The Aim of Quality Management
The outcome or vision of quality management is that every employee throughout the organization is involved in improving systems such that the right things are done at the right times to exceed customer expectations – and, that operating costs are less, productivity higher, employee attitudes are more positive, patient and physician satisfaction is higher, and patient outcomes of care are improved. In other words, the organization is viewed by all as a highly effective provider – a world class provider – of health care.Dr. Demming is the father of quality management and was instrumental in introducing quality management in industry in Japan and the US. We had the opportunity to learn directly from this guru.
Quality management is the new paradigm for most organizations involving defining quality, measuring quality, and continuously improving quality. In other words, quality management involves creating a culture of continuous learning and continuous improvement.
- Each Employee It is imperative that all employees be included to improve the process of service delivery. If central sterile supply fails to deliver the service or product needed by the operating room, how effectively can the operating room carry out its role in providing excellent service to the patient?
- Improving Systems In most hospitals, lots of energy is spent in redoing or correcting work already done. The employees have ideas on how to improve the current systems and how to prevent problems from occurring. The employees by and large did not design the systems in which they work, rather some manager (who probably isn't even there any more) designed it. And, it was designed to meet last year's needs. It is being used today and the error rate (defect rate as seen by our customers) is higher than need be. We can involve employees in redesigning the process or systems in which they operate. The benefit is staggering (in terms of reduced FTE's, higher productivity, and higher customer satisfaction.)
- Right Things Eighteen percent of the employee ideas in one client hospital were aimed at getting better job skill education. These ideas came from employees who have been educated in their jobs at an average of 8.5 years. In the past, these employees were educated in their job duties and procedures in word-of-mouth fashion. Each employee gets a little further away from the original job description (remember the story being whispered around the camp fire which finally gets back to the instigator as an entirely different story.) Is there any question that employees don't understand what the right things are? Flow charting the work process provides all employees with the “Big Picture” and shows them where they fit into the overall service activity being provided as well as what exactly they are required to do.
- Right Time Employees need to be made aware of how their activities impact on services being provided by their own department as well as other hospital departments. For example, an x-ray that is needed prior to orthopedic surgery, but which is not done on time, delays not only the patient, but also the physician staff, nursing staff, and other scheduled patients. Services and products which are not produced in a timely manner contribute significantly to wast and increased hospital expenses.
- Meet or Exceed Customer Expectations Each team of employees needs to identify their primary customers (physicians, patient, nursing floor, etc.) and to work closely with these customers to determine the customers' needs and expectations. Identification of primary customers and customers' needs and expectations will provide employees necessary feedback on the perceived quality of their activities by the customer.
- Measurement Like financial management, quality management must demonstrate measurable improvements. Measures must be determined and data collected to determine if improvements are being made on each measure. Some measures may be cycle time, frequency of errors, costs, productivity, morale, patient satisfaction, physician satisfaction, patient outcomes of care, and the like.
| Mercy Hospital Chicago, IL USA |  |
| Fairview Minneapolis, MN USA |  |
| MidState Medical Center Meriden, CT USA |  |
| St. Joseph Health Center St. Louis, MO USA |  |
| McGraw Hill New York, NY USA |  |
| Connecticut Children's Medical Center Hartford, CT USA |  |
| Audrain Medical Center Mexico, MO USA |  |
