Management’s Role in Quality Assurance

Purpose of the project

The goal of this plan is to establish a coordinated approach that will address the superiority assessment and course enhancement within the Patient Care Section of the Bureau of HIV/AIDS, North Carolina Department of Health. The Patient Care Section is dedicated to ensuring the highest quality of HIV medical care and support services provided to HIV/AIDS clients throughout the state of North Carolina.

Framework: Ryan Act 200 demands that all Ryan White agendas need to create a quality management program. This program will, therefore, support providers in ensuring that supportive services give access and adherence, ensuring adherence to PHS guidelines and lastly ensure that clinical, demographic and consumption information is accessible when monitoring and evaluation of the native endemic are needed.

Legislative requirements of this project are categorized into six themes.

i. Enhanced access

ii. Eminence management

iii. Aptitude improvement

iv. Embattled resources

v. Synchronization and associations

vi. Contribution and collaboration of other agencies.

The state of North Carolina in conjunction with the unit of health has embraced the sterling criteria of organizational brilliance. This criterion was founded on a set of interrelated core values, behaviors and beliefs that are present in accomplishment organizations. The basic framework of quality assurance is based on the Sterling criteria because this criterion is a foundation for integrity key business requirement in a result-oriented context (Kerzner, 2018).

The senior management team in the patients care section is responsible for planning, directing and coordinating health services related to the States HIV programs. The leadership of this team approves and reviews the activities of the plan when they carry out their activities. A committee has been established to evaluate the plan's objectives and goals. The members of this committee involve a representation member of individuals from all the departments of the state of North Carolina health department. The following are the responsibilities of the Quality Committee.

· Documentation of opportunities that need improvement.

· Documentation of improvement team

· Offering input and recommendations concerning priorities, designs, and plans that can improve the organization's performance.

· I am contributing to scope development.

Content: This quality management plan is designated to address performance improvement activities that are based on the major functional areas as well as the aspects of care. Improvement opportunities, therefore, will be chosen from the following areas.

Customer focus. The selection here will be categorized into primary clinical care which will include patents' outcome, satisfaction, management, and improved access. The second category is the supportive services which include continuity of care and linkages and coordination.

Organizational excellence. Organizational excellence is categorized into human resource focus, operation and business resources, infrastructure development, evaluation, and quality improvement and training needs regarding quality improvement.

Community partnership relationships. This is categorized into external partners who include private provider agencies, Medicaid, etc. and internal partners, customers, and stakeholders.

The following are the overall goals of a quality management program.

· We are striving to establish a collaborative relationship with community agencies and stakeholders to collectively uphold the health status and welfare of the community member being served.

· It is establishing a planning mechanism that will incorporate entire baseline facts from leadership inputs and the internal sources, staffs as well as the patients.

· Stressing on the design of the needs associated with existing services, workflows as well as the patient care services so that patient satisfaction will be maximized.

· Evolve and refine the measurement systems that are responsible for identifying the sentinel events and trend identification through regular collection and recording of data.

· Improving quality in all dimensions through the implementation of multi-disciplinary project teams and encouraging participating problem solving.

The report about the patient's response will be used to ensure that all heir complains taken into consideration.

This modules goal is defining regulatory readiness assessment as well as the purpose it will serve in the State of North Carolina Health Department. It is evident that changes in health care delivery are required to minimize health disparities and enhance quality improvement. Before initiating these changes, the impacted health department needs to be assessed, and its readiness noted. Organizational leadership also need to be assessed. The flowing readiness assessment was done.

This assessment was conducted to determine the overall organizational readiness for change in the existing infrastructure. This assessment helps in determining what is currently working well in the organization and those that are not adding up and thus they need improvement. Technology infrastructure is also assessed, and places that need improvement are also noted, a decision making approach is also analyzed.

This assessment involves assessing the readiness of the team in charge of change, team infrastructure as well as leadership support. Through this assessment, the team identifies what is working well and what needs improvement. This assessment will allow the organization to assess the current data collection methodologies and their relationship with overall improvement goals.

The above two levels of assessment are essential, and they occur in different levels and time within an organization.

