despatched questionnaires to those hospitals and came upon that had been loads of high quality assurance and administration methods occurring. Firstly the hospital employees met normally to debate the standard area within the public hospitals however this was finished solely in 16 hospitals out of complete of 22, other than this almost all of the hospitals that had been examined confirmed the synchronization of workers and docs collectively to learn the sufferers and in addition confirmed a lot of the hospitals benchmarking methods utilized by Western hospitals and a few developed their very own, displaying that the present area of high quality assurance and administration in Malaysia was going fairly effectively.

2.6. Standardization

Kume (1993) talks about standardization saying that respectable requirements have to be arrange earlier than any goal is to be achieved however he additionally talks concerning the problem in designing these requirements. Many say that setting requirements generally limits improvements and new concepts (Okusa, 1985) however standardization is a crucial ingredient in efficiency and in attaining targets, as requirements divide methods into good and relevant and dangerous and unrelated (Kondo, 2000).

2.7. Significance of standardization

Standardization is extraordinarily vital in the case of well being care, its one of many primary components that retains medical remedy right and equal in all components of the world (Shtub, 2010). Based on Shtub’s (2010) analysis, standardization is a hospital is carried out in each motion. Hiring docs and nurses, designing and constructing emergency and working rooms and even the complete structure of the constructing must observe particular requirements and entail standardization. In his analysis Shtub (2010) tried to develop a standardization mannequin for hospital physicians and tried to develop completely different requirements and preliminaries for hospital departments reminiscent of surgical procedure, gynecology and pediatrics.

Aside from Shtub many different researchers have tried to design strategies of standardization for medical services, Pelletier (2003) tried to design standardization fashions for worker staffing in hospitals however his examine didn’t succeed because the complexity of well being care is kind of troublesome and other than personal hospitals, the general public hospitals in Pelletier’s analysis didn’t accommodate the design.

Many methods have been created to Help in standardization and Cruz (2006) remained no far behind. His design was a pc based mostly system that might Help in planning the hiring of physicians in hospitals in response to given requirements. His mannequin tried to determine the entire want for physicians within the hospital he was researching in by checking into all departments. Physicians who despatched their proposals had been checked concerning their CV’s and matching the weather with the given requirements set by the software program they usually had been then employed to characterize the medical facility. Aside from Cruz, in 1991 america of American tried to design a standardization methodology for staffing physicians on the Veterans Administration Hospital (Libscomb, 1991). The committee designed two strategies of standardizing the hiring of physicians. One was represented utilizing a statistical mannequin that labored very similar to Cruz (2006) mannequin and represented the necessities for the doctor and the given requirements to match the 2 in response to given parameters. The second mannequin was developed when the primary failed and mixed the statistical software program with an knowledgeable judgment mannequin that not solely calculated the parameters and their complete but additionally confirmed the professional’s and con’s of hiring every doctor and retaining him/her within the hospital.

Though standardization is utilized all around the world with regard to high quality management there are nonetheless many cultures which have promising well being establishments whereas many are nonetheless attempting to construct medical establishments that observe a given goal (Paul, 2006). In his analysis, Ababaneh (2010) tried to evaluate the standard assurance in Jordan’s public hospitals. The outcomes confirmed that though their had been high quality assurance requirements required to be adopted; many hospitals didn’t give them a lot significance and failed in accord of their high quality.

Based on Fagersorm (2001) standardization in hospitals concerning physicians and nurses is kind of vital. Each private and non-private hospitals in the complete European Peninsula have sure standardization fashions for its employees. Fagersorm (2001) breaks down these fashions into eleven classes. When the necessity for hiring a employees arises you will need to observe that a employees must know 1) updating actions which embody morning conferences and x-ray conferences with sufferers, 2) sick rounds that comprise of morning, night and night time rounds, three) clarifications and accumulating data which accommodates the duty of laptop, phone and frontal clarifications in addition to receiving studies, four) interacting with sufferers and this not solely included the affected person however his household and in addition bodily examination and taking blood, 5) conferring and session that contains of session in addition to employees briefing, 6) documentation, this contains the preparation of the letter of launch and orderings x-rays and different medical examinations, 7) ready, eight) administrative actions that features planning and controlling, 9) analysis and examine which requires the individual to accompany college students and conduct researches, 10) actions outdoors the division that include operation and session amongst different departments and eventually 11) private, which incorporates getting meals and private hygiene.

A significant standardization methodology adopted for well being care is the signified Worldwide acknowledged Commonplace for Quality Techniques, the ISO 9000 (McCarthy, 1994). Utilizing this standardization methodology all around the globe makes it simpler for establishments to measure the efficiency and high quality of labor finished in well being establishments in several areas (Rooney, 1989).

In his analysis, atham (2005) examined the efficiency of public hospitals within the Center Japanese nation; Oman. The collected outcomes confirmed that from a complete of 5 hospitals, three that had been public didn’t present excessive efficiency in regard to medical services though they acquired a heavy quantity of funds from the federal government. The two personal hospitals then again thrived as they’d cutting-edge know-how and docs educated from all around the world incomes heavy incomes.

2.eight. Issues with high quality assurance

Discrimination is usually famous because the synonym for inequality (Wendell, 2003), Discrimination in public hospitals is an outdated phenomenon (Kleiner, 2001). Kerim Ozcan (2011) recognized the completely different components of discrimination in public hospitals of Turkey. By conducting a analysis on well being care workers it was seen that employees in public hospitals is a sufferer to discrimination. Nurses and feminine docs are a sufferer of distrust as folks really feel that they don’t purchase the expertise to be a health care provider. Age was additionally discovered to be a unfavourable level is youthful docs had been discovered to be victims of discrimination as folks most popular older docs in public hospitals, stating them as they’d extra expertise they had been a extra preferable selection.

Based on Sturm (2001) there may be lots of “second era” discrimination in public hospitals. Many don’t choose feminine docs or employees and reject their purposes, inflicting gender discrimination and other than this there’s a primary discrimination of know-how, high quality assurance and operations. As public hospitals obtain their funds to the board, most use them up for their very own private profit leaving fairly little for the hospital. Corruption is a a simple to seek out ingredient in public hospitals (Acker, 2006) and contemplating this Sturm talks concerning the problem or negligence in implying high quality assurance. Non-public hospitals must make earnings and a popularity to take care of contemplating they’re costly they may solely attain sufferers if it has a reputation. A public hospital then again will keep there, funded by the federal government therefore effectivity and profitability aren’t the 2 most important targets of working. Those that work in these hospitals attempt to forgo high quality assurance contemplating they don’t actually have any fundamentals for requirements and manuals to observe (Urwin, 2006).

Zernott, (1993) talks about one other downside with high quality assurance and that’s the distinction in a typical foreign money. Financial theories don’t actually come into the scenario of well being care however Zernott talks concerning the problem of working and measuring high quality assurance with requirements contemplating that each nation in a continent has a special foreign money. The budgets designed to challenge and management high quality assurance could possibly be standardized however with the issue of fluctuating currencies it might be inconceivable to take action. No matter funds the UK points for high quality assurance design it is likely to be too c