1. Quality Tools
Presented by
Hatim A Banjar
Risk manager and patient safety officer
Al-Amal Hospital in Jeddah

2.  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.

3.  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, goals
2. The department policies and procedures
3. The operational desired out come

4. 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.

5.  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.

7.  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

8. 1. Check Sheet. A simple tool for collecting
data about problems or complaints.
Appliance Department Complaints
Late Wrong Faulty Total Units %
Month delivery appliance installation installed Complaints
January 2 3 3 8 800 1.00%
February 4 3 4 11 900 1.22%
March 1 4 3 8 750 1.07%
April 4 5 2 11 1050 1.05%
May 3 5 5 13 1400 0.93%
June 2 6 3 11 980 1.12%
July 3 4 4 11 1030 1.07%
August 5 6 6 17 1500 1.13%
September 3 5 5 13 1330 0.98%
October 4 6 6 16 1500 1.07%
November 3 7 5 15 1320 1.14%
December 3 8 6 17 1550 1.10%

9.  2. Histogram. A graph which presents
the collected data as a frequency
distribution in bar-chart form.
Complaint Type
9
8
7
6
Frequency
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

10.  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.

11.  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.

12.  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.

13. department Patient Security Psychiatry X Ray Nursing OPD Ward Internal activity Home ,work
nursing Pass and
referral
process
Admission
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 activity
Internal from referral
Search 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 Referral
Discharge
P.T = patient

14.  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

15.  Cause-and-effect diagram (fishbone
diagram). Offers a structured
approach for identifying all possible
causes of a problem.

16.  Select the potential process
improvement. Determine the action
that needs to be taken to
 improve the process (must be
supported by documented evidence.)

17.  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.

18.  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.

20.  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 schedule
A schedule stating the stages and steps
of the solutions with and who will carry
it out and how will he do it

21. 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 Wards
Repair frames and netting and ask maintenance safety
widows netting to repair damaged ones officers 7/4/2011 10/4/2011

22.  Do the improvement/data
collection/data analysis.
 Execute the plan on a small scale or
by simulation.

23.  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.

24.  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

25.  Act to hold the gain/continue
improvement.
 Implement the change if it is working.
 If it fails, abandon the plan and repeat
the cycle