Currently, the current quality system in use in the State of North Carolina is The North Carolina Healthcare Quality Alliance. This system is a partnership between the organizations that represent the healthcare centers, accredited organization, and employers versus the federal Centers for Medicare and Medicaid Services (CMS). This quality system works under three approaches (Iwasawa, 2016). The first one is getting payers to agree on the on a uniform set of quality measures. The second approach is offering support to the physician practices that implement evidence-based guidelines. The last method is the collection and presentation of the reports about the performance exhibited about the measures set aside

Due to IQRMP structure of the organization is ready to incorporate this system. This system is not limited to many organizational aspects

Pros of this combination include;

· Increased marketability. Many businesses have admitted that ISO 9000 registration comes with markedly heightened credibility with prospective and current alike. This system proves that the company is dedicated to offering quality services to its customers. This advantage manifests in long term customer retention and increased customer acquisition and an added benefit to venture into new business.

· I have reduced operational expenses. The rigorous registration experienced in ISO 9000 exposes some shortcomings in some operation areas. The company, therefore, takes appropriate steps to counter these programs when they are brought in the light. As a result, the efficiency of the company is enhanced as well. Hence organizations can increase their savings (Heagney, 2016).

· Better management control: so much documentation is involved during ISO 9000 registration process as well as during self-assessment. Many organizations and business that are using it tend to have an increased in the company's overall wellbeing. This is a significant benefit.

· It has improved internal communication. ISO 9000 certification puts more emphasis on the self-analysis and the operation management issues. This encourages interactions among various internal departments of organizations. This becomes productive at the end of it because interacting departments can easily solve the issues that they are undergoing.

· It has improved customer service. The registration and documentation of ISO 9000 many at times serves to refocus on the priorities of organizations and the possible ways through which the customers can be pleased. It also helps with heightening customer awareness.

Cons on the other hand include;

· Vast emphasis on documentation. ISO 9000 heavily relies on internal operation procedures and documentation. Horror stories in many companies have arisen due to deep documentation. Small business needs to be focused on their priorities and not too much documentation.

· Length of the process. ISO 9000 involves longer registration procedure. Registration also takes long to be approved. This leads to delay in organizational operations.

· Frequent inadequate funding. ISO 9000 has been criticized about the cost that the organization spends for them to attain its certification. The charges are very high.

The major pro of six sigma over other approaches is that it is customer driven. Anything that is not accepted by the end customer is considered a defect to the organization using this approach. This ensures that aspects that are admitted to the user are taken into consideration. Thus minimizing extra charges (Allen, 2019). This increases organizational savings.

The second advantaged attached to this approach is that it tackles issues behind the production of an item or its completion rather than considering its outcome. This proactive tactic helps in determining how improvements can be made in advance before the shortcomings are found.

Cons, on the other hand, include; this approach leads to rigidity because they are applied entirely behind the production and planning process. This can later lead to delays and stifle organizational creativity.

This approach can take customers focus to the extreme in which the internal quality control measures are not taken into consideration because of overlying on goal achievement six sigma consumer level.

Pros include a centralized nature of QMS ensures uniformity in project documentation. This means that less learning is required for new resources and chances of having better management are high in the status of health. Productivity level is high because the projects begin in the minds of the junior programmers. Leads to overall increment in Return if Investment. It also enhances on time delivery

Cons, on the other hand, include this approach is not suitable for many organizations.

The approach requires additional resources which may be unavailable in small organizations and business

The combination that is most appropriate for this project is ISO 9000. This is because the pros of this approach outweigh the cons by far. The advantages of this combination also directly affect some aspects of this project. For instance, improving internal communication is one of the project purpose, which is an advantage in ISO 9000

Quality Dimensions Project Matrix

Key Quality Dimensions

Cost of Quality

The two common costs related to cost of quality are the cost of conformance and the cost of nonconformance (PMI, 2017)

Cost of nonconformance = internal failure costs + external failure costs

Cost of conformance = prevention costs + appraisal costs

The costs of nonconformance for the HIV/AIDS patient care project include rework- $300 and customer complaints, $200

Cost of nonconformance = $300 +$100

= $400

The cost of conformance the HIV/AIDS patient care project include training-$200, quality documentation-$50, equipment-$100, testing-$100 and inspection-$50

Cost of conformance = $200+$50+$100+$100+$50

=$500

Cost of quality =$400+$500

=$900

Quality Process Improvement Tools and Techniques

In an organization improvement process, a lot of tool and techniques are used. In this case project plan, I will use the cause and effect analysis to improve the poor customer services in an organization. Cause and effect approach works best because one can identify all potential causes and one is able to come up with the best resolution.

