Quality Tools Presented by Hatim A BanjarRisk manager and patient safety officer Al-Amal Hospital in Jeddah
Continual improvement is a type of change that is focused on increasing the effectiveness and/or efficiency of an organization to fulfil its policy and objectives. It is not limited to quality initiatives. Improvement strategy, results, customer, employee and supplier relationships can be subject to continual improvement.
Any chart, device, software, strategy, or technique that supports quality management efforts and helps in problem solving is a quality tool. Quality problems arise when there is a deviation from :1. The organizational mission, vision, values and ethics, goals2. The department policies and procedures3. The operational desired out come
1. Define the problem and establish an improvement goal.2. Collect data.3. Analyze the problem.4. Generate potential solutions.5. Choose a solution.6. Implement the solution.7. Monitor the solution to see if it accomplishes the goal.
Performance Improvement Model to Identify and Solve Problems and Processes The FOCUS phase helps to narrow the team’s attention to a discrete opportunity for improvement. The P-D-C-A phase allows the team to pursue that opportunity and review its outcome.
Find a process that needs improvement. Define the process and its customers. Decide who will benefit from the improvement. Understanding how the process fits within the hospital’s system and priorities
2. Histogram. A graph which presents the collected data as a frequency distribution in bar-chart form. Complaint Type 9 8 7 6Frequency Late 5 Wrong 4 Faulty 3 2 1 0 Fe ary il ay M y ne A ly em r te t O er ch r ov er ep us ec e be pr r Ju ua b D mb N ob M Ju ar A nu S ug m br ct e Ja Month
Select a team who is knowledgeable in the process. Determine team size, members who represent various levels in the organization, select members, and prepare to document their progress.
Clarify the current knowledge of the process. Define the process as it is and as it should be. Team reviews current knowledge and then must understand the process to be able to analyze it and differentiate the way it actually works and they way it is meant to work.
Flowchart: A picture of the separate steps of a process in sequential order, including materials or services entering or leaving the process (inputs and outputs), decisions that must be made, people who become involved, time involved at each step and/or process measurements.
department Patient Security Psychiatry X Ray Nursing OPD Ward Internal activity Home ,work nursing Pass and referralprocessAdmission New Search and Admission Chest x Ask P.T for Internal yes yes admission metal properties ray activity to hospital detector Pass no Take no P.T to P.T returns Search Search activityInternal from referralSearch or pass Finish activity yes Suspicions search No Receive P.T in Abdominal ward Take P.T x ray to ward Discharg e Give P.T Take P.T properties leave to OPD ReferralDischargeP.T = patient
Understand the causes of variation. Team will measure the process and learn the causes of variation. They will then formulate a plan to data collection, collecting the data, using the information to establish specific, measurable, and controllable variations. Root cause analyses
Cause-and-effect diagram (fishbone diagram). Offers a structured approach for identifying all possible causes of a problem.
Select the potential process improvement. Determine the action that needs to be taken to improve the process (must be supported by documented evidence.)
Pareto Chart. Orders problems by their relative frequency in decreasing order. Focus and priority should be given to problems that offer the largest potential improvement.
Decision matrix: Evaluates and prioritizes a list of options, using pre-determined weighted criteria. Multivoting: Narrows a large list of possibilities to a smaller list of the top priorities or to a final selection; allows an item that is favored by all, but not the top choice of any, to rise to the top. Brainstorming: A method for generating a large number of creative ideas in a short period of time.
Plan the improvement/data collection. Plan the change by studying the process, deciding what could improve it, and identifying data to help. Tool used Implementation scheduleA schedule stating the stages and steps of the solutions with and who will carry it out and how will he do it
Implementation Schedule Reducing the number of reports of potentially harmful Process: objects found with patients in ward Location: Al-amal Hospital in Jeddah Responsibil Complete Tasks Activities ity Start Date Date Prepare needed policies for maintenance, sport therapy, security, nursing Quality Set policies departments department 5/4/2011 5/5/2011 Support Cover gardens with floor services tiles, remove light stands,Gardens renovations install sealing lights Eng, Turki 10/4/2011 30/4/2011 Do round and chick all wards frames and window WardsRepair frames and netting and ask maintenance safety widows netting to repair damaged ones officers 7/4/2011 10/4/2011
Do the improvement/data collection/data analysis. Execute the plan on a small scale or by simulation.
Check the data for process improvement. Observe the results of the change. Document the results of the change. Modify the change, if necessary and possible.
Control Chart. Is a statistical tool used to monitor the performance of a process over time. It is a time-ordered graph of sample data which can be used to identify when assignable causes of variation may be present Control Chart for Complaints 1.30%% complaints 1.00% 0 2 4 6 8 10 12 14 0.70% Month
Act to hold the gain/continue improvement. Implement the change if it is working. If it fails, abandon the plan and repeat the cycle