Chapter 20 quality

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Chapter 20 quality

  1. 1. Chapter 20
  2. 2.  Define “quality” in the context of Central Service operations, and tell how to identify it  Describe components in a quality Central Service program  Discuss quality control indicators: ◦ Administrative indicators ◦ Customer satisfaction indicators ◦ Technical indicators
  3. 3.  Explain the basics of Failure Mode and Effects Analysis and Root Cause Analysis  Discuss common quality programs: ◦ Quality assurance and process improvement ◦ Continuous quality improvement ◦ Total quality management ◦ Other quality programs and standards  Review quality procedures in the Central Service Department
  4. 4.  Physicians, Nurses and professional personnel served by Central Service staff members
  5. 5.  To be successful, Central Service Technicians must look at what they do from their customers’ perspectives  The degree or grade of excellence of a product or service  The consistent delivery of products and services according to established standards  Quality is not a Quick-Fix  Achieving World-Class Quality requires a multi-year plan.  Top Level Administrators must emphasize and support Quality  Quality requires effort from everyone in the facility
  6. 6.  Empowerment  Leadership  Standard Data  Planning Tools and Procedures  Staff Members  Process Management
  7. 7.  The act of granting authority (power) to employees to make decisions within their areas of responsibility  Decisions that may have been made by managers in the past are made by front line employees and supervisors. In other words, those most familiar with the details of the process
  8. 8.  Define standards to be attained  Help: ◦ Manage Data ◦ Plan Opportunities ◦ Establish Priorities ◦ Empower People
  9. 9.  Help create and maintain standards  Ensure that coaching occurs daily for all employees  Set Priorities  Undertake problem-solving and quality planning  Be responsible for error-proofing  Address three types of error: ◦ Inadvertent ◦ Intentional ◦ incompetence
  10. 10.  Department Leaders, Shift Supervisors, Lead Technicians should be first line “Guardians” of the quality program  All employees should adhere to standards are priorities set by managers
  11. 11.  Should help their teammates follow established guidelines
  12. 12.  Financial Data  Organizational Data (i.e. Turnover Data)  Patient and Employee Satisfaction Levels  Number of Defects  Cycle Times
  13. 13.  Collect  Compile for Analysis
  14. 14.  Reduces Existing Problems  Prevents Potential Problems  Identify Factors that are important to customers  Study the competition  Do everything better than (or at least equal to) the competition  Remember that the process (not people) is the cause of most problems  Think about how to improve
  15. 15. 1. Identify needs and requests of the department’s customers 2. Identify an ideal process to consistently address each need/request 3. Compare actual steps and outcomes for each process to the ideal outcome. (for example, 100% error free trays) 4. Plan process control activities to improve the system 5. Measure Defects. With a good process the defects should decrease
  16. 16.  Define traits of successful employees  Provide employees with knowledge, skills and tools  Empower employees to participate in solutions
  17. 17.  Patient Focus  Process Management  Continuous Quality Improvement  Fact-based Decisions
  18. 18.  Senior leaders must be involved in process management  Studying processes is critical  Process problems cause defects  Reducing defects increases quality and helps meet quality standards
  19. 19.  Administrative Indicators  Customer Satisfaction Indicators  Technical Indicators
  20. 20.  What do we do?  How are we doing it?
  21. 21.  Response time for STAT requests  No outdates  Sterilization Quality Assurance Monitors  Correct and Complete Instrument Sets  Customer Satisfaction Levels  Availability of Patient Items  Logging and Documentation  Flash protocols are followed  Case Cart contents are correct
  22. 22.  Regulated by policies, procedures and other administrative actions to assure safe and efficient departmental operations: ◦ Management Control Monitors ◦ Inspection Control Monitors ◦ Facility Meeting Information
  23. 23. Department Management Policies & Procedures Training and Education System
  24. 24. Policies Procedures Work Assignment Lists (with expected timelines and outcomes) Written documentation helps assure consistency
  25. 25. A technical, statistical sampling method that measures the quality of production.
  26. 26. Technical, statistical sampling which measures the quality of production “Checks your work”
  27. 27. Measurable Performed Regularly “Relates to an outcome of patient care or employee safety”
