The Health Inspectorate of Latvia merged three inspection bodies into a single organization and applied the ISO9001 quality management standard to support the restructuring. They used QPR Software's QPR ProcessDesigner to map key processes. This helped communicate roles and responsibilities during the merger in a controlled manner. It identified inefficiencies and ensured processes continued smoothly despite staff changes. As a result, the Inspectorate improved efficiency and quality of services while maintaining operations with a small staff.

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The Health Inspectorate of Latvia is an administrative body that is
responsible for the supervision and control of healthcare services, drugs
and medical equipment and the safeguarding of national health via control
of pharmaceutical companies, high-risk institutions, cosmetic product
safety and monitoring of public health risk factors.
Developing a Quality Management System
for the Health Inspectorate of Latvia
In 2007 the management of
Latvian Health Inspectorate
decided to introduce a quality
management system (QMS)
based on the requirements of
ISO 9001 and LVS EN ISO/IEC
17020.
Quality Management: Tool to
Manage a Merger
The head of the inspectorate, Mr. Egils
Harasimjuks, had been a strong
supporter of the use of quality
management systems. Earlier in his
career he had learned from colleagues
in Finland that a QMS does not have to
be a document-centric effort but could
also be applied more effectively in a
process-oriented manner.
The inspectorate that he had been
appointed to lead had just been
formed from the merging of three
inspection bodies (Latvia’s State
Sanitary Inspectorate, its State
Pharmaceutical Inspectorate and its
Health Care and Work Capacity Quality
Control Inspectorate), which
demanded the new organization to
focus on reorganizing of activities and
roles without disrupting any of the
processes. Egils Harasimjuks realized
that a process-oriented QMS
approach would be a perfect solution
to support the reorganization work in a
controlled manner.
What also strongly influenced the
decision was the fact that the Latvian
government that same year had
decided to support the implementation
of quality management systems with
the issuing of the National quality
standard LVS EN ISO9001, a regulatory
requirement for public administration
quality management systems.
Starting the Project
The Health Inspectorate was
established in 2007, after the merger of
the three aforementioned institutions.
“This wasn’t an easy task” Egils
commented, “The size of functions
tripled and we had to integrate the
staff of seven different organizations
into one team. You can imagine the
challenges…not in the least since
each organization came with their own
Faced with the challenges of
restructuring the activities of
three inspection bodies into
one, the Health Inspectorate
of the Republic of Latvia
applied the ISO9001 quality
management standard,
supported by QPR Software’s
QPR ProcessDesigner to
discover, map, plan,
implement and improve the
new processes of the
restructured organization.
CUSTOMER CASE
“QPR offers an easy and fast
way for drafting process
descriptions, communicating
these and promote process
improvement in a collaborative
approach.”
Egils Harasimjuks
Head of the Health Inspectorate

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culture, traditions, approaches and
performance indicators.”
The work started with the head of the
inspectorate approving the
establishment of a working group. It
then determined its structure and
responsibilities. The group consisted
of specialists, each responsible for key
areas: control officials, methodology
supervisors, quality experts and
external consultants. The Head of the
Inspectorate had an oversight and
advisory role. The group set out to
develop 4 key processes – supervision
planning, control and supervision,
performance data collection and data
analysis.
To perform this work effectively, the
Head of the Inspectorate suggested
the workgroup to use a modern
methodology and supporting
technology with a proven track record.
The choice soon fell on QPR Software.
“QPR offers an easy and fast way for
drafting process descriptions,
communicating these and promote
process improvement in a
collaborative approach” commented
Egils Harasimjuks, “The QPR Portal is
a convenient platform for posting
notifications and exchanging
comments on further performance
improvements”, he continued.
Managing change
The methodology the workgroup
adopted was simple but effective: First
a responsible official would go through
all the steps of the process and
consultants and quality experts would
capture that in a process map
description. A next meeting would
focus on reviewing the description and
adding of additional details to enrich
the description. Once all proposals
have been captured and discussed the
process description would be
promoted to “complete” status, after
which the work group would move on
to the next process.
“When we began using the software
however, not everybody was happy”
Egils pointed out. “Some units saw it
merely as a waste of their time.
However, gradually, the heads of units
and their subordinates responsible for
processes changed their mind as they
began to realize the benefits of
process descriptions.” During the
early days of the project, the
resistance to the initiative however
was significant enough for the Head of
the Inspectorate to mandate the
responsible units to take active part in
defining the processes.
Results
The working group managed to
complete its objective before the set
deadlines. The work mainly focused on
sorting out the new functions and
taking care of maintaining quality
levels of the services the Inspectorate
provided: improvement work had to be
postponed for later. “We managed to
meet the objectives of the merger and
its target on quality, and today we can
already see the results of the slightest
process adjustments, for example, in
health care budget control” Egils
Harasimjuks said.
Another key achievement is that the
Inspectorate actually managed to
boost work efficiency with a small
staff. “The credit for this belongs to
the new work methods we adopted
and the technology that supported us
in discovering, mapping, planning and
implementing these. To me it is all
about effective process description. In
other words, those inside the
organization responsible for the
delivery of a function or a process
come together, go through the
process, and agree on activities and
tasks to decide who does what and
how. This is a good way to determine
inefficiencies and required
adjustments, and everyone is on the
same page about what needs to be
done. Finally, a good and unambiguous
process description also ensures
there will be no process disruptions
that may result from staff turnover”
Egils Harasimjuks pointed out.
Lately the process descriptions, which
are now accessible to everyone in
electronic format via the QPR Portal
have been further enriched with
references to articles concerning all
laws and regulations that govern the
process steps in question, so that
everyone knows exactly which legal
requirements need to be met in every
step of the process. It will make
drafting the job descriptions of
employees integrated into the
Inspectorate and internal regulations
at the unit level much easier.
Most process descriptions were
completed before the actual
restructuring of the organization. Once
the restructuring was done, the
process work could focus on making
improvements.
Benefits and Future
In 2011 the Head of the Inspectorate
concluded that the organization had
clearly been able to witness the
benefits of the invested work.
“Primarily we became aware of the
inefficient process steps that required
adjusting. Secondly, everyone now is
aware of the actions that need to be
undertaken at each and every
moment, and third, there are no more
process disruptions due to staff
turnover. In addition to that, our
organization has become more
efficient, clients have more confidence
in the quality of the services and the
Inspectorate enjoys an improved
image.”
The QPR-based quality management
system offers the organization well-
defined, well-structured and well-
documented internal procedures,
accessible to everyone. The work is
still in progress, as the Inspectorate
aims for continual improvement of its
operations and services.
“One of our aims is to achieve
accreditation and obtain the ISO9000
certificate. Our aim was to first ensure
we have an excellent operating
system, and then get the certificate –
the certificate was never our primary
goal; We want to deliver great service
level to our customers first, and that’s
what we achieved”, concludes Egils
Harasimjuks.