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Basic concept of quality final by DR.MUSHTAQ.A.KHOSA


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Basic concept of quality final by DR.MUSHTAQ.A.KHOSA

  1. 1. Basic Concept of Quality By: Dr. Mushtaq Khosa TQM Director Alith General Hospital
  2. 2. What is Quality • Beauty • Goodness • Freshness Degree of excellence • Expensiveness
  3. 3. Quality Totality of characteristics of an entity that bear on its ability to satisfy and needs.(ISO) impliedstated
  4. 4. Quality 100% Customer Satisfaction
  5. 5. Quality Zero Defects “DRIFT”
  6. 6. Process Output
  7. 7. Total Quality Management TQM isamanagement strategy that continuously improvesthe quality of theservices/productsand itsprocess.
  8. 8. GOOD PERFORMANCE POOR PERFORMANCE GOODPROCESS Antibiotic administered 2 hours prior to surgery. OR Team performs Time Out before the procedure. Nurse sucessfuly inserted ET Tube to the desaturated patient. Nurse pushes the 10ml remaining potassium infusion.
  9. 9. Theorist Shewhart Deming Juran Fiegenbaum STATISTICAL CHART QUALITY CONTROL HANDBOOK PDCA CYCLE QUALITY CONTROL (1923) (1951)
  10. 10. Primary Elements of TQM Change Agent Commitment Support Everyone is responsible Journey with no end Determines the level of quality Series of steps Decision Making based on Data Plan to achieve common Goals (Vision & Mission)
  11. 11. Role of Leadership in TQM • Leading from the front. • Promoting cultural change. • Opens Communication. • Instilling more customer focus. • Inspire and influence employees to become willing followers in the achievement of organizational goals. • Role model for Quality.
  12. 12. Role of HODs in TQM •Act as a facilitator of Quality Improvement within the department. •a strong source of inspiration for other employees. •Responsible for the development of their staffs and department. •Set standards, formulate Policies and Procedures within the department.
  13. 13. Role of the Staffs in TQM • At every level within an organization whatever your activity is, you are responsible for quality, from introducing the system to supervising, monitoring and implementing it on day to day basis.
  14. 14. Job Description • A written statement of a specific job, based on the findings of a job analysis. • Includes duties, purpose, responsibilities, scope, and working conditions of a job along with the job's title, and the name or designation of the person to whom the employee reports. • Job description usually forms the basis of job specification.
  15. 15. Policy and Procedures • A set of policies determining the principles, rules, and guidelines which are formulated or adopted by an organization to reach its long- term goals. • Policies and procedures are designed to influence and determine all major decisions and actions, and all activities take place within the boundaries set by them.
  16. 16. Dimensions of Quality Quality is doing the Right Thing • Appropriateness • Efficacy Right first time • Effectiveness • Accessibility • Timeliness • Safety • Continuity • Efficiency • Respect & Care
  17. 17. FOCUS-PDCA Data of Nursing Indicators show high incidence of Hospital Acquired Pressure Ulcers in the Ward. Dept. 1433 1434 ER 6 5 DR 3 4 NICU 3 2 WARD 20 21 AKU 2 3 Total 34 29 Team Leader :Director of Nursing Facilitator: Nursing Quality Staff Team Members: 2-Head Nurse 1-Ward Staff 1- Surgery Specialist Find Organize
  18. 18. FOCUS- PDCA Patient arrived in the Ward Assess for the presence of Pressure Ulcer OVR Refer to GS Preventive Measures Implement Pressure Ulcer Care Follow Up Yes Pressure ulcer No Clarify
  19. 19. FOCUS-PDCA Understand Increase incidence of HAPU Manpower Methods Environment Material Assessment (not done/Improper) Positioning ( not done as required) Nurse Shortage Staff Attitude (non compliance to pressure ulcer assessment and preventive measures) Busy Ward Long Stay Patient Lack of Air Mattress Shortage of Pillow Patient’s Bed not functioning No P&P
  20. 20. FOCUS-PDCA Select P&P on Pressure Ulcer Prevention and Management Adopt Pressure Ulcer Assessment Tool (e.g. BRADEN SCALE)Braden_Scale.pdf Intensive education on Pressure Ulcer Assessment Implement monitoring system of high risk patients Provision of needed equipment's and materials
  21. 21. FOCUS-PDCA Plan • P&P on Pressure ulcer Assessment (BRADEN SCALE) • Request for Administration Support regarding continuous provision of required materials/equipment. • Create a team that will monitor the patients at risk of developing pressure ulcers regularly for proper care and intervention. • Intensive teaching to improve staff skills, develop staff practices/ experience, and heighten awareness of the new P&P. Do • P&P was made, Pressure Ulcer Assessment Tool was Implemented. • High Risk patients was monitored to ensure preventive measures were implemented. • Continuous Nursing Education for prevention of Pressure Ulcer. • Additional materials and supply were provided.
  22. 22. FOCUS-PDCA Check • Reduction of Pressure Ulcer on the 1st quarter of 1435 was noted. Act • Continuous monitoring. • +Implement in other units after positive evaluation is achieved. • -Revision of P&P. Dept. 1433 1434 1st Q 1435 ER 6 5 3 DR 3 4 3 NICU 3 2 2 WARD 20 21 13 AKU 2 3 1 Total 34 29 22
  23. 23. Obstacles of TQM Implementation • Lack of management commitment. • Inability to change the organizational culture. • Improper Planning. • Lack of continuous training and education. • Isolated individual and department. • Inadequate attention to customers. • Inadequate use of empowerment and teamwork.
  24. 24. Benefit of TQM • Eliminate defects or errors. • Reduces waste and quality cost. • Improves communication. • Provides opportunity for personal growth. • Increase motivation and acceptance of new ideas. • Increases Job Satisfaction. • Employee recognition. • Promotes teamwork.
  25. 25. Motivation through shared vision Motivation through shared vision Motivation through fear and loyalty Motivation through fear and loyalty Transforming an Organization Attitude: “Its their problem” Ownership of every problem affecting the customer Ownership of every problem affecting the customer Continuous Improvement Attitude: “The way we’ve always done it” Attitude: “The way we’ve always done it”
  26. 26. Decisions based on data and facts Decisions based on data and facts Decisions based on assumptions/ judgment calls Decisions based on assumptions/ judgment calls Transforming an Organization Everything begins and ends with management   Everything begins and ends with customer Everything begins and ends with customer Doing it right the first time Crisis management and recovery
  27. 27.  “Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.” - William A. Foster