Lecture 1 TQM 311 lecturer: Noura Al-Afeef Medical Record Department.

Lecture 1

TQM 311lecturer: Noura Al-Afeef

Medical Record Department

•What is Quality?•Definition of Quality in healthcare?•Total Quality Management Philosophy?•Quality Principles?•Why Quality?•Quality Assurance versus Quality Improvement?•Quality Myth?•Hospital/Department Strategy(Mission,Vision,Values)?

What is Quality?

• Fitness to use • Excellence• Satisfaction• Standard are created when the experts are

able to understand what the right things are and how the right things are best achieved.

• QA,QC,TQM

Definitions of Quality in Health care

Quality as dictionary defined (Webster's new world college and American heritage dictionaries:•Having a high degree of excellence

•Doing the right things right the first timeEx: the story of the patient sponge

• If the processes are followed and the sponge retrieved while the pt is opened in the OR

• If the processes are followed and the sponge retrieved while the pt is still in the hospital

• If the pt leaves the hospital with more than what he come in with

Juran institute defines quality as both:1. Freedom from deficiencies : freedom from any avoidable intervention

required to achieve an equivalent outcome Ex:Nosocomial infection, lost lab result etc.2. Product features: services attract and satisfy patients ,meet

customer expectation and distinguish one organization from others

Ex: computerized health record, follow up care

AHRQ and AHCPR Defines Quality :o AHRQ (the U.S Government Agency for Healthcare Research Quality)o AHCPR ( Agency for Healthcare Policy and Research)Accessible, effective, safe, accountable, and fair This means: • Providers deliver the right care to the right patient at the

right time in the right way.

• Patients can access timely care, have accurate and understandable information about risks and benefits ,are protected from unsafe health care services and have reliable and understandable information on the care they receive.

• Both patients and clinicians have their rights respected.

Total QM Philosophy• The concept of TQM as advocated by

management theorists and industrial engineers has been adopted by healthcare leaders.

• Definition of TQM: involving quality and leadership commitment which provide the energy and rationale for implementation of the process of CQI within the organization wide quality strategy.

Quality Management Principle:• Customers(internal and external):needs,

expectations.• Employees/staff: expertise, recommendation,

access to top management, involvement in planning and decision making.

• Management: commitment, empowerment of employees.

• Teamwork .• Focus on process and system rather than

individual.

• Focus on prevention rather than inspection• Use of formal problem solving methods and

statistical tools

Why Quality?• Eliminate hazard to patient• Eliminate rework• Save time and money• Desire for recognition and the strive for excellence • Pressure of competition and to enhance marketing• Requirement to define and meet patient needs and

expectations• Accreditation ,certification

Quality Assurance versus Quality ImprovementOld thinking New thinking

• Externally driven internally driven

• Self oriented customer oriented

• Focus on individual focus on processes

• Works to end points has no end points

• seeks to assure seeks to continually improve

Quality Assurance versus Quality ImprovementOld thinking New thinking

• Product quality was the key customer requirement is the key

• Focused of product and service focused on all business tasks

• Corrective method are preventive method are followed followed

• Responsibility lied with quality responsibility lied with every department employee

• Quality was consider to be a tool Quality was considered to be process

philosophy

Quality MythQuality Myth

1-We can’t measure Quality?We can measure quality through the system including:

Input Process Output

(Physician ( setting standard) (satisfaction)

qualification)

2- Quality is luxury?

Quality is deliver the right care to the right patient at the right time in the right way

3- Quality is costly?

Quality is save the money, waste, rework

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Hospital /Department Strategy Hospital /Department Strategy

IncludingIncluding

(Mission, Vision, Values)(Mission, Vision, Values)

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Definition of Mission Purpose or reason of existing ? It basically answers questions such as (what/who the organization is?

It is declares the overall role organization related to desire services ,avalibility of resources and commitment to meeting community needs.

should be updated 3-5 years

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أمثلة لرسائل المؤسسات:

يقدم مستشفى سعد رعاية صحية مميزة في يقدم مستشفى سعد رعاية صحية مميزة في بيئة صحية آمنة ُت$عنى بالمريض، رافع�ا بذلك بيئة صحية آمنة ُت$عنى بالمريض، رافع�ا بذلك ..مستوى خدمات الرعاية الصحية في المملكةمستوى خدمات الرعاية الصحية في المملكة

�نت6بع أحدث الطرق الطبية المعاصرة مدعومة� نت6بع أحدث الطرق الطبية المعاصرة مدعومةبتقنية متقدمة وخبرات عالية الكفاءة؛ مع بتقنية متقدمة وخبرات عالية الكفاءة؛ مع

االلتزام بعقيدُتنا ومبادئنا اإلسالميةااللتزام بعقيدُتنا ومبادئنا اإلسالمية

وما نقدمه للمرضى ذو قيمة عالية من حيث وما نقدمه للمرضى ذو قيمة عالية من حيث ..جودة الخدمة والتكلفةجودة الخدمة والتكلفة

مستشفى سعد التخصصيمستشفى سعد التخصصي

Definition of vision

The organization dreamRefers to the future goal It basically answer questions such as what the

organization strive to be?It must be realistic, achievable and bind people

together around a common identity

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أمثلة لرؤية المؤسسات:

نضيف معايير جديدة للرعاية الصحية نضيف معايير جديدة للرعاية الصحية في المملكة ومجلس التعاون لدول في المملكة ومجلس التعاون لدول

..الخليج العربيةالخليج العربيةنلتزم بالمعايير الدولية المعروفة نلتزم بالمعايير الدولية المعروفة

..الخاصة بالمستشفياتالخاصة بالمستشفيات� � متميزا� � متميزا�نعمل لنكون مركزا� ..نعمل لنكون مركزا

لنكن مركزا� عاليR التخصص في الرعاية، لنكن مركزا� عاليR التخصص في الرعاية، ..يركز على خدمة المريضيركز على خدمة المريض

مستشفى سعد التخصصيمستشفى سعد التخصصي

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ValuesPhilosophy ,beliefs that leads the behavior including social consideration and ethics.

قيم جامعة الملك سعود:الجودة والتميز•القيادة والعمل•الحرية األكاديمية •الشفافية•

• Developing mission vision and values in health care organizations is the key to determine the organizational direction their function and expectations.

• The leaders of organization have an overview about the entire organization resources ,needs and demands .therefore the leaders are responsible for developing mission ,vision and values that works within the organizational culture.

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