Quality Ohps

7/30/2019 Quality Ohps

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QUALITY

TQM = TOTAL QUALITY MANAGEMENT

CQI = CONTINUOUS QUALITY IMPROVEMENT

Are these the same?

How different?

Can you have one without the other?

So what is QUALITY ASSURANCE?

BEFORE you look at Donabedian or the RCN Dynamic process.

etc (the nursing/health gurus NB mostly from the USA), considerthe history, development of quality awareness within business

generally:

There are three basic principles of never-ending improvement:

Focusing on the customer

Understanding the process

Allemployees committed to quality

Oakland (1993) Total Quality ManagementButterworth Heinemann

To this could be added:

WHO is the customer (and for what what is it I/we are

providing? what is our/my core business? My/our

market?)

WHERE does the process startand stop how do we/I both

define it AND MONITOR/MEASURE it? Value chain?

HOW can we get ALL employees (members of our teams

and suppliers/value chain members) committed to quality?

Is this part of corporate strategy, marketing strategy, a quality

strategy in itself OR ARE THEY ALL PART OF THE WHOLE

in order to be an entrepreneurial business based on a sustainable

strategy within a dynamic environment?

A reflection point: if quality is associated (in nursing terms) with

best practice (and this with Bolam/competency) then could there

be a link between quality and accountability??


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THE MAIN CONCEPTS OF QUALITY

and the

MAIN GURUs ASSOCIATED WITH THEM

MAIN CONCEPTS (in business generally):

Quality is associated with meeting the customers

requirements needs and expectations

Quality must be championed by top management and

part of every employees understanding of the way the

business is done Quality REQUIRES that process be understood

Quality must address the WHOLE process, the WHOLE

chain, ALL suppliers/customers

Quality must eliminate WASTE/inappropriate work (be

efficient) whilst maximising the

appropriateness/effectiveness of that which is delivered

Quality must be monitored (? controlled) and processes

recorded in order to constantly improve Quality can therefore be tightly controlled or flexibly

monitored and adjusted

Quality carries a COST

COST of quality may be classified as Prevention,

Appraisal and Failure Costs

Quality is on-going, continuous, it must be part of the

fabric of the organisation (however small) and part of

every person (however apparently unimportant) in theorganisation and its value chain

MAIN GURUs (in business generally);

W. Edwards Deeming

Philip B Crosby

Joseph M Juran

Kaizen Teian System


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W EDWARDS DEMING

The Deming cycle of continuous improvement:

PLAN DO CHECK ACT

PLAN: establish performance objectives and standards

DO: measure actual performance

CHECK: compare actual performance with the objectives and

standards determine the gap

ACT: take the necessary actions to close the gap and make the

necessary improvements

DEMINGS 14 POINTS FOR MANAGEMENT

1. Create constancy of purpose towards improvement of product

and service

2. Adopt the new philosophy. We can no longer live with commonly

accepted levels of delays, mistakes defective workmanship

3. Cease dependence on mass inspection. Require, instead, statistical

evidence that quality is built in

4. End the practice of awarding business on the basis of price tag

5. Find problems. It is the managements job to work continually on

the system6. Institute modern methods of training on the job

7. Institute modern methods of supervision of production workers.

Responsibility must be changed from numbers to quality

8. Drive out fear, so that everyone may work effectively for the

company

9. Break down barriers between depts

10.Eliminate goalsetcasking for new levels of productvity

without providing methods

11.Eliminate work standards that prescribe numerical quotas12.Remove barriers that stand between the worker and his right to

pride in workmanship

13.Institute a vigorous program of education and training

14.Create a structure in top management that will push everyday on

the above 13 points


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PHILIP B CROSBY4 absolutes of quality:

Definition conformance to requirements

System prevention

Performance standard Zero defoects Measurement price of non-conformance

CROSBYS 14 STEPS TO QUALITY IMPROVEMENT1. Make it clear that management is committed to quality

2. Form quality improvement teams with representatives from each

dept

3. Determine where current and potential quality problems lie

4. Evaluate the cost of quality and explain its use as a management

tool5. Raise the quality awareness and personal concern of all employees

6. Take actions to correct problems identified through previous steps

7. Establish a committee for the Zero defects program

8. Train supervisors to actively carry out their part of the QIP

9. Hold a Zero Defects Day to let all employees know there has

been change

10.Encourage individuals to establish improvement goals for

themselves and their teams

11.Encourage employees to communicate to management theproblems they face in achieving their improvement goals

12.Recognise and appreciate those who participate

13.Establish quality councils to communicate on a regular basis

14.Do it all over again to emphasise that QIP never ends

JOSEPH M DURAN

DURANs 10 STEPS TO QUALITY IMPROVEMENT1. Build awareness of the need and opportunity for improvement2. Set goals for improvement

3. Organise to reach the goals

4. Provide training

5. Carry out projects to solve problems

6. Report progress

7. Give recognition

8. Communicate results

9. Keep score

10.Maintain momentum by making annual improvement part of theregular systems and processes of the company


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NURSING QUALITY INITIATIVES

DySSSY

DYNAMIC STANDARD SETTING SYSTEM (RCN 1990)

now known as

DYNAMIC QUALITY IMPROVEMENT PROGRAMME

(DQI)

Principles (6 key):

1. Owned and controlled by practitioners done by rather

than done to

2. Participation and involvement of practitioners done by

encourages whole team participation

3. Patient/client focused prime objective is to describe

quality interventions in terms of the patient

(impact/experience/health gain); to include outcome as

well as structure and process variables

4. situation based developed with sensitivity to philosophy

5. set within achievability rather than minimum, ideal or

optimum, a realistic pursuit; desirability must be a

consideration6. interprofessional potential encourages teams

Choose a topic, set a standard then:

STRUCTURE

PROCESS -

OUTCOME

Auditing: WHAT, BY WHOM, HOW, HOW OFTEN, WHEN,

HOW MANY to be audited?????

Have you experience of this?

Does this work?

Would this be sufficient in other business arenas?

Strong points?

Weaknesses of system in business terms?

Is quality linked to accountability?

Quality Ohps

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