Continuous improvement: the Deming Wheel (PDCA)encognize G.K.
To a certain extent, improving the performance of a company can be achieved through the improvement of its underlying structure, processes and organization. As part of the famous Kaizen practices, a common management method used to initiate and sustain a virtuous circle of continuous improvement is the Deming wheel, also known as the Shewhart cycle and more frequently referred as the PDCA cycle. This method simply consists in running iteratively four steps on the system to improve: Plan (define objectives, success criteria, contingencies), Do (execution), Check (analyse result against initial objectives and success criteria), Act (adjust).
PDCA stands for Plan-Do-Check-Act. It can also stand for Plan-Do-Check-Adjust or Plan-Do-Study-Act.
Plan: Plan or outline a problem. Create a process improvement plan.
Do: Do or apply countermeasure to address root cause. Execute a process improvement plan.
Check: Check or assess if the problem is fixed. Inspect feedback and adjust the plan accordingly.
Act: Adjust or fine tune the fix. Integrate a process improvement plan into the system.
https://goleansixsigma.com/lean-six-sigma-pdca-infographic/
https://goleansixsigma.com/pdca-pdsa/
This is a short presentation that I have created for explaining the iterative process for continuous improvement. It shows the Plan-Do-Check-Act (P-D-C-A) methodology that is standard practice in industry for process improvement and product improvement. This is a methodology used for developing anything from automobiles, to mobile phones, to software, and Information Technology.
Continuous improvement: the Deming Wheel (PDCA)encognize G.K.
To a certain extent, improving the performance of a company can be achieved through the improvement of its underlying structure, processes and organization. As part of the famous Kaizen practices, a common management method used to initiate and sustain a virtuous circle of continuous improvement is the Deming wheel, also known as the Shewhart cycle and more frequently referred as the PDCA cycle. This method simply consists in running iteratively four steps on the system to improve: Plan (define objectives, success criteria, contingencies), Do (execution), Check (analyse result against initial objectives and success criteria), Act (adjust).
PDCA stands for Plan-Do-Check-Act. It can also stand for Plan-Do-Check-Adjust or Plan-Do-Study-Act.
Plan: Plan or outline a problem. Create a process improvement plan.
Do: Do or apply countermeasure to address root cause. Execute a process improvement plan.
Check: Check or assess if the problem is fixed. Inspect feedback and adjust the plan accordingly.
Act: Adjust or fine tune the fix. Integrate a process improvement plan into the system.
https://goleansixsigma.com/lean-six-sigma-pdca-infographic/
https://goleansixsigma.com/pdca-pdsa/
This is a short presentation that I have created for explaining the iterative process for continuous improvement. It shows the Plan-Do-Check-Act (P-D-C-A) methodology that is standard practice in industry for process improvement and product improvement. This is a methodology used for developing anything from automobiles, to mobile phones, to software, and Information Technology.
The PDCA cycle is the key principle behind ISO 9001 and all modern management system standards. Because of that, we believe that it's of great benefit if those involved in developing and implementing systems can have a broad understanding of the concept.
So, Qudos has put together a brief introduction in this video. It explains the 4 steps in the cycle, how it can be applied, how it relates to ISO standard clauses, and then provides some examples for each stage of the cycle.
PDCA Cycle
PDCA is an iterative four-step management method used in business for the control and continual improvement of processes and products. It is also known as the Deming circle/cycle/wheel, Shewhart cycle, control circle/cycle, or plan–do–study–act (PDSA). Another version of this PDCA cycle is OPDCA.
Detailed concepts of the Plan Do Check Act Process – Critical to achieving an...ASQ Buffalo NY
The PDCA process has been the most widely used process and management system improvement methodology world-wide and the foundation of virtually every ISO standard developed.
PDCA (plan–do–check–act) is an iterative four-step management method used in business for the control and continuous improvement of processes and products. When used and managed properly, this process can go a long way in ensuring you meet your organizational goals.
We all understand why improvement and a focus on excellence are important, so what we need is a method to use to help with our improvement efforts.FOCUS-PDCA is an improvement methodology that many organizations use to guide their improvement efforts. It’s simply a formalized process for improvement.
A presentation on the continuous improvement tool of total quality management, i.e. PDCA- Plan,Do,Check,Act. Covers the basics of PDCA to give an idea on it's need, use, methodology etc. The presentation will help the beginners gain knowledge about the PDCA cycle and will cover their basic needs on it.
