total quality management

MSCMOPM 532 Case

Part1: Construction of fish bone (cause and effect) diagram (8 marks)

Pretend that you have just come from a relative's wedding reception. It didn't turn out as well as it should

have, and the bride's parents are pretty mad at how things turned out. Use the supplied template to

construct a conventional cause-and-effect diagram. Identify twelve sources of defects for the issue

"dissatisfied customer of wedding reception caterer." (Your dozen need not be exactly three per main

cause but should be a balanced treatment.) Categorize each cause onto a main cause. Provide brief

support for each of your choices.

Part2: Construction of flow chart (10 marks)

International Medical Center, Jeddah, is one of the busiest and most respected hospitals for the medical

treatment of children and women in Jeddah

One of the tools the hospital uses consistently is the process flowchart. Omer Ali, who carries the

“Clinical Practice Improvement Consultant,” charts scores of processes.

The flowcharts help study ways to improve the turnaround of a vacated room (especially important in a

hospital that has operated at 130% of capacity for years), speed up the admission process, and deliver

warm meals warm.

Lately, IMC has been examining the flow of maternity patients (and their paperwork) from the moment

they enter the hospital until they are discharged, hopefully with their healthy baby a day or two later.

The flow of maternity patients follows these steps (5 points):

1. Enter IMC’s Labor & Delivery check-in desk entrance.

2. If the baby is born en route or if birth is imminent, the mother and baby are taken by elevator and

registered and admitted directly at bedside. They are then taken to a Labor & Delivery Triage room on

the 8th floor for an exam. If there are no complications, the mother and baby go to step 6.

3. If the baby is not yet born, the front desk asks if the mother is preregistered. (Most do preregister at the

28–30-week pregnancy mark). If she is not, she goes to the registration office on the first floor.

4. The pregnant woman is taken to Labor & Delivery Triage on the 8th floor for assessment. If she is ready

to deliver, she is taken to a Labor & Delivery (L&D) room on the 2nd floor until the baby is born. If she is

not ready, she goes to step 5.

5. Pregnant women not ready to deliver (i.e., no contractions or false alarm) are either sent home to return

on a later date and reenter the system at that time, or if contractions are not yet close enough, they are

sent to walk around the hospital grounds (to encourage progress) and then return to Labor & Delivery

Triage at a prescribed time.

6. When the baby is born, if there are no complications, after 2 hours the mother and baby are transferred

to a “mother-baby care unit” room on floors 3, 4, or 5 for an average of 40–44 hours.

7. If there are complications with the mother, she goes to an operating room and/or intensive care unit.

From there, she goes back to a mother–baby care room upon stabilization — or is discharged at another

time if not stabilized. Complications for the baby may result in a stay in the Neonatal Intensive Care Unit

(NICU) before transfer to the baby nursery near the mother's room. If the baby cannot be stabilized for

discharge with the mother, the baby is discharged later.

8. Mother and/or baby, when ready, are discharged and taken by wheelchair to the discharge exit for

pickup to travel home.

Questions

1. As Ali’s new assistant, you need to flowchart this process. Explain how the process might be improved

once you have completed the chart.

2. If a mother is scheduled for a Caesarean-section birth (i.e., the baby is removed from the womb

surgically), how would this flowchart change?

3. If all mothers were electronically (or manually) preregistered, how would the flowchart change?

Redraw the chart to show your changes.

4. Describe in detail a process that the hospital could analyze, besides the ones mentioned in this case.

(Note: Use Word to draw the flow chart. You will get zero if you copy and past from any website).