Total quality management in healthcare organisations

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TOTAL QUALITY MANAGEMENT IN HEALTHCARE ORGANIZATIONSAN OVERVIEWPOONAM CHAUDHARYSenior Medical TechnologistGMCH-32CHANDIGARH

QUALITY OF HEALTH CAREQuality: A strategy aimed at the needs of customer for present & future (Edwards Deming).Conformance to requirements (Philip B Crosby).Totality of features & characteristics of hospital services that bear on its ability to satisfy stated & implied needs of its patients.AIM To provide quality, efficient & economic management of health care delivery system.

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QUALITY HEALTHCARE-HISTORY

WHY QUALITY?Rapid advancement in healthcare due to rapid diagnosis and day care surgeries.awareness in patients market competitionHealthcare team of skilled and unskilled

Multicentric and multifaceted functionsTo accomplish the organisational objective i.e., the quality healthcare at the minimum cost.Medical tourism

DIMENSIONS OF QUALITY

QUALITY MANAGEMENT SYSTEMQuality does not happen by chance.It needs to be developed.In any HCO, it is established in a planned way keeping in mind the objectives of the HCO, staff involvement and considering the patient needs.It is the result of sincere efforts, intelligent thinking and skillful execution.

DEVELOPMENT OF TQM IN HCO QC-QA-TQM

QUALITY CONTROLA TOOL FOR QUALITY ASSURANCEQuality control means that all the products/services rendered to the patient care are carried out as per the product design criteria /SOP so that there is not any chance of defects/errors.It comprises of measuring the process, analysis of data under effective supervision.SOPs-are based upon certain guidelines keeping the quality parameters in mind. For example, emergency room physicians have SOPs for patients who are brought in an unconscious state; nurses in an operating theater have SOPs for the forceps and swabs that they hand over to the operating surgeons; and laboratory personnel have SOPs for handling, testing, and subsequently discarding body fluids obtained from patients.The absence of QC will lead to the medication error or the patient care negligence.

QUALITY CONTROL ELEMENTS

QUALITY ASSURANCEIt is the planned or systematic actions necessary to provide adequate confidence that a patient services or safety will satisfy given requirement for quality.QA may act as an audit function since it includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.It can also be understood as the system of defect prevention.

PRIMARY OBJECTIVE: ENHANCEMENT OF PATIENT CARE

QUALITY ASSURANCE SYSTEM

QUALITY ASSURANCE SYSTEM

QUALITY MANAGEMENT SYSTEMA MODEL

TOTAL QUALITY MANAGEMENTTQM means that the organization culture is defined by and supports the constant attainment of customer i.e., the patient satisfaction through an integrated system of tools, techniques and training.It involves the continuous improvement of organization processes, resulting in high quality products and services.Hence, TQM is a continuous, customer-centered, employee driven improvement.

TQM PRINCIPALS4 common principles:Do it right the first time to eliminate costly rework.Listen to and learn from customers and employees.Make continuous improvement on every day matter.Build teamwork, trust, and mutual respect.

THE CORE CONCEPT OF TQM

CONTINUOUS QUALITY IMPROVEMENTTHE QUALITY CIRCLE

TQM-ESSENTIAL COMPONENTS

ESSENTIALS OF TQM

A TQM MODEL

Seven Basic Quality Tools

8-21

Run Chart

Scatter Diagram

Histogram

Fishbone Diagram

Check Sheet

Pareto ChartFlow Chart

ROOT CAUSE ANALYSIS

ISHIKAWA FISH BONE DIAGRAM

USE OF FLOW CHARTS

USE OF HISTOGRAMS

USE OF PARETO CHARTS

USE OF RUN CHARTS

USE OF CONTROL CHARTS

USE OF SCATTER DIAGRAM

LEAN MANAGEMENT AND 6 SIGMA

6 DMAIC Process

8-31DefineMeasureAnalyzeImproveControl

TQM AND ACCREDITATION

TQM- A NEED OF THE HOUR

BENEFITS-TQM

BENEFITS-TQM

THANK YOU