Quality tools

Quality ToolsPresented by

Hatim A Banjar

Risk manager and patient safety officer

Al-Amal Hospital in Jeddah

Continual improvement

Continual improvement is a type of change that is focused on increasing the effectiveness and/or efficiency of an organization to fulfil its policy and objectives.

It is not limited to quality initiatives.

Improvement strategy, results, customer, employee and supplier relationships can be subject to continual improvement.

Definition

Any chart, device, software, strategy, or technique that supports quality management efforts and helps in problem solving is a quality tool.

Quality problems arise when there is a deviation from :

1. The organizational mission, vision, values and ethics, goals

2. The department policies and procedures

3. The operational desired out come

Basic steps in problem solving

1. Define the problem and establish an improvement goal.

2. Collect data.3. Analyze the problem.4. Generate potential solutions.5. Choose a solution.6. Implement the solution.7. Monitor the solution to see if it

accomplishes the goal.

FOCUS P-D-C-A

Performance Improvement Model to Identify and Solve Problems and Processes

The FOCUS phase helps to narrow the team’s attention to a discrete opportunity for improvement.

The P-D-C-A phase allows the team to pursue that opportunity and review its outcome.

FOCUS

F --- FIND

Find a process that needs improvement.

Define the process and its customers.

Decide who will benefit from the improvement.

Understanding how the process fits within the hospital’s system and priorities

Tools used1. Check Sheet. A simple tool for

collecting data about problems or complaints.

Appliance Department ComplaintsLate Wrong Faulty Total Units %

Month delivery appliance installation installed Complaints

January 2 3 3 8 800 1.00%February 4 3 4 11 900 1.22%March 1 4 3 8 750 1.07%April 4 5 2 11 1050 1.05%May 3 5 5 13 1400 0.93%June 2 6 3 11 980 1.12%July 3 4 4 11 1030 1.07%August 5 6 6 17 1500 1.13%September 3 5 5 13 1330 0.98%October 4 6 6 16 1500 1.07%November 3 7 5 15 1320 1.14%December 3 8 6 17 1550 1.10%

2. Histogram. A graph which presents the collected data as a frequency distribution in bar-chart form.

Complaint Type

0

1

2

3

4

5

6

7

8

9

Month

Fre

qu

en

cy

Late

Wrong

Faulty

O --- ORGANIZE

Select a team who is knowledgeable in the process.

Determine team size, members who represent various levels in the organization, select members, and prepare to document their progress.

C ---- CLARIFY

Clarify the current knowledge of the process. Define the process as it is and as it should

be. Team reviews current knowledge and then must understand the process to be able to

analyze it and differentiate the way it actually works and they way it is meant to work.

Tool used

Flowchart: A picture of the separate steps of a process in sequential order, including materials or services entering or leaving the process (inputs and outputs), decisions that must be made, people who become involved, time involved at each step and/or process measurements.

department process

Patient Security Psychiatry X Ray Nursing OPD Ward nursing

Internal activity Home ,work Pass and referral

Admission Internal Search Discharge

yes

No

yes no

yes

no

P.T = patient

Search and metal

detector

Admission Chest x ray

Search

Suspicions

Abdominal x ray

Take P.T to ward

Internal activity

Take P.T to activity

Finish activity

Receive P.T in ward

Ask P.T for properties

Pass

Take P.T to OPD Referral

Give properties

Discharge

New admission to hospital

P.T leave

P.T returns from referral or pass

Search

search

U --- UNDERSTAND

Understand the causes of variation. Team will measure the process and learn the causes of variation.

They will then formulate a plan to data collection, collecting the data, using the information to establish specific, measurable, and controllable variations.

Root cause analyses

Tool used

Cause-and-effect diagram (fishbone diagram). Offers a structured approach for identifying all possible causes of a problem.

S --- SELECT

Select the potential process improvement. Determine the action that needs to be taken to

improve the process (must be supported by documented evidence.)

Tool used Pareto Chart. Orders problems by their

relative frequency in decreasing order. Focus and priority should be given to problems that offer the largest potential improvement.

Decision matrix: Evaluates and prioritizes a list of options, using pre-determined weighted criteria.

Multivoting: Narrows a large list of possibilities to a smaller list of the top priorities or to a final selection; allows an item that is favored by all, but not the top choice of any, to rise to the top.

Brainstorming: A method for generating a large number of creative ideas in a short period of time.

P-D-C-A

P --- PLAN Plan the improvement/data

collection. Plan the change by studying the

process, deciding what could improve it, and identifying data to help.

Tool used Implementation scheduleA schedule stating the stages and

steps of the solutions with and who will carry it out and how will he do it

Implementation Schedule

Process:Reducing the number of reports of potentially harmful objects found with patients in ward

Location :  Al-amal Hospital in Jeddah

Tasks Activities Responsibil

ity Start Date Complete

Date

Set policies

 Prepare needed policies for maintenance, sport therapy,

security, nursing departments

 Quality department  5/4/2011  5/5/2011

Gardens renovations

Cover gardens with floor tiles, remove light stands,

install sealing lights

 Support services

Eng, Turki  10/4/2011  30/4/2011

Repair frames and widows netting

 Do round and chick all wards frames and window

netting and ask maintenance to repair damaged ones

  Wards safety

officers   7/4/2011  10/4/2011

D --- DO

Do the improvement/data collection/data analysis.

Execute the plan on a small scale or by simulation.

C --- CHECK

Check the data for process improvement.

Observe the results of the change.

Document the results of the change. Modify the change, if necessary and possible.

Tool used Control Chart. Is a statistical tool

used to monitor the performance of a process over time. It is a time-ordered graph of sample data which can be used to identify when assignable causes of variation may be presentControl Chart for Complaints

0.70%

1.00%

1.30%

0 2 4 6 8 10 12 14

Month

% co

mp

lain

ts

A --- ACT

Act to hold the gain/continue improvement.

Implement the change if it is working.

If it fails, abandon the plan and repeat the cycle