The basic purpose of Improving Quality is to change the way we do things.
Emphasis is on prevention, not inspection
My message is that quality does not happen by accident – it must be planned in
The PDCA cycle is the key principle behind ISO 9001 and all modern management system standards. Because of that, we believe that it's of great benefit if those involved in developing and implementing systems can have a broad understanding of the concept.
So, Qudos has put together a brief introduction in this video. It explains the 4 steps in the cycle, how it can be applied, how it relates to ISO standard clauses, and then provides some examples for each stage of the cycle.
PDCA Cycle
PDCA is an iterative four-step management method used in business for the control and continual improvement of processes and products. It is also known as the Deming circle/cycle/wheel, Shewhart cycle, control circle/cycle, or plan–do–study–act (PDSA). Another version of this PDCA cycle is OPDCA.
Detailed concepts of the Plan Do Check Act Process – Critical to achieving an...ASQ Buffalo NY
The PDCA process has been the most widely used process and management system improvement methodology world-wide and the foundation of virtually every ISO standard developed.
PDCA (plan–do–check–act) is an iterative four-step management method used in business for the control and continuous improvement of processes and products. When used and managed properly, this process can go a long way in ensuring you meet your organizational goals.
We all understand why improvement and a focus on excellence are important, so what we need is a method to use to help with our improvement efforts.FOCUS-PDCA is an improvement methodology that many organizations use to guide their improvement efforts. It’s simply a formalized process for improvement.
A presentation on the continuous improvement tool of total quality management, i.e. PDCA- Plan,Do,Check,Act. Covers the basics of PDCA to give an idea on it's need, use, methodology etc. The presentation will help the beginners gain knowledge about the PDCA cycle and will cover their basic needs on it.
The basic purpose of Improving Quality is to change the way we do things.
Emphasis is on prevention, not inspection
My message is that quality does not happen by accident – it must be planned in
This presentation was given by Julia Gray and Jack Moran from the Public Health Foundation at the 2011 NPHPSP Annual Training on Applying QI Techniques
Similar to CQI and PDCA for Sterile Compounding Pharmacies (20)
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Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
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Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
1. Willis C. Triplett, Pharm.D.
Tuesday, July 22, 2014
Continuous Quality Improvement For
Sterile Compounding Pharmacies
2. USP Chapter <797> states:
“A provider of CSPs shall have in place a formal QA program
intended to provide a mechanism for monitoring, evaluating,
correcting, and improving the activities and processes described
in this chapter. Emphasis in the QA program is placed on
maintaining and improving the quality of systems and the
provision of patient care. In addition, the QA program ensures
that any plan aimed at correcting identified problems also
includes appropriate follow-up to make certain that effective
corrective actions were performed.”
USP Chapter <797>
3. USP Chapter <797> further states that characteristics of the QA Program
shall include:
1. Formalization in writing;
2. Consideration of all aspects of the preparations and dispensing of
products as described in this chapter, including environmental testing
and verification results;
3. Description of specific monitoring and evaluation activities;
4. Specification of how results are to be reported and evaluated;
5. Identification of appropriate follow-up mechanisms when action limits
or thresholds are exceeded; and
6. Delineation of the individuals responsible for each aspect of the QA
program.
USP Chapter <797>
4. › Often abbreviated as “CQI”;
› Refers to a PROCESS of IMPROVEMENT that reiterates
continuously – the moment it succeeds, it targets the next
weakness and starts all over again from the beginning;
› The same steps are followed in the same order with each
iteration of target problem-improvement;
› Those steps are “PLAN-DO-CHECK-ACT.”
Continuous Quality Improvement
6. › CQI based on the belief that, no matter how good a business
process is, it can be improved, and that…
› …no matter what the current state of our process is, we can
and should strive toward a new, higher performance target.
Continuous Quality Improvement
7. Management notes that HIPAA
violations are occurring too often
HIPAA violations found
to center on pack and
ship process
Pack and ship team
members retrained
Outsourced pack and
ship couriers retrained
HIPAA violations still
occurring too often
HIPAA violations still
occurring too often
HIPAA violation
incidence falls by 90%
Pack and ship work
flow redesigned
Example of CQI in action:
8. › In essence, CQI is like scientific research on the enterprise’s
own results;
› It is based on statistical evaluation and requires faithful
compilation of accurate performance records. In most
organizations, the source of such information will be the
enterprise software;
› Each iteration of PLAN-DO-CHECK-ACT is an experiment to see
if the problem has been remedied to an acceptable level of
risk.
