Your SlideShare is downloading. ×
0
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Quality Assurance in Hospitals
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Quality Assurance in Hospitals

40,093

Published on

The presentation describes in a comprehensive manner the various aspects of quality and how to develop a quality assurance system in the hospital.

The presentation describes in a comprehensive manner the various aspects of quality and how to develop a quality assurance system in the hospital.

Published in: Business, Technology
14 Comments
63 Likes
Statistics
Notes
No Downloads
Views
Total Views
40,093
On Slideshare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
0
Comments
14
Likes
63
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. QUALITY ASSURANCE IN HOSPITAL DR. N. C DAS
  • 2. QUALITY ASSURANCE SYSTEMQuality assurance is a range of activities (including review, evaluation,surveillance, appraisal and monitoring) which collectively comprise theintelligence gathering arm of quality assurance.These are:- * Quality consists of doing those things necessary to meet & exceed theneeds & expectations of those we serve & doing those right things rightevery time . * * * *Review is the process of critical reflection used byclinicians wishing to assess their own (or their peers) performance* Audit is the activity of review when conducted on a continuous androutine basis.* Evaluation is one-off assessment of the impact of a service on indices ofhealth* Surveillance is routinely repeated evaluation* Appraisal is ad hoc data collection and analysis by management inrelation to health care delivery* Monitoring is ongoing appraisal
  • 3. QUALITYQUANTUMUPHOLDASSUREDLEVELINTESTYEILD Dr.N.C.DAS
  • 4. WHAT IS QUALITYQuality is not a number but is a function of positive perception.Quality, simplistically, means that a product should meet one‟srequirement.Quality is the inherent characteristic & distinctive attribute thatmakes a product different from others.Ensures conformity to requirement.Products & services should be essentially free from defects ,there by becoming cost effective.Quality consists of doing those things necessary to meet &exceed the needs & expectations of those we serve & doing thoseright things right every time .It is the result of good intention, sincere effort, intelligentthinking and skillful execution.All dimensions like accessibility, appropriateness, continuity,effectiveness & efficiency must be given equal importance inquality.
  • 5. QUALITY MANAGEMENT“It is a holistic approach to the art ofmanaging quality output consideringtogether the people, process and productsrather than independent factors and driventowards the objective with effective &efficient performance output”. DR. N.C DAS
  • 6. QUALITY REQUIREMENTS1.Customer participation in QM;2. Leadership for the steering of quality;3. Personnel as a prerequisite for high quality;4. QM for preventive as well other activities;5. Management of processes as a basis for QM;6. Information as a basis for the continuousenhancement of quality;7. Systematisation of QM;8. Feed back and detailed recommendations;9. Quality criteria support quality management;
  • 7. WHY QUALITYRapid advance in Health care sector.Rapid development in diagnostic and operation technology.Increased awareness of people about health.Stiff market competition.Improved communication technology and roll of Media.The service is for allouring the pain, sickness and disease.The service is patient centric and person specific.Provided by a team of highly skilled to non skilled group ofdoctors, nurses and other medical staff.The type of function is multi centric and multifaceted.The over all objective is good patient care up to their level ofsatisfaction.There is only one answer to this --- A good quality systematicHealth care by developing a carefully planned hospitalquality management system..
  • 8. QUALITY ASSURANCE SYSTEM DR. N. C. DAS
  • 9. QUALITYQUANTUMUPHOLDASSUREDLEVELINTESTYEILD Dr.N.C.DAS
  • 10. WHAT IS QUALITYQuality is not a number but is a function of positive perception.Quality, simplistically, means that a product should meet one‟srequirement.Quality is the inherent characteristic & distinctive attribute thatmakes a product different from others.Ensures conformity to requirement.Products & services should be essentially free from defects ,there by becoming cost effective.Quality consists of doing those things necessary to meet &exceed the needs & expectations of those we serve & doing thoseright things right every time .It is the result of good intention, sincere effort, intelligentthinking and skillful execution.All dimensions like accessibility, appropriateness, continuity,effectiveness & efficiency must be given equal importance inquality.