How cause and effect analysis works

Cause and effect approach is used to sort and generate hypothesis by identifying all problem plausible causes within an organization or a process through enquiring participants to list all possible effect causes of the identified problem (Andersen, 2007). Cause and effect diagrams are usually used to help conduct this analysis, this is because cause and effect diagrams can provide a huge amount of information by clearly showing events and possible potential actual causes links and provide ideas why the problem is happening and effects of the cause. Through this analysis, problem solvers can broaden their thinking and are able to the problem in a broader picture. The advantage of this approach is that a problem solution may be found immediately and the right measures implemented. In other cases, the solution may not be obvious but various statistical analysis various theories can be tested. With this approach, I am sure I will be able to find a solution for various issues affecting the organization such as inflated costs of operation and low-profit margins combined with overall low performance.

Cause and effect flow chart sample

Cause and effect flow charts mostly take the shape of fish-borne. Cause and effect analysis in most cases tries to find problem solution by considering six areas which may have contributed to a characteristic effect which are: materials, method, personnel, measurement, environment, and machine. It serves as a useful tool for opening thinking and coming up with possible problem solution. In the flow chart, the problem that is investigated is usually shown at the end of the horizontal arrow with potential causes shown entering the main arrow (Horev, 2010). Other arrows may be attached when principal sub-factors cause. Brainstorming in most cases is used to come up with causes. All facts are gathered and written on the left side of the fish backbone spine and all possible improvement ideas on the right side.

Materials

Methods

Work environment

Call workflow

Call assignment

Improved customer service

CRM Application

People skills

People

Machine

Above diagram shows an example cause and effect analysis of customer service improvement approach.

The process that will be affected when the above implemented includes:

Methods-These are procedures and processes to deliver services by customer service.

Call workflow will be affected which entails time it takes to wait for a call on hold or when a call is passed from one person to another.

Call assignment – it involves how a call is assigned and whether customers reach the right person.

Materials – it entails policies work environment and structures in the context of customer service.

Work environment

If workers work in a poor environment their outcome will also be poor.

Machine

Are tool available for jobs by the agents.

Use of CRM application will help keep track of all customer interactions and help serve customer easily.

People

Customer service/agents must have certain skills to ensure customer service is good. Customer service depends on the skills of the agents.

Quality Performance Monitoring and Control

Introduction

During the planning process of any project, their need for the integration of a quality management plan. The formulating of such a proposal will aid in putting up mechanisms of how best to check on the quality of the product. It will help to create a clear perspective on what you intend to deliver to the market. How best to brand the product to stand a better chance of entry into the market as the gap is clear. The management team can get to know about the regulatory procedures of the project and understands them. For a project like ours of putting up a health facility, it requires donors and partnership the management team have an easier time to convince donors and partners on why they should journey together as they got it all figured out. A market study can also be carried out at the point to ensure that the practicality of the quality and the views of the target market. An excellent quality management plan helps to cut on the cost of production by reducing waste as all the requirements are clearly outlined as well as the processes. Such a plan also saves on time which is a very crucial element in both the production and service industry.

Quality performance and monitoring control

This process is carried upon the onset of a project all through its life cycle. It is done more so as a comparison process between the outlined plan and what is the current condition in the implementing of the project. It is carried out at all phases of a project. The main objective is to provide a check and balance to the project more so to ensure that the tasks are carried out as per the procedures outlined, the timelines adhered and all are within the budget. Any deviation from the plan is noted down and a study is conducted to determine the cause and the proper measures to be carried out (Erinle, 2015). It’s important to note that each deviation is unique and hence a proper case study should be conducted to determine the cause.

