Leaders

1. Leaders Using Quality Assurance principles in emergency planning

2. Task for this afternoon • Think about quality in disaster management • Defining what quality is • What does this mean for disaster programs? • What are some principles in improving quality? • How can these be used in disaster programs? • Applying this at St David’s hospital

3. Defining Quality • What does “Quality” mean?

4. Defining Quality • The Degree of Excellence—the dictionary definition Excellence implies--- • It is made of good materials • It is better than other similar things to which it is compared • Meets expectations people have of it • It does what is intended of it • The results are worth the investment (value for money) • To achieve excellence takes work

5. Doing the right thing • Quality is sometimes said to be doing the right thing in the right way

6. Doing the right thing • Quality is sometimes said to be doing the right thing in the right way Thing wrong right wrong Way right

7. Doing the right thing • Quality is sometimes said to be doing the right thing in the right way Thing wrong right wrong Way right

8. Doing the right thing • Quality is sometimes said to be doing the right thing in the right way Thing wrong right wrong Way right

9. Doing the right thing • Quality is sometimes said to be doing the right thing in the right way Thing wrong right wrong Way right

10. The right thing at the right time • Quality is sometimes said to be doing the right thing at the right time

11. The right thing at the right time • Quality is sometimes said to be doing the right thing at the right time Thing wrong right wrong Time right

12. The right thing at the right time • Quality is sometimes said to be doing the right thing at the right time Thing wrong right wrong Time right

13. The right thing at the right time • Quality is sometimes said to be doing the right thing at the right time Thing wrong right wrong Time right

14. Right thing and right time • Both have a major importance for disaster managers • Many problems with disaster management

15. Improving efficiency and effectiveness • Assessing the performance gap What could be achieved

16. Improving efficiency and effectiveness • Assessing the performance gap What could be achieved Our vision— where we could be

17. Improving efficiency and effectiveness • Assessing the performance gap What could be achieved What is presently being achieved Our vision— where we could be Where we are now

18. Improving efficiency and effectiveness • Assessing the performance gap What could be achieved What is presently being achieved } The Performance Gap

19. Improving efficiency and effectiveness The challenge: Close this gap with accessible resources • Assessing the performance gap What could be achieved What is presently being achieved } The Performance Gap

20. Improving efficiency and effectiveness We may have to change the way we do things to get here • Assessing the performance gap What could be achieved What is presently being achieved } The Performance Gap

21. A famous person said… If you continue to do things the same way as you always have, you will ___________________ ___________________.

22. Meeting expectations • Activities may • Fall short of expectations • Meet expectations • Exceed expectations • What are expectations? • Whose expectations? • Disaster managers • Politicians • Ordinary citizens • Changing expectations—how to do?

23. Defining Quality by standards • Defining Quality • Many definitions which often overlap • Quality is measured by standards and performance Q = P S • Quality is measurable against standards • But who sets the standards?

24. Where do we get the standards? • International standards • PAHO • FEMA • Country standards • Organizational standards • Standards change

25. Where do we get the standards? • International standards • PAHO • FEMA • Country standards • Organizational standards • Standards change

26. Where do we get the standards? • International standards • PAHO • FEMA • Country standards • Organizational standards • Standards change

27. Creating a vision for excellence • Where do you want to go? • What do you want your organization to be • What do you want its quality to be? • How are you going to get there • Make up you own standards • Or adapt others for your needs • Be prepared to change these regularly

28. Thinking about quality • Quality methods got started when inspection wasn’t doing it

29. Thinking about quality • Quality methods got started when inspection wasn’t doing it More inspectors stopped faulty products leaving the factory, but did not improve their quality

30. Looking for ‘root causes’ • Industry started looking for root causes of poor quality • The cause turned out usually to be in the process of making something • If we want to make something better we look at the individual steps needed to make it

31. Looking for ‘root causes’ • Industry started looking for root causes of poor quality • The cause turned out usually to be in the process of making something • If we want to make something better we look at the individual steps needed to make it • not usually at changing the people Processes 85% Causes of poor quality People 15%

32. Emphasis on quality has brought changes in management styles • From an inspection—small “span of control” structure

33. Emphasis on quality has brought changes in management styles • From an inspection—small “span of control” structure

34. Emphasis on quality has brought changes in management styles • From an inspection—small “span of control” structure • To a more ‘horizontal” team-based management structure

35. Emphasis on quality has brought changes in management styles • From an inspection—small “span of control” structure • To a more ‘horizontal” team-based management structure

36. What has this meant for disaster management? • We have a much more ‘decentralised’ structure • More work is being done as teams • Less by committees • These teams may cross various functions • Practice and drills are needed more than ever • There is a greater sense of accountability to the “users” • “Stakeholders” part of almost all activities now

37. Parts of Quality Assurance Quality Assurance

38. Parts of Quality Assurance Quality Design Quality Assurance Quality Improvement Quality Control

39. Parts of Quality Assurance Quality Design Trying to fix existing activities Quality Assurance Quality Improvement Quality Control

40. Parts of Quality Assurance Quality Design Trying to fix existing activities Inspecting for compliance Quality Assurance Quality Improvement Quality Control

41. Parts of Quality Assurance Building quality in from the beginning Quality Design Trying to fix existing activities Inspecting for compliance Quality Assurance Quality Improvement Quality Control

42. How can these new approaches affect disaster mgmt • Time to look again at each part of the disaster cycle • Quality design • New plans and new systems (can we do it in a new and better way?) • Quality improvement • Changing policies (fixing things, applying lessons learnt) • Quality control • We assure quality by certifying standards are met

43. Phases in a disaster The disaster cycle mitigation preparedness Disaster rehabilitation response

44. Quality Assurance methods can be used at each point Phases in a disaster The disaster cycle mitigation preparedness Disaster rehabilitation response

45. Principles of Quality Assurance ØFocus on needs of the users ÙStrengthen the process through which services are provided ÚUse of data to improve services ÛTeams to improve quality ÜImproving communication

46. ØFocus on the needs of the user • Who are the users of our services? • What does the user want and need for our service? • How do we know this? • Get control of quality close to the user • Establishing a dialogue between providers and users to meet needs of the user • A system has both internal users and external (ultimate) users. • Unless needs of internal users are meet, then the ultimate user is not likely to have needs satisfied

47. ØFocus on the needs of the user • Who are the users of our services? • What does the user want and need for our service? • How do we know this? • Get control of quality close to the user • Establishing a dialogue between providers and users to meet needs of the user • A system has both internal users and external (ultimate) users. Provider User Provider User Provider User Provider User Provider User

48. ØFocus on the needs of the user • Who are the users of our services? • What does the user want and need for our service? • How do we know this? • Get control of quality close to the user • Establishing a dialogue between providers and users to meet needs of the user • A system has both internal users and external (ultimate) users. Provider User Provider User Provider User Provider User Provider User External or ultimate customer

49. ØFocus on the needs of the user • Who are the users of our services? • What does the user want and need for our service? • How do we know this? • Get control of quality close to the user • Establishing a dialogue between providers and users to meet needs of the user • A system has both internal users and external (ultimate) users. Provider User Provider User Provider User Provider User Provider User Internal customers External or ultimate customer

50. ØFocus on the needs of the user • Who are the users of our services? • What does the user want and need for our service? • How do we know this? • Get control of quality close to the user • Establishing a dialogue between providers and users to meet needs of the user • A system has both internal users and external (ultimate) users. Provider User Provider User Provider User Provider User Provider User Internal customers • Unless needs of internal users are meet, then the ultimate or external user is not likely to have needs satisfied External or ultimate customer