  • 11. DIFFERENT PERCEPTION OF QUALITY PROVIDER RECEIVER ORGANISER• To provide care as per • Accessibility • Social Equity established norms • Affordability • Effective public• Doing the right thing resource utilization • Prompt attention• Doing it the right way • Standardised care• Doing it right the first • Less waiting time • Cost contentment time • Receiving the right •Satisfaction of both• Doing it on time service for their use provider and receiver without exceeding cost • Being satisfied that their • Fruitful outcome• Availability of needs have been met • Profit margin Adequate resources • Early cure and return to• Satisfaction with the work final outcome • Being treated with• Helps in improving integrity, courtesy and skills, efficiency and respect experience
  • 12. DIMENTIONS OF QUALITYJoint commission on Accreditation of Health care organisations (JCAHO) hasdescribed the following criterias as quality dimensions(safety, effectiveness, efficiency, timeliness, efficacy and equityRespect and caring, availability, appropriateness), RESPECT AND SAFETY TIMELINESS CARING EFFICACY EFFECTIVENESS EFFICIENCY APPROPRIATENES CONTINUITY AVAILABILITY S/ EQUITY
  • 13. WHY QUALITY IS NEEDEDRapid advance in Health care sector.Rapid development in diagnostic and operation technology.Increased awareness of people about health.Stiff market competition.Improved communication technology and roll of Media.The service is for allouring the pain, sickness and disease.The service is patient centric and person specific.Provided by a team of highly skilled to non skilled group ofdoctors, nurses and other medical staff.The type of function is multi centric and multifaceted.The over all objective is good patient care up to their level ofsatisfaction.There is only one answer to this --- A good quality systematicHealth care by developing a carefully planned hospitalquality management system..
  • 14. ADVANTAGE OF QUALITY– Reduction in • Improved care wastage • Shorter lead times– Better team spirit • Better relationship with– Less staff conflict, customers enhanced job • Reduced cost, increased satisfaction profit– Increased efficiency • Improved systems and– Confidence to standardized procedures clients, • Better workmanship,– less customer • Guaranteed quality complaints,– lower rejection rates, less rework
  • 15. QUALITY REQUIREMENTS1.Customer participation in QM;2. Leadership for the steering of quality;3. Personnel as a prerequisite for high quality;4. QM for preventive as well other activities;5. Management of processes as a basis for QM;6. Information as a basis for the continuousenhancement of quality;7. Systematisation of QM;8. Feed back and detailed recommendations;9. Quality criteria support quality management;
  • 16. PARTS OF THE QUALITY SYSTEM Organization Personnel Equipment Process Purchasing Control Information (QC & EQA) & Inventory & Specimen Manageme Management nt Documents Occurrence Management Assessme & Records nt Process Customer Facilities & Improvement Service Safety CDC
  • 17. COMPONENTS OF QUALITY SYSTEM PROMOTING QUALITY CORRECTING QUALITY QUALITY SYSTEMDetermination Promotion Policy and Beneficiaries of empowerment of Quality management standards and requirement and decision making participation guidelines Regulations Health Management outcomes systems for Payment Quality Practices monitoring quality System mgt. Satisfaction Information Complaints
  • 18. HOSPITAL QUALITY SYSTEM QYALITY SYSTEM INTERNAL EXTENALQUALITY SYSTEM QUALITY SYSTEMORG STRUCTURE HOSPITAL ACREDITATIONSAFETY, EFFECTIVENESS, ISO CERTIFICATIONEFFICIENCY, TIMELINESS, EXTERNAL MEDICALPATIENT-FUCUSED EQUITY AUDIT
  • 19. COMPONENTS OF INTERNAL QUALITY SYSTE OUTCOMESSTRUCTURE PROCESSES OF CARE INPUTS STEPS OUTPUTS•Patients •Inventory Methods •Physiologic•Equipment •Coordination parameters•Supplies •Physician orders •Functional status•Training •Nursing Care•Environment •Ancillary staff OUT COME •Housekeeping •Transport • Patient Satisfaction •Cost
  • 20. INPUT---PROCESS----OUTPUTA. INPUT Input is what we invest inputs are the various needs and resources that projects can draw upon as it sets out to accomplish its work. Inputs include resources like manpower, data, and money and materials.B. PROCESS Process is the ensemble of activities of planning , implementing and monitoring the performance of an activity. Process manipulates the inputs to get the output. It include functions, actions, and operations. Process management is the application of knowledge, skills, tools, techniques , and systems to define, visualize, measure, control, report and improve processes with the goal to meet customer requirements.C. OUTPUT Outputs, are the results of processes, which include products, information, and reports. It disseminate (output) data and information and provide a feedback mechanism to meet an objective. Outputs are the results of processes.
