M t d lit t lManagement and quality tools

Ola H. ElgaddarMBChB MS MD CPHQ LSSGBMBChB, MSc, MD, CPHQ, LSSGB

Lecturer of Chemical Pathology Medical Research Institute

Alexandria UniversityAlexandria UniversityOla.elgaddar@alexu.edu.eg

Performance ImprovementPerformance Improvement ToolsTools

(II)( )

According to the Healthcare Quality Certification Board (HQCB):Certification Board (HQCB):

I) T l f l iI) Tools for planning:Hoshin PlanninggForce field analysisGantt chartGantt chart

A di t th H lthAccording to the Healthcare Quality Certification Board y(HQCB):

II) Tools for team:B i t iBrainstormingAffinity diagramy gSelection grid

According to the Healthcare Quality Certification Board (HQCB):Certification Board (HQCB):

III) Tools for data collection:IndicatorsIndicatorsCheck sheets

A di t th H lth Q litAccording to the Healthcare Quality Certification Board (HQCB):

IV) Tools for data analysis:IV) Tools for data analysis:Run / Control chartsHistogramHistogramScatter diagram

According to the Healthcare Quality Certification Board (HQCB):( Q )

IV) T l f t l i (RCA)IV) Tools for root cause analysis (RCA):Flow chartCause - Effect diagramPareto chartPareto chart

IndicatorsIndicators are quantitative measures ofa specific part of a process or of ana specific part of a process or of anoutcome, and comparing it to a target.p g gBy themselves, they don’t directly

lit th th h lmeasure quality, rather, they helpprovide data that when analyzed, givep y , ginformation about quality

Indicators1) Rate based:1) Rate based:No of patients with a specified outcomefrom a disease management program /from a disease management program /total No of patients participating in theprogramprogram

2) Sentinel event:2) Sentinel event:100 % analysis and 0 % acceptabilityAll patients on which wrong side surgrywas performed

IndicatorsDefine:- The intent-Numerator and denominator-Numerator and denominator(Operational definition)( p )- Reliability- Validity

Indicators

Data triggers:- Sentinel event

Expected performance rate- Expected performance rate- Trend (Specified rate change over time)Trend (Specified rate change over time)- Pattern (Specified diff between groups)

Check listA structured, prepared form for collectingand analyzing data.and analyzing data.

When to Use a Check Sheet?When to Use a Check Sheet?When data can be observed and collected

repeatedly by the same person or at therepeatedly by the same person or at thesame location.

When collecting data on the frequency ofWhen collecting data on the frequency ofevents, problems, defects, etc.

When collecting data from a productionWhen collecting data from a productionprocess.

Control charts (SPC)Control charts (SPC)The control chart is a graph used to studyThe control chart is a graph used to studyhow a process changes over time.

It has a central line for the average, ang ,upper line for the upper control limit and alower line for the lower control limitlower line for the lower control limit.

These lines are determined from historicaldata.data.

Control charts (SPC)Control charts (SPC)By comparing current data to theseBy comparing current data to theselines, you can draw conclusions aboutywhether the process variation isconsistent (in control) or isconsistent (in control) or isunpredictable (out of control, affectedby special causes of variation)

Control charts (SPC)Control charts (SPC)Common cause variation:Common cause variation:

Variations are inherent in the processand remain till the system changes

Special cause variation:Special cause variation:The variations are considered to be theeffect of many, individually small,unobserved influencesunobserved influences.

HistogramIt shows how often each different value inIt shows how often each different value in

a set of data occurs.It is the most commonly used graph to

show frequency distributions and to viewshow frequency distributions and to viewhow the distribution of the data centers itselfaround the mean or main specificationaround the mean, or main specification.

Histograms show the center of the data,the spread of the data and any dataskewness or outliers.

Scatter diagramThe Scatter Diagram is a Quality ToolThe Scatter Diagram is a Quality Toolthat can be used to show therelationship between "paired data“, i.e:shows correlationshows correlation.

Strong “r” = Higher correlation, inith ideither sides

Flow chartFlow chart