Discussion

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Lisa

Quality Models and Methods: Types, principles, and processes

When speaking about quality you may hear people refer to Quality Assurance (QA) or Quality Improvement (QI) which often are used interchangeably and refer to how well something is either working or how well a job is done. Total quality is “a philosophy or an approach to management that can be characterized by its principles, practices, and techniques. Its three principles are customer focus, continuous improvement, and teamwork. Each principle is implemented through a set of practices, the practices are supported by a wide array of techniques that make the practice effective.

Some continuous quality improvements methods are :

Performance management - the methodologies, metrics, processes and systems used to monitor and manage the business performance of an enterprise

Six sigma- a statistical term referring to the goal of achieving zero defects or failures. Six Sigma quality is considered a rate of less than 3.4 defects per million opportunities, which translates to a process that is 99.99966 percent defect free. The use of Six Sigma is encouraged in health services organizations as a way of achieving high reliability through use of rigorous and disciplined approach of process improvement tools, methods, and statistical analysis

Lean-is used to remove wasted effort from healthcare processes without compromising quality

Three principles of total quality:

Customer-focused quality- means that key patient and other customer requirements and expectations are identified and drive improvement efforts. Defining customers and stakeholders is a prerequisite to determining their requirements. 

Continuous improvement- may also be expressed through managers’ execution of their managerial functions. Managing by fact and depending on performance data to inform decisions is requisite to this principle.

Teamwork - referring to cross functional or interdisciplinary project teams. Healthcare organizations seeking to make changes in complex processes or activities that involve more than one discipline or work area often use a team approach. Quality improvement is fundamentally a team process in which significant and lasting improvements rely on the “knowledge, skills, experience, and perspectives of different individuals”

Resources

Patrice Spath. (2017). Applying Quality Management in Healthcare : A Systems Approach, Fourth Edition: Vol. Fourth edition. Health Administration Press.

Maren

 The Centers for Medicare and Medicaid Services (2021) defined quality improvement as ”the framework used to systematically improve care. Quality improvement seeks to standardize processes and structures to reduce variation, achieve predictable results, and improve outcomes for patients, healthcare systems, and organizations.” A quality improvement (QI) approach, also called continuous quality improvement (CQI), emphasizes the ongoing improvement of processes to enhance the quality of the outputs, for example, by limiting defect outcomes. Examples of process improvements in operating rooms are preoperative checklists, sponge counts, and team briefings to prevent negative results or surgical complications (Spath, 2017).      The role of the management is to set organizational goals on how human, financial, material and intellectual resources are protected, assigned, and used. Furthermore, the goals involve how activities in the organization are created, carried out, coordinated, and developed. The manager's views and strategies differ regarding the organizational position and responsibilities, such as team, project, department or organization-wide. How managers in health services describe and arrange quality in their daily activities is often affected by their own experiences. A manager with an education in health services administration background focuses, for example, on the importance of organizational structures and stakeholder relationships; this leads to numerous ways quality concerns may be stated and addressed in healthcare organizations. Quality improvement is essentially a team process dependent on knowledge, skills, understanding and views of different individuals.         Managers have to show continuous improvement in their daily activities to attain the same in their organizations. The principle of constant improvement is dependent on the manager's performance in their managerial practices. Therefore, managing facts regarding performance data is essential. For example, by watching the patient transportation system, the supervisor is immediately alerted when a problem appears and can quickly react and address the issue. He can reassign staff to increase available employees and reduce the response time. He analyzes problems by comparing the total number of transports with the average response time. With the daily data, he can identify documented concerns and address them quickly, improving employee accountability and enhancing patient relations. The manager also reviews the statistics to analyze any problems that need to be solved directly by the managers. Furthermore, he reviews the monthly stats with the administrators, as annual statistics are also used for the budgeting process (Spath, 2017).       According to W. Edwards Deming's System of Profound Knowledge, the four components of theories of systems, the concept of knowledge, understanding variation, and psychology of change are necessary for quality improvement in the health care system. Organizations cover several departments, people, and functions working collectively to achieve a common goal, such as the quality of care and customer service. Leadership has to optimize the system as a whole. Therefore, leaders have to gain knowledge of the scenario through small tests. The knowledge is essential to adjust and enhance the system. Furthermore, it is vital to encourage anticipated variation and prevent adverse deviation. Finally, leaders have to comprehend the motivation of employees and offer skill training to change and succeed (Roehrs, 2018). As Roehrs (2018) stated, "The aim of leadership should be to improve the performance of man and machine, to improve quality, to increase output, and simultaneously to bring pride of workmanship to people."

 

References:

Centers for Medicare and Medicaid. (2021). Quality Measurement and Quality Improvement. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Measure-and-Quality-Improvement-

Roehrs, S. (2018, September 25). Building of profound knowledge. Current Problems in Pediatric and Adolescent Health Care. Volume 48, Issue 8,P. 196-197, https://www.sciencedirect.com/science/article/abs/pii/S1538544218300865

Spath, P. (2017). Applying Quality Management in Healthcare: A Systems Approach, Fourth Edition: Vol. Fourth edition. Health Administration Press.