  • 21. D. OUTCOME•It is the Impact of a process.•It may be a level of performance, or achievement.•It may be associated with the process, or the output.Outcomes imply quantification of performance.Outcomes imply quantification of performance.It may include cost reduction , Product appreciation or client satisfaction.The out come may be:- Short Term (learning: awareness, knowledge, skills, motivations) Medium Term (action: behavior, practice, decisions, policies) Long Term (consequences: social, economic, environmental etc.)
  • 22. INTERNAL QUALITY SYSTEM IN PUT PROCESS OUTPUT i). QUALITYi). PERSONNEL i). SOP Error ofii) MATERIAL ii). INTER treatment./Deathiii) SUPPLIES PERSONAL Complicationiv). FINANCEv). TECHNOLOGY RELATION LAMA, AVLSvi). RULES AND iii). ART OF CARE ii). QUANTITY REGULATIONS iv). MANAGEMENT BTR, BOR, OT TECHNIQUES Disability v).DOCUMENTATION iii). COST iv). CONSUMER SATISFACTION INPUT PROCESS OUT PUT CONTROL CONTROL CONTROL
  • 23. COMPONENTS OF QUALITY SYSTEM1. INPUTS•Adequate buildings and working space•Necessary equipments always available and functioning•Necessary medications and medical supplies always available•personnel•Anybody who touches the patient or a relevant process in the system:-Departments, physicians, clerks, pharmacy, nursing, OT, ICU, care technicians,phlebotomist, patient transport, administration2. PROCESSES•All those affecting relevant aspects of patient care:-Clinical decision making, order writing, admission intake, medication delivery,direct patient care, discharge planning, communication, discharge follow-up, etc3. 4. OUTPUT•Which are the end result of the process :-Physiologic parameters, (Meeting standards )functional status, (Efficiency, Effectiveness, Quality)5. OUTCOMEWhich are the end result of the outputPatient satisfaction ,Cost
  • 24. QUALITY SYSTEMQuality does not happen by chanceQuality needs to be systematicallydevelopedWith objective planning, staffinvolvement and considering patientneed.
  • 25. DEVELOPING A QUALITY SYSTEM Quality system Quality Manual Quality procedures Quality plan Quality audit
  • 26. QUALITY SYSTEMSTAGE 1 –Chief executive of the firm should commit to quality assurance bydeclaring quality policy e.g. „Towards total customer satisfaction‟Make formal statement of the objectives e.g. „ To achieve ISO 9002certification in 18 months‟Organizing management structure and defining responsibilitiesfollowing the above activitiesSTAGE 2 –Examine and review the existing internal documentation, activities andprocedures prior to preparation of quality manual and qualityprocedures i.e. quality systemSTAGE 3 –Apply general quality procedures to specific contracts when the qualitysystem is completed and fully approved internally.Staff should be familiar with quality assurance and understand theirroles but training is required.
  • 27. QUALITY SYSTEMSTAGE 4 –Prepare quality plans and additional quality proceduresfor specific contracts.STAGE 5 –Apply quality plans to specific contracts. Training may benecessary.STAGE 6 –Internal and external audit of quality system; reviewperiodically all quality manuals and procedures.
  • 28. QUALITY MANAGEMENTIt is a holistic approach to the art ofmanaging quality output consideringtogether the people, process andproducts rather than independentfactors and driven towards theobjective with effective & efficientperformance output.
  • 29. ELEMENTS OF QUALITY MANAGEMENTErrors in the hospital are invariably due to system failure in85% ofcases(Edward Deming).Only 15% are attributed to people‟s performance.Therefore attention should be given on bad system than bad people.Improvement of systemic errors can be done by:-Commitment of TOP Management,Active support of Middle Management.Education and training of staff.Formation of quality management team.Developing Quality culture in the work place.Making aware all staff about the goal and objective of the organisation.Developing quality policy and quality manual.Developing Standard Operating Procedure for all areas (SOP) .Good Hospital Information System (HIS).Formulation of criterias and Standards for Measuring activities.Constant monitoring and Supervision and feed back.Introducing Medical Audit System.Rectification of errors and Evaluation.External quality control.