  28. 28.  Inspection of a sample from a larger lot to decide whether the lot should be accepted
  29. 29.  A table of numbers generated in an unpredictable, hap- hazardous sequence that is used to create a random sample
  30. 30.  Safety Inspections  Regulatory Inspections  Accreditation Surveys
  31. 31.  Committee Minutes  Safety Committee Information  Infection Control Committee Information  Staff Meeting Minutes
  32. 32. Speed Accuracy
  33. 33.  Customer Surveys  Incident Reports  Tray Cards  Customer Complaints  Staff Complaints
  34. 34.  Process control measures utilized to assure that planned technical conditions within sterilizers and aerators are met  Should be used in all areas that perform sterile processing, including sterilization activities that occur outside of Central Service  Mechanical Indicators  Chemical Indicators  Biological Indicators
  35. 35. FMEA Failure Mode and Effect Analysis A process designed to predict the adverse outcomes of various human and machine failures to prevent adverse outcomes
  36. 36. RCA Root Cause Analysis A process that “looks backwards” at an event to help prevent its future occurrence
  37. 37.  A comprehensive and measured effort to provide total quality. Also a technical, statistical sampling method that measures production quality
  38. 38.  The strategy of finding solutions to eliminate the root causes of process performance problems
  39. 39.  The concept of measuring the current output of a process or procedure, and then modifying it to increase the output, increase efficiency, and/or increase effectiveness
  40. 40.  Input  Throughput  Output  Outcome Recognizes that improvement can occur with individuals, teams, organizational units (departments) and the organization itself
  41. 41.  A quality process which applies statistical methods to improve work processes.  CQI Audits: ◦ assist in assessment and identification of problems ◦ promote communication
  42. 42.  A quality process that focuses on delivering near-perfect products and services  Six Sigma Goal: Deliver high performance, reliability, and value to the end customer
  43. 43. Define Measure Analyze Design Verify
  44. 44. Define Measure Analyze Improve Control
  45. 45.  Industry-Driven Organization  Ensures standards are set, monitored, and maintained  Routine or unannounced inspections (called surveys) are used to monitor a healthcare facility’s performance
  46. 46.  Award given by the American Nurses Credentialing Center to hospitals that satisfy factors that measure the strength and quality of nursing care
  47. 47.  International Standards Organization  An international standard used by participating organizations to help assure that they consistently deliver quality products and services
  48. 48.  Always wear PPE  Disassemble all items that are meant to be disassembled  Measure Chemicals properly  Load and operate washers properly  Follow procedures  Clean as you were trained to  Check equipment before using to insure it is working
  49. 49.  Check for holes and lint when using linen  Check for holes in all disposable wrappers and filters  Never use a wrapper, filter, or instrument that has fallen on the floor  Always follow count sheets  Check instruments for functionality, cleanliness, alignment, proper assembly and sharpness
  50. 50.  Always load sterilizer carts as trained  Always verify mechanical and chemical indicators after each sterilization cycle  Do not touch sterilized items until cool  Properly complete all documentation
  51. 51.  Always follow established pick sheets  Check product packaging for holes, expiration dating, and appropriate color changes  Carefully load items on shelves, carts, and other storage units to ensure they stay intact
  52. 52.  Pay attention to what you are doing. Avoid distractions like excessive talking, loud music, etc.  Don’t do anything that you haven’t been trained to do  If you are unsure about a completed project, ask someone to check your work  If you get distracted, check the entire project to ensure it was done correctly  If you can’t perform at 100%, don’t do the project. Don’t start projects that you can’t finish  Re-check all work  Remember, neatness counts!  Always help other staff members, even if they don’t think they need help  If you think something is wrong, speak up  Report inoperative or damaged equipment
  53. 53.  Attend all the educational in-services, seminars, infection control, service technician, and vendor-sponsored programs that you can. The more education you can obtain, the better Central Service Technician you will become  Always follow the rules  Question anything about which you are unsure

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