Quality means doing the right things right the first time.
Standards are created to understand what the right things are and how the right things are achieved.
In 1994, The Joint Commission on Accreditation of Healthcare Organization(JCAHO) listed "Dimension of Performance", which can provide the framework for quality management activities in all healthcare settings.
1. The Efficacy of the procedure or treatment in relation to the patient´s condition.
2. The Appropriateness of a specific test, procedure, or service to meet the patient´s need.
3. The Availability of a needed test, procedure, treatment, or service to the patient who
needs it.
4. The Timeliness with which a needed test, procedure, treatment, or service is provided to the patient.
5. The Effectiveness with which tests, procedures, treatments, and services are provided.
6. The Continuity of the services provided to the patient with respect to other services, practitioners, and providers and over time.
7. The Safety of the patient(and others) to whom the services are provided.
8. The Efficiency with which services are provided.
9. The Respect and Caring with which services are provided.
Joseph M. Juran, one of the most influential of the quality gurus describes three quality management processes they call the "Quality Trilogy" : Quality Planning, Quality Control, Quality Improvement.
Quality Planning incorporates design, development, and initial implementation efforts of a new process and redesign issues if appropriate. Quality Control/Measurement activities encompasses all ongoing activities designed to measure actual performance. Quality Improvement teams/committees use Quality Control information, collecting additional information and performing in-depth evaluation as necessary, either to achieve specific performance goals or to improve an existing process.
CQI(Continuous Quality Improvement), as espoused by the differnt theories of Edward Deming and Joseph Juran, is largely credited with revolutionizing Japanese manufacturing after World War II. Hospitals can achieve impressive results when they systematically build quality into the delivery of patient care.
The following concepts form the basic philosophy of quality improvement in ealthcare: M Leadership commitment.
Quality is a central priority for the organization.
Customer-mindedness.
All employee are involved.
Focus on process and systems rather than individuals.
Emphasis on prevention rather than inspection.
The use of formal problem-solving methods and statistical tools.
Initially you may doubt quality improvement´s chances for success. But as you become personally involved and find solutions for those problems, you may begin to feel differently. It is possible to improve work processes, customer-focused system and continuous improvement will result in better patient outcomes and a more satisfied customer.
We can achieve this by improving ourselves and try to find the way to do differently to provide the good quality care to our patients.
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