  • 30. COMPONENTS OF QUALITY MANAGEMENT SYSTEM QUALITY QUALITY PLANNING CONTROL SYSTEM PATIENT NEED QUALITY SATISFACTION QUALITYIMPROVEMENT ASSURANCE TOTAL QUALITY MANAGEMENT
  • 31. COMPONENTS OF QUALITY PLANNINGPOLICY STATEMENT RISKS AND ON QUALITY RISK MANAGEMENT PLANNING RECORDS AND DOCUMENTATION QUALITY MANUALWORK INSTRUCTION OR WORK SHEET SOP
  • 32. 4 TIER QMS DOCUMENTATION QUALITY MANUALTIER-1 (objectives, policies, philosophies) PROCEDURES MANUAL TIER-2 (purpose, scope, standard) JOB INSTRUCTIONS TIER-3 (work sheet/specific work instructions) TIER-4 FORMS & RECORDS
  • 33. QUALITY MANUAL CONTENTS AIMS AND STANDARDS LEVEL OF MANAGEMENT OBJECTIVES AND CRITERIA SYSTEM CONTROL CORECTION JOB AND DESCRIPTION EVALUATION QUALITY MANUAL MONITORING DEVELOPING AND HIS SUPERVISION QUALITY QUALITY ORGN. TRAININGMEASUREMENTS DIMENTIONS ANALYSIS
  • 34. 1.ORGANISATIONAL ANALYSISOrganisation structure must meet the organisational functions and Objectives.Review organisational relationship with its external environment.Analyse organisational structure with respect to Hierarchy, span of control ,Authority and delegation.Functions, Work distributions and accountability.Identify Problem areas, analyse to understand the „Cause and Effect‟ for suitableremedial measures.2. TRAININGTrain the management about quality System.Train the Quality monitoring team.Training of staff how to maintain quality at work place and their specific roll.3. DEVELOP HISi) Hospital operation Statistics. - Hospital Resources and their utilization. - Administrative and financial data.ii). Hospital Morbidity Statistics. - Patient characteristics - AVLS, BTR, BOR, Infection rates. - Consultations, complications and Errors. - Type of treatment, investigations. - Outcome of hospital stay, Events, Death/ Discharge.
  • 35. FORMULATION OF CRITERIA AND STANDARDS INDICATRES AREAS Prevention Ambulatory care sensitive Quality Indicators Conditions, House keeping, HIC. BMW disposal. Inpatient Quality Mortality following Indicators ( PROCESS) procedures Mortality for medical conditions Utilization of procedures Volume of procedures Patient Safety Post-operative Indicators complications Iatrogenic conditions/Errors.
