health, Quality, methodolgy-draft-01

Prepared By Dr Gamal SolimaPrepared By Dr Gamal Solimann

Health Care,Health Care,Not only qualityNot only quality

But also improvementBut also improvement

Rule # TwoRule # TwoHealth Care Quality isn’t a Health Care Quality isn’t a

destination but a Tripdestination but a Trip


AgendaAgenda 31-05-201031-05-2010

Health Care QualityHealth Care Quality

Methods for Policies and Methods for Policies and Procedures Procedures

ImplementationImplementation ““Problem Solving”Problem Solving”


PartsParts------------------

1- PDCA= Plan, Do Check, Act1- PDCA= Plan, Do Check, Act

2- FOCUS= Find, Organize, 2- FOCUS= Find, Organize, Clarify, Understand, SelectClarify, Understand, Select

3- SE = Sentinel Events3- SE = Sentinel Events 4- SWOT= Strength, 4- SWOT= Strength,

Weakness, Opportunity, Weakness, Opportunity, Threats Threats

5- TF= Team Formation5- TF= Team Formation


PART 1PART 1

PDCAPDCA

Plan Do Check ActPlan Do Check Act

Used for a problem seen for Used for a problem seen for 1st time1st time

Also called “Deming Cycle” Also called “Deming Cycle”


PDCA: -It is a simple, logical,

and systematic approach to

1- Compose a new process 2- Problem solving.


Plan:1- Design a timeline of

resources ,activities, training and target dates.

2-Develop a data collection plan.

3- Assess tools for measuring outcomes.

4- Determine when to get the target


Do:

Collect DATA & implement interventions.


Check:

analyze results of data and evaluate

reasons for variation.


Act:

act on what is learned and determine next steps.

1-If the intervention is successful, work to make it part of operating

procedure.2- If it is not successful, analyze sources of failure, design new solutions and repeat the PDCA

cycle.


PART 2PART 2

FOCUSFOCUS

In case a process already

exists,Begin with FOCUS


FOCUSFOCUS

Stands for:Stands for:

• Find a process to improve • Organize to improve a

process • Clarify what is known • Understand variation

• Select a process improvement


Step 1 "F" Find

a problem, process improvement opportunity.

• Problem identified through assessment or through

prioritization?• What is your baseline data ,

• Who are the internal and external customers?

• Write a one or two sentence of the improvements that is needed.


Step 2

"O" Organize

• One team that knows about the problem or process in review.

Who would be helpful?

Tell the selected team to achieve the purpose of the project.

Plan and decide who is going to be the leader, as well as who is going to write

and document.


Step 3.

"C" Clarify current knowledge of the process/problem.

A problem well stated is a problem half solved.


Analyze the process the background of the problem? What is the cost of the process? Is there customer complaints, incidents? Is the problem chronic or sporadic? Use tools: flowcharting and brainstorming.


Step 4. "U" for Understand

1-Causes of process variation and find possible causes of

problem. 2-Investigate unusual

happenings that require some research & analysis.

The Ishikawa or cause-effect fishbone diagram

M.M.M.M.E. men (personnel, staffing and training),

materials or items used, the methods or operating procedures, machines or equipment

such as computer systems, and the environment such as sound and workload


Step4 followM.M.M.M.E. mnemonic

Men (personnel, staffing and training)

Materials or items usedMethods or operating procedures

Machines or equipment such as computer systems,

Environment such as sound and workload


Step4 follow

Ask yourself questions, what might be the cause?

Is the problem affected by employee fatigue related to

on-call schedule?


Step 5

"S" Selects

•Select the performance improvement to consider as priority

•select an improvement strategy


RememberRemember

"Quality is never an accident, it is always the result of:

1.high intention2. sincere effort3. intelligent direction4. skillful execution.

It represents the wise choice of many alternatives."


Step 5 followfollow

Define: goal, process, or outcome improvement.

Questions to ask : Will the action eliminate the

problem?Will process variation be

decreased?

1. Identify the potential action, solution, alternative

2.consider many alternative actions & choose the best solution or first

steps


Part3Part3

SE = Sentinel SE = Sentinel EventsEvents


DefinitionDefinition::

A “Sentinel Event” is an unexpected occurrence

involving death or serious physical or psychological injury, not related to the

natural course of a patient’s illness or underlying

condition.


“serious physical or psychological injury”

specifically includes loss of limb or function.

That includes any process which would carry a

significant chance of a serious adverse outcome and includes

delays in diagnosis and treatment.


Outcome is not death or major permanent loss of function: • Suicide • Homicide • Surgery on the wrong patient or body part • Impairment (major/permanent loss of bodily function – i.e. serious physical or psychological injury not result of an underlying medical condition. • Any unexpected death with no relation to underlying medical condition • Rape • Child Abduction or discharge to the wrong family• Hemolytic Blood Transfusion


Part 4Part 4

SWOT= SWOT=

Strength, Weakness,Strength, Weakness,

Opportunity, ThreatsOpportunity, Threats


Definition

Methodically and honestly assessing your company’s

strengths and weaknesses plus the opportunities and threats. It gives

you a rare opportunity for objective analysis.

A SWOT analysis helps you match your company’s resources to

threats and opportunities in the competitive environment.


SWOT

Set an objective for the analysis

Set adequate time for information-gathering

Evaluate the results of your analysis against your original objective


SWOT

easy to usecombines quantitative and qualitative analysisencourages interdepartmental collaborationcan help you set a strategic plan or present new ideas to your team.


1.List external opportunities2.List external threats.3.List internal strengths.4.List internal weaknesses.

Match 1 and 2With 3 and 4

To obtain strategies


Strengths can come from many sources,

•team members, •product line, •bank account, •Production process,•patents,•market share.


SWOT Assess in 3 AreasSWOT Assess in 3 Areas

1- The level of 1- The level of serviceservice we we provideprovide

2- The 2- The competencecompetence of our of our teams workingteams working

3- The 3- The performanceperformance of our of our hospitalhospital

Prepared By Dr Gamal Soliman

•

•

Strength-Opportunity StrategiesExpand globallyIncrease sales staffIncrease advertisingDevelop new productsDiversifyWeakness-Opportunity StrategiesJoint ventureAcquire competitorExpand nationallyBackward integration Strength-Threat StrategiesDiversifyAcquire competitorExpand locallyRe-engineerWeakness-Threat StrategiesIncrease promotionRetrenchRestructureDownsize


Part 5- TFPart 5- TF

Team FormationTeam Formation


"a team is a collection of individuals who exist within a larger social system. This system over here is a hospital, These people who can be identified by themselves and others as a team, who are interdependent, and who perform tasks that affect other individuals and groups.


Types of Teams:

1-Project (Task) Teams Well-defined assignments are the focus of the Project (or Task) Team. 2- Cross-functional Teams The Cross-functional Team is comprised of members from different departments. 3- Self-directed Teams "empowered to make certain decisions about their work”


BENEFITS OF TEAMS

• a proven tool for change;• a means to tap into the experiences and ideas of employees at all levels of the medical practice;• greater productivity, more effective use of resources, increased • creativity and innovation, and higher quality decision making, • which can in turn lead to the development of a more sound organization • empowerment at all levels of the organization.

Health & Medicine

health, Quality, methodolgy-draft-01