The quality management team need to critically understand the scope of the project. This will best help in determining whether the deviation being experienced is due to factors that were not taken into consideration during the planning process. They will then come up with a profound decision on how to tackle such to achieve the success of a project. Reason being a deviation from such factors requires an in-depth survey to find out if they affect factor such as quality, the time taken, the views from both the patient (Bradley & Thompson, 2015)and the workforce and more so the budget. None factored issues more so dynamic changes affecting the project may require a restructuring of the entire project plan. Hence quality management team need to take all the diverse factors into consideration in making decisions so as not to jeopardize the quality and lead to the successful completion of a project.

It is important to note that change is inevitable hence the quality control team needs to be open on how to address arising matter. It is expected that there is a backup plan at each stage. In case things don’t turn up as planned or when the service delivered is not as per the quality standards set out. At such a point, the views of the patients and the workforce should be taken into consideration. Patients’ wellbeing is key and hence the workforce needs to understand why the setout guidelines are important to foster teamwork (Rubertino, 2014.).

Just as prevention is better than cure the quality management team needs put in place mechanisms of preventing certain results from occurrence rather than putting in place counter reaction mechanisms. This approach requires vast experience so as understand what triggers the various deviations and help to put in place mechanisms to cub that. It is therefore important that a quality management team more so on a new project should consist of individuals familiar with that field. It may not necessarily require that the individuals have dealt with such a project but need to understand the broad spectrum of the project (Evans & Lindsay, 2014). There is a need also for a backup plan for the workforce more so on specialized tasks to ensure that there is a continuation in case a situation arises.

Identify the tasks, task duration, and resources that should be added or already exist in the project plan to monitor and control quality.

Periodically there will be a need for patients to fill in questioners on the performance of the service they are receiving from the health practitioners. They will not be required to fill in their details hence one should not be afraid that the information they give will be used to discriminate those who participate during the exercise. The study of the questioners will prompt in-depth research necessitating for proper measures to be carried out (Ozcan, 2017).

Most of the healthcare-associated infections arise due to negligence in following the proper protocol be in carrying out procedures or cleaning activities in the facility. Random checks will be conducted to monitor how properly the laid-out procedures are being carried out. These will foster a sense of accountability on the health practitioners (Pitt, 2014).

Training will be carried out on a regular basis to ensure that the workforce in the facility is prepared to handle the emerging issues in health. These training will be conducted to make sure that the practitioners get the required skills and experience. On each training, the importance of communication will be addressed to help foster collaboration and teamwork.

Annually at least 3 months will be dedicated to research by a given team in each department. This team will work together will specialist from other research centers to help come up with better measures of tacking a problem. To make sure that quality is our topmost priority. They will also come up with a plan on dealing with dynamics in the department.

Annually 40% of the budget is allocated to expansion. The quality control department falls under this category. This is because our main objective is to always raise the standards of our facility and this can only be achieved through quality. This broad scope caters for factors such as the purchases of the best equipment, the replacement of equipment with modern ones, the construction of new amenities and the empowerment of the health practitioners. Being a service industry there is a need to focus on the workforce making sure we source for the best and qualified personnel. Making sure the working conditions are favorable and motivating them through bonuses for achieving quality.

Discuss how you will use at least 2 of the following quality performance tools and techniques to perform monitoring and control

Benchmarking is a comparison mechanism. For the facility, it will be necessary to compare the department that is doing well to those that are performing poorly as well as compare the facility to others that are doing better in terms of quality delivery. It as a learning platform to the workforce and all will be involved in setting the goals after a benchmark. This process will help us come with better mechanisms of handling each process hence there is no need to reinvent the wheel (Tuominen, 2016.). However, it is important to note the benchmarking tools is important for us as a new facility but will only help us to be at per with others hence necessitating the use of another tool.

The cause and effect tool can be of significant help in the facility. These are applied by the formulating of a chart to study the root cause of a problem. Such a chart will identify a given problem, identifying all the probable causes and narrowing down to the main cause. Health is such a sensitive sector as it involves human life, it is, therefore, important to find the main cause of an issue (Consulting, Heuvel, Lorenzo, & Jackson, 2015).

Management's Role in Quality Management(TBD)

References

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