  • 36. SERVICE QUALITY MEASUREMENT STRUCTURE PROCESS OUT COME i). QUALITY OF CAREi). STRUCTURE i). PHYSICIAN AND ERRORSDESIGN PATIENT INFECTIONSii). RESOURCES INTERACTION DEATHS-BEDS ii). INTER- ii). QUANTITY OF-PERSONNEL PERSONAL CARE-- SUPLIES RELATION No. OF PATIENTS-- Finance TREATED iii). TECHNIQUES NO. OF OPERATION-- EQUIPMENTS AND NUMBER OF PATIENT-- SPACE PROCEDURES REFUSED ADMISSIONiii). TECHNOLOGY iv). TOTAL QUALITY Iii). COST OF CAREiv). RULES MANAGEMENT COST PER BEDv). PROCEDURES (TQM) COST PER PATIENT iv). PATIENT SATISFACTION
  • 37. TYPICAL QUALITY RECORDSQS Elements ISO 9001 Quality Records ref:Mgt responsibility 4.1 Mins. of mgt reviewQuality system 4.2 QM,PM, PQP,JI/SWIContract review 4.3 Mins. of tender reviewDesign control 4.4 Design plan, inputs,…Doc & data control 4.5 Register-files, sigs,revsPurchasing 4.6 Register of acceptable subsControl of Cost 4.7 Cost verification records
  • 38. QS Elements ISO 9001 ref: Quality RecordsIdent & Traceable 4.8 Product/batch recordsProcess control 4.9 MS, stds, qualificationsInspection & Testing 4.10 ITP, insp reportsControl of insp, 4.11 Register of equipments andmeasuring & test cal. certificatesequipInsp. & Test status 4.12 Job cards, progress insp rep.Control of complains 4.13 Com reports, defects reportsCorrective & Prev A 4.14 Corrective action reports
  • 39. QS Elements ISO 9001 ref: Quality RecordsHdlg, storage, 4.15 Delivery notes, dispatchpackaging, presv, del advicesControl of quality 4.16 Insp./test reports, auditsrecords reportsInternal quality audits 4.17 Audit reports, CARTraining 4.18 Qualification records, training course recordsServicing 4.19 Visit reports, maint. Logs,Stats. techniques 4.20 Control charts
  • 40. QUALITY CONTROL•QC is product oriented Activity•Quality Control (QC) is a system of routine technical evaluation, tomeasure and control the quality of the product as it is being developed.•A set of activities designed to evaluate a finished work product/service.•QC activities focus on finding defects in specific out puts - e.g., are thedefined requirements the right requirements have been met.•QC is set of activities whose purpose is to ensure that all qualityrequirements are being met that is defect detection, and done by testing•Quality Control is mainly an inspection function.•QC is product/output Oriented Activity•It is a processes and methods used to compare product quality torequirements and applicable standard•Action taken when a non conformance is detected
  • 41. QUALITY CONTROL Evaluation of planned or systemic actions to provide enough confidence that a product or service has satisfied the given requirements of quality as pre- determined. IDENTIFY THE SERVICE/ PRODUCT MATCH INDICATORS COMPARE WITH ESTABLISH STANDARD EVALUATE OUTPUTQUALITY ACHIEVED QUALITY NOT ACHIVED REVIEW THE PROCESS & ENHANCE STANDARD AREAS OF IMPROVEMENT
  • 42. QUALITY ASSURANCE•QA is process oriented Activity•It is a planned system of monitoring procedures of process conductedby personnel not directly involved in the inventory compilation/developmentprocess.•A set of activities designed to ensure that the development and/ormaintenance process is adequate to ensure a system will meet itsobjectives.•QA activities ensure that the process is defined and appropriate.Methodology and standards development are examples of QA activities.•A QA review would focus on the process elements of a project - e.g., arerequirements being defined at the proper level of detail.•QA is set of activities whose purpose is to demonstrate that an entitymeets all quality requirements.•This is done by adopting a standard set of process and usual QAtechniques like review, training, facilitation etc.•It can be termed as defect prevention.•Quality assurance is an audit function.
  • 43. QUALITY ASSURANCE •A set of activities designed to ensure that the development and/or maintenance process is adequate to ensure a system will meet its objectives. INPUT PROCESS OUTPUT IDENTIFY THE PUT THE SYSTEM MONITOR THE OUTPUT PROCESS INTO ACTION AND STANDARD ANDSET THE PROTOCOL MONITOR AS PER COMPARE TO SOPs SET QUALITY LEVEL PREPARE SOP SET QUALITY LEVEL
  • 44. QUALITY CONTROL vs. ASSURANCE QUALITY CONTROL QUALITY ASSURANCE •• QC is product oriented Activity QA is process oriented Activity • A set of activities designed to ensure• A set of activities designed to evaluate that the development and/or a developed work product. maintenance process is adequate to• QC activities focus on finding defects ensure a system will meet its in specific deliverables - e.g., are the objectives defined requirements the right • It ensure that the process is defined requirements and appropriate. Methodology and• After manufacturing the product, the standards development are examples quality control process begins. of QA activities.• quality control follows the guidelines • It focus on the process elements of a and standards established by project - e.g., are requirements being assurance of quality department to defined at the proper level of detail. check whether output meet the quality • is meant to produce defect-free goods requirements or not. or services which means being right• Depending upon the results, suitable the first time with no or minimum corrective action is taken by quality rework. control personals.
