Healthcare Management

Health Care: Quality Improvement of Tools

Quality of care in health systems is very wide-ranging and at the same time difficult to standardize. Depending on the corrective standard, quality can be understood in various ways, using different terms, labels and models, Quality of care in health systems is defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

“To err is human”, it is observed that majority of medical errors result from flawed system and processes, not individuals. A report from the Institute of Medicine (IOM), stressed on the improvement of the lower functional level of the present health care industry and put forth the following:…

Quality Improvement Tools in Health Care:

It is evident that, figuring out the quality, safety problems and focusing on the system and not on an individual, has been useful for evaluation of the problems. Many quality improvement tools come into play such as Root-Cause Analysis, Six Sigma, Lean Management, Quality Function Deployment (QFD), Business Process Reengineering (BPR), Total Quality Management and many others.

Root-cause analysis is a strategic problem solving technique that aims to identify the root cause for a problem or reason for an area of deficiency in the best possible way. This analysis states that for every problem, there is a root cause and on eliminating the root cause the problem can be solved. It is believed that by directly solving the cause, problem recurrence can be prevented. Although it is considered to be an iterative method, it is well used as a tool for continuous quality improvement.

Six Sigma is a business strategy used for hospital management. It was developed by Motorola, USA in the year 1986. It is an excellent quality technique that strives for near perfection and is an effective strategy for continuous improvement. It is a detailed data driven approach for differentiating between the cause of variation and outcome measures of process. It includes two important methods which are known as DMAIC (Define, Measure, Analyze, Improve and Control) and DMADV (Define, Measure, Analyze, Design and Verify), the former is used for improving an existing process and the latter for creating a new product or process designs.Though there are various controversies in this quality tool, it is widely used in variety of industries including health care.

Lean Management is an important quality tool for production practice and is focused completely on “preserving value with less work”. It involves quality steps that aim to eliminate wasting of resources during production and ultimately provide value to end customer. It works from the view point of the customer who experiences the product or service and aim to provide that value of product or service for which customer is ready to pay. Five important principles are involved in lean management, they are Defining the value, diagnosing the pulse of the process, Seamless and value adding process, Pull Production and finally Ensuring Perfection.

Quality Function Deployment is a business management strategy that involves various methods which strive to transform the customer demands into a design quality, by deploying the functions and methods for achieving that design quality into component parts and sub systems and finally to the important elements of the manufacturing systems. It was developed by Dr. Yoji Akao in Japan in the year 1966. He was able to develop this concept by combing the quality control and quality assurance tools with function deployment in value engineering. It is an immensely used quality method that transforms the voice of the customer i.e. customer demands for product or services into value engineering elements.

Business Process Reengineering is a quality improving method which aims to analyze and re-design the already existing business processes or work flows within an enterprise with an intention to enhance the outcome of product and services. It is defined as “the  fundamental rethinking  and  radical  redesigning  of  business  processes  to  achieve dramatic  improvements in  critical  contemporary  measures  of  performance,  such  as  cost,  quality,  service,  and  speed”.
The BPR cycle includes four steps and they are Process Identification, Analysis, Design and Implementation & Evaluation.

Total Quality Management (TQM) is an important quality tool developed by Sir. W. Edwards Deming a management theorist. TQM is designed to enhance the performance of the various organizational processes as a whole. It includes variety of techniques for achieving efficiency, problem solving, standardization, maintaining design of the product and control of business operations. It is a comprehensive approach with the philosophy that everyone who is involved in the development of product or service from the point of origin to point of consumption is responsible for total quality management of the business process, product and service.

These are broad set of established quality improvement tools, which are functional and can be applied to wide range of situations.

In conclusion, appropriate quality improvement tool selection and timely adoption by the healthcare organization results in increased patient, physician and employee satisfaction. Everybody desires for the best during their medical treatment or stay in the hospital and quality is the only tool that can ensure this. It raises community confidence in the services provided by the hospital. It also provides opportunity to healthcare unit to benchmark with the best.

Continuous quality improvement improves the overall professional development of clinicians and para-medical staff. Moreover, quality in health care also enhances the faith of the patient on the doctors and other facilities of the health care organization, ultimately giving it a public recognition. It is truly a strategic tool that best works in the interest of the patient and community.

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