Continous Qaulity improvement

1. USING 5S-CQI-TQM
TO IMPROVE QUALITYOF HEALTH
SERVICES IN UGANDA

2. Presentation outline
Introduction
Implementation of 5S-CQI-TQM at
Tororo General Hospital
Results
Conclusions
2

3. Introduction
 There is worldwide and national concern about quality and
safety of health care. Poor quality of health services can be
found at all levels of the health care system.
 A disorganized hospital is prone to medical errors resulting in
many deaths and injuries.
 Currently the quality of health services in hospitals in Uganda
is unsatisfactory as shown by long waiting time, overcrowding
at service points and unhygienic work environments among
others.
 Many hospitals ignore the non health expectations of the
people like dignity, basic human needs, prompt attention in
care and treatment, communication , confidentiality and
autonomy resulting in growing public dissatisfaction with the
quality of hospital services.
 Implementation of a more responsive, client focused and
sustainable health care system is therefore a felt need in
Uganda. 3

4. Financial
problems
Human Resource
problems
Time
limitation
Infrastructure
problems
Technical
problems
Lots of problems

5. However……..
Government cannot stop providing
health services, even under serious
resource shortage.

6. Looking at reality….
• Hospitals are disorganized and:
– A test result is lost
– A long waiting for consultation
– A doctor cannot be contacted for emergencies
– A death due to a fall from the bed
– A death from sepsis in wards or theatres
– A failing/shortage in supply system

7. Q&S should be sought of by us even under
shortage of resources.
Quality and Safety
in
Health Service!

8. Who should manage the work?
All health personnel, who are
allocated his or her working
territory and responsibility,
should manage their work…!

9. Everybody likes to do
what he/she likes and
NOT what should be
done!!!
BUT wait a minute…!

10. What else do we need???
In order to do what should be done,
Knowledge and skills are not
enough!!
POSITIVE
“ATTITUDE”

11. Part-1
5S activities?

12. Situation of Workplace

18. 20-May-24 1

23. 20-May-24 1

26. What is 5S ?
• 5S is a philosophy and a way of organizing and
managing the workspace and work flow with
the intent to improve efficiency by eliminating
waste, improving flow and reducing process
unreasonableness.
• It is Working Environment
Improvement

27. Question
• Which shop would you like to do shopping?

28. 5S in Japanese/English
Japanese English
S-1 Seiri Sort
S-2 Seiton Set
S-3 Seiso Shine
S-4 Seiketsu Standardize
S-5 Sitsuke Sustain

29. 1st S: Sort (Seiri )
Focuses on eliminating unnecessary items from the
workplace that are not needed for current process
in the hospital
Materials/Ite
ms Classification
Need it
May not
need it
Not need it

30. 2nd S: Set (Seiton )
After Sorting, organize layout of items
Designated locations
Use tapes and labels
Ensure everything is available as it is needed
and at the “point of use”

31. 20 minutes 20seconds
Work Environment Improvement by 5S
Searching a file
Sort Set

32. 3rd S: Shine (Seiso )
Cleaning with meaning and Beautifying
Taking care of one’s working place and tools
Fail to do so = Irresponsible worker! Who can
provide quality of services???

33. Shine
Your territory can be nicely arranged only by
your participation…!

34. 4th S: Standardize (Seiketsu )
Generate a maintenance system for the first 3 S
Work instructions
Standard operational procedures
Color coding / Sign boards for easy understanding
General
•Un sterile
•Empty
•Negative
•Sterile
•Full
•Positive
•Safe •Infected
materials

35. Standardize
Visualize slogans

36. 5th S: Sustain (Shitsuke )
Self discipline and Training
Training people to follow good work habits and
the strict observation of workplace rules
Periodical staff training
Poster display
On the job training

37. Sustain
Improve attitude to learn and practice

38. Sort, Set, Shine, Standardize
Well organized work environment
can be achieved from small and
day-to-day efforts.
Work-load reduction

39. 5-S
Targets of Five-S include:
• Zero changeovers leading to product/ service
diversification
• Zero defects leading to higher quality
• Zero waste leading to lower cost
• Zero delays leading to on time delivery
• Zero injuries promoting safety
• Zero breakdowns bringing better maintenance

40. ..and finally
• Sort
• Set
• Shine
• Standardize
• Sustain

41. QUESTIONS?!