  • 45. QUALITY CONTROL vs ASSURANCE QUALITY CONTROL QUALITY ASSURANCE• Quality control ensures that these • quality assurance process is a series of defined standards are followed at steps taken at the different stages of the every step. product life cycle i.e. from the product concept to the launch of the product to its• It is focused on detecting the defects obsolescence. once the product is manufactured. • Assurance of quality is a set of preventive• Quality control is a failure detection activities, which are focused on processes system that uses a testing technique • Assurance defines the standards to be to identify errors or flaws in products followed• some process parameters cannot be • Quality guarantee department develops all the planning processes and procedures to controlled and here is where quality make sure that the output is of good quality control comes into picture. • Assurance of quality is a failure prevention• Quality control is a corrective process system that predicts safety, quality• The processes of quality control standards and legality involve calibration, sampling and • Quality guarantee processes involve documenting reviews and giving implementing real-time quality checks in feedback for improvement every department • It is a monitoring process• It is an Evaluation process
  • 46. QUALITY IMPROVEMENTMaintaining the process of quality standards throughout and efforts made to improve upon is termed as„continuous quality improvement‟.Continuous quality improvement is therefore a keycomponent of successful management technique.There are four “quality improvement initiatives” thathospitals could use as a yardstick to achieve the bestoutcomes:- Nurses must be actively involved throughout theprocess, Quality outcomes should be transparent, Decisions must be supported by quality research, Staff should feel empowered to make decisions andbe held accountable
  • 47. QUALITY IMPROVEMENT PLAN The quality improvement plan emphasizes on three aspects for continuous improvement SYSTEMSERVICE/PRODUCT PEOPLE‟S IMPROVEMENT IMPROVEMENT1. Quality of supplies2. Sterile procedure 1. Motivation & leadership3. Working Environment PROCESS 2. In service training & skill4. Proper maintenance of IMPROVEMENT developments. records 3. Awards & recognition5. SOPs 4. Seminar & work shops Inpatient Quality6. Use of latest technique for 5. Empowerment of people Indicators (IQIs) separation Prevention Quality Indicators (PQIs) Patient Safety Indicators (PSIs)
  • 48. COMPONENTS OF IMPROVEMENTA. SERVICE IMPROVEMENT Can be done through introducing latest technology and machines Ensuring supplies at right time at right place in right quantity. Regular maintenance and standardisation of equipments. Implementing standard operating procedure.B. PROCESS IMPROVEMENT Introducing suitable modern management techniques Follow ISO certification guide lines Get the certification from NABH Define clear cut job responsibilities. Fix accountability. Detect problems early and solve it.C . PEOPLES IMPROVEMENT Develop regular staff training program Onsite training of staff at work place. Develop staff work culture Introduce quality circle discussions. Inculcate team spirit, leadership and motivation among workers.
  • 49. TOTAL QUALITY MANAGEMENTT – Take the entire organization, patient, staff and its activitiesinto consideration.Q – Quantum output to meet pre- determined standard/objective.M – Manage step by step i.e. Planning, Organizing, Controlling,Provisioning, Staffing.
  • 50. •Determine goals & priorities .Apply the plan•Determine processes •Train & educate the workers•determine tracking indicators •Monitor tracking indicators •Take action to eliminate any problems •Standardize process if successful •Check results of •If not Plan future improvements implemented plan •Identify any problems TQM CYCLE
  • 51. WHAT IS TOTAL QUALITY MANAGEMENTTotal Quality Management is that aspect of the overall managementfunction that determines and implements the quality policy.1. It is a business management strategy aimed at embeddingawareness of quality in the entire organizational process.2. It is defined as a combination of organization functions andmanagement techniques centered on quality, based on theparticipation of all members focusing on long term successthrough meeting customer needs, satisfaction andorganizational objective.3. Quality management takes in to consideration PEOPLE,PROCESS and PRODUCT When along with these three elements Patients need is also taken into consideration It is termed as „TOTAL QUALITY MANAGEMENT‟OBJECTIVE: Do the right things, right the first time, every time andreduce losses due to wasteful practices.
