Unit Head: all
administrative load of
the department
Annual HOD targets:
planning & execution
Monitoring of the clinical
quality indicators
2
Identification , approval
& Monitoring of PDCA
Incident & complaints
handling , monthly
review
Monitoring of IPC, HAI
VAP CAUTI CLABSI
MRSA , trainings
Development &
implementation of
clinical pathway,
guidelines & protocols,
Monitoring through
supervised audits
Discuss &
recommendations for
CAPA/intervention from
medical record audit
reports
Dissemination &
communication of all
quality and educational
activities through
various forums
Making interventions,
implementation and
monitoring of
improvements fr