Healthcare Administration 7 Discussion 1
Serenity3203
AH598Ch13slideshow.pptxChapter 13
IMPROVING PERFORMANCE AND CONTROLLING THE CRITICAL CYCLE
Objectives (1 of 2)
Define the management functions of quality improvement and controlling.
Introduce the concept of the search for excellence and examine its relationship to the function of controlling.
Relate controlling to directing in an essential cycle that affords ongoing attention to follow-up and correction.
Objectives (2 of 2)
Introduce the concept of benchmarking and describe its place in the management process.
Describe selected techniques for improving quality.
Enumerate the essential characteristics of adequate controls and introduce some commonly used tools of control.
The Continuing Search for Excellence
Terms associated with this search:
TQM: Total quality management
Quality control; quality assurance
Quality circles; performance improvement
CQI: Continuous quality improvement
Essential Top Management Commitment
An underlying philosophy
Participative management style
Active promotion of the concept
Truly delegate authority and responsibility
Employee empowerment
Intra- and interdepartmental teamwork
Performance Improvement Focus
Continuous quality improvement: focus on standard operations
Routine, periodic studies stemming from external mandates (e.g., Joint Commission)
“Debug” new processes (e.g., Joint Commission tracer methodology implementation)
Critical areas of interest (e.g., patient safety, revenue cycle, disaster preparation)
When an Improvement Fails (1 of 2)
During the early stages of implementation, the manager must:
Remain attentive to feedback
Make necessary adjustments
Provide clients with assistance in adjusting to the change
When an Improvement Fails (2 of 2)
When the data and feedback indicate that the hoped-for improvement has not occurred, the manager must be willing to make the necessary change, including withdrawal of the new process.
Definition of Control
The management function in which performance is measured and corrective action is taken to ensure the accomplishment of organizational goals
Participants in the Commitment to Excellence (1 of 2)
Governing board: Leadership role; adoption of philosophy of excellence
Line managers: Continuous process improvement of routine activities and periodic quality improvement initiatives
Quality improvement teams and committees: Interdepartmental cooperation (e.g., patient safety studies)
Participants (2 of 2)
Employees: Peer group activities through quality circles and teams
Clients: Response to invitation to give feedback (e.g., patient satisfaction surveys)
The Basic Control Process
Establish standards
Measure performance
Correct deviations
Control Mechanisms Should Be:
Timely
Economical
Comprehensive
Specific and appropriate
Objective
Responsible
Understandable
Six Sigma Strategies
Based on statistical analysis of variations in performance measures, Six Sigma is particularly suitable for studies such as:
Risk management reviews
Infection control monitoring
Clinical audit studies
Patient safety analysis
Coding error rates
Accounts receivable delays
The DMAIC Process
D: Define the project goal and customers/clients
M: Measure the process to determine current performance
A: Analyze and determine root cause(s) of the defect
I: Improve the process by eliminating the defect
C: Control future process performance
Benchmarking
Select a standard of practice against which performance will be measured
Standards may be internal (e.g., a department’s best performance)
Standards may be obtained from external sources (e.g., a professional association, federal agencies, accrediting organizations)
The GANTT Chart
Visible control chart
Scheduling and progress monitoring
Work-time relationships
Work accomplished compared to work planned
Interrelationship among the phases of the work
The Flowchart
To develop a procedure (think logically about task linkage)
To illustrate and emphasize key points in a written procedure
To compare present and planned workflow
To audit the workflow, especially about delay points
TQM Display Charts
Run chart: Trends
Histogram: Patterns; rates and frequency
Scattergram: Relationship of variables
Cause-effect: Problem identification
Pareto chart: Determining priorities
The Critical Cycle
The importance of follow-up: Make new decisions, or re-enforce original decisions in light of the findings of the various performance studies. Use the findings to adjust work processes in light of current information.