Continuous Quality Improvement
9. › The PLAN revolves around picking the target that the team will improve;
› The target of the PLAN should be the system’s MOST CRITICAL WEAKNESS;
› The target is determined by a frank and (brutally) honest examination of the
system’s failures;
Continuous Quality Improvement
10. › The choice of target is based on a weighing of the difficulty of the
improvement versus the importance of the failure.
Continuous Quality Improvement
(Vital) 10
9 A
8
7 B
6 E C
5
4 F D
3
2 G
(Trivial) 1 Z
1 2 3 4 5 6 7 8 9 10
Very Difficult (Very Easy)
ImpactorImporatance
Difficulty
Among these choices,
A would be the first
target and B would be
the second.
Life is probably too
short to ever get to Z
11. › Picking the right target is a vital management decision, since CQI resources are always
limited.
› The PLAN must be focused on only one activity at a time within a given team. There can
only be one “top priority” at a time.
› Management must maintain a laser-like focus on the success of the PLAN. It must never
be forgotten or “lost in the shuffle”;
› The PLAN must make sense to the team’s workers and the goal must be desirable in
their eyes. It will not succeed unless they see the need for it. Management should
educate the team regarding “what it means to them.”
Continuous Quality Improvement
12. › Once the target deficiency is chosen, the team meets to
identify and rank the most likely root cause(s) of the
problem;
› After consensus is reached regarding the root cause(s), the
remedy is designed. In a large organization, the remedy
should be tested in one site, one department, or one unit;
› The chosen unit is retrained to operate according to the
remedial process. Once trained, the unit begins to “DO”.
Continuous Quality Improvement
13. › The “DO” stage is the actual experiment on the remedy;
› The test department begins to operate in the “new way,” and
the results are collected and compiled carefully for a
prescribed period of time; (a week, a month, a quarter, etc.)
Continuous Quality Improvement
14. Continuous Quality Improvement
› After sufficient data have been collected and compiled in the
“DO” step, the results are analyzed in the “CHECK” step;
› The analysts contrast the actual results of the “new” process
(the remedy) versus the historical results (“that’s the way
we’ve always done it.”)
› The analysts and management determine whether the target
has been acceptably met, nearly met, or not met nearly well
enough;
15. › If the remedy has achieved the target goal, it is accepted as the new
way things will be done. (Adoption)
– Policy and Procedures are altered to reflect the remedy (the “new way we do this”)
– Existing staff will be retrained in the “new way” company-wide.
– New hires will be taught according to the “new way.”;
› If the remedy caused improvement, but not enough to meet the goal,
the “PLAN” team reconvenes to make further changes, and the “DO”
step starts all over again; (Adaptation)
› If the remedy failed to cause any improvement in the target goal, the
team starts all over again with a new “PLAN” step. (Abandonment)
Continuous Quality Improvement
16. › So, the remedy worked and we’ve improved our process,
memorialized it in policy, and adjusted our staff training.
We’re done, right? Feet up on the desk? Time to kick back?
› Sadly, we only kick back if all of our other results are perfect.
Otherwise, we identify our next-most-important problem and
start another cycle of PDCA. Back to work!
Continuous Quality Improvement
17. › PLAN-DO-CHECK-ACT always works;
› PLAN-DO-CHECK-ACT does not always work the first time. In
creating the tungsten filament light bulb, Edison failed
hundreds of times before he succeeded. He was asked if he
hated “wasting his time,” with the hundreds of failures. His
answer was that none of the hundreds of failures were a
waste of time because each one showed that a proposed
solution DID NOT WORK.
› What would really be a waste of time is trying the same non-
working solution more than once.
Continuous Quality Improvement
18. › PLAN-DO-CHECK-ACT is how we learn and grow. If you don’t
believe me, just watch an infant moving to toddlerhood. Every
step:
– Rolling over;
– Hands and knees;
– Standing up by holding onto fixed objects;
– Standing up without support;
– Taking the first step;
– Taking multiple steps;
– Walking;
– Running.
› …involves PDCA on the part of the infant. Every graduation
involves goal-setting, experimentation, success/failure, evaluating
results, contrasting against the “old way,” and changes in “policy.”
Continuous Quality Improvement
19. › Questions, Comments, Criticism, Counterpoints?
› To learn more about this topic contact Willis Triplett at:
– willis.triplett@comply797.com