  • 52. FOUR “Ps” OF TQM Peoples ProcessCommitment Improvement TQMPatients Need Product Satisfaction In time
  • 53. PRINCIPLES OF TQMC – Commitment by top managementO – Organization and structure for TQMN - Normal financial control activitiesS – Supplier relationships initiativeT – Training, education and safety awareness of staffR – Relationships cordial with customersU – understanding and commitment by employeesC – Communications net workingT – Teamwork encouragementI – Independent certification level to ISO 9000O – Objective measurement of functionsN – Natural use of tools and techniques and skills
  • 54. SUCCESS OF TOTAL QUALITY MANAGEMENT TQMMANAGEMENT AND CULTURE EMPLOYEESTAFF COMMITMENT EMPOWERMENT LEADERSHIP AT TQM QUICK TOP SUCCESS RESPONSE FACT BASED CUSTOMER DECISION FOCUS MAKING CONTINOUS IMPROVEMENT
  • 55. DEVELOPING TQM CULTUREAll departments of the hospital were asked to compile a list ofquality problemsReview of the list by the Hospital Quality CommitteeProvide feedback to the departments and support departments forthe analysis of problems and design of solutionsHOSPITAL QUALITY COMMITTEEEstablish a Comprehensive quality plan for the Hospital in closecooperation with departmentsInitiate, coordinate and support Quality Groups in the varioushospital departmentsTo give advice to Quality Groups for developing their action plansSupport implementation of action plans of the Quality GroupsMotivation and appraisal of Quality GroupsFeedback to Hospital Management TeamEstablish quality circles in all departmentsTrain more staff with QM skillsWork on the problems with each department
  • 56. QUALITY CIRCLES(QC)• SIGNIFICANCE OF QC:I. UTILISING EDUCATION,EXPERIENCE AND CREATIVITY.• QC –AN INTEGRATED PROGRAMME:1. MEMBERS2. CIRCLE LEADERS3. FACILITATORS4. CO-ORDINATOR5. STEERING COMMITTEE• PROCESSa) PROBLEM IDENTIFICATIONb) PROBLEM SELECTIONc) PROBLEM ANALYSISd) IMPLEMENTATION &RECOMMENDATION TO THE MANAGEMENT. QC ENVISAGES PARTICIPATORY MANAGEMENT STYLE WITH A “BOTTOM UP” APPROACH.
  • 57. TQM - CULTURECOMMITMENT TOMANAGEMENT OF REDUCE MEETING EMPLOYEES PROCESSING COUSTOMER TIME AND COST NEED FINISH IN SET PREDETERMINE NEW TARGET TIME TQM ACTIVITIES CUSTOMER RECOGNITION SATISFACTION & AWARD IMPROVE IMPROVE EMPLOYEES EMPOWERMENT PLAN SYSTEM
  • 58. QUALITY MANAGEMENT vs. TQMQuality element Previous state (Traditional) Total Quality ManagementDefinition Product oriented Customer orientedPriorities Second to service and Cost First among the equals of service and costDecisions Short term Long term Source: Basterfieldet al, 2002 pp3)Emphasis Detection PreventionErrors Operations SystemResponsibility Quality Control Every oneProblem solving Managers TeamsProcurement Price Life cycle costs, partnershipManager‟s Role Plan, assign, control and Delegate, coach, facilitate and enforce mentor
  • 59. • Inadequate financing • Inadequate M3• An expenditure and not • Large gap between demand &investment supply• No regionalisation of Med • Lack of motivation, misuse &care policy pilferage.• No strict referral system • Poor budgetary planning• Political and beaurocrate •Unionism internal conflictsinterference • Lack of latest gadgets• Lack of regular re-orientation • Poor handling Of• training in advancement of grievances/complaintstechnology • Lack of standing guidelines/procedures • evaluation of care from patient/relatives DR.N.C.DAS
  • 60. QUALITY DIAMOND (FOUR ELEMENTS OF QUALITY SERVICE) CUSTOMER SATISFACTION CONTINUITY COMMITMENTIN IMPROVEMENT OF STAFF QUALITY DIAMOND EXPECTATION OF PATIENT AND STAFF
  • 61. hospiad Hospital Administration Made Easy http//hospiad.blogspot.comAn effort solely to help students and aspirants in their attempt to become a successful Hospital Administrator. DR. N. C. DAS

×