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Learn how quality assurance and strategic management impact healthcare outcomes, patient satisfaction, and organizational efficiency. Explore continuous quality improvement, organizational change strategies, and effective ways to minimize resistance to change. Discover the importance of quality conformity and design in healthcare services.
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QUALITY ASSURANCE & CHANGE STRATEGIC MANAGEMENT IN HEALTHCARE 3 MARCH , 2009
QUALITY • DOING THE RIGHT THINGS RIGHT, THE FIRST TIME & EVERY TIME • Quality of conformance – absence of defects • Quality of design – customer satisfaction
CUSTOMERS • PAYORS • PATIENTS • ANY DOWNSTREAM USER OF OUTPUT • VIRTUALLY EVERYONE IN YOUR ORGANIZATION
HEALTHCARE QUALITY • MEDICAL OUTCOMES • PATIENT SATISFACTION • CLIENT SATISFACTION
EVALUATION OF QUALITY • ACCURATE DIAGNOSES • IMPROVEMENT AT DISCHARGE • MORBIDITY & MORTALITY • EFFICACY OF TREATMENT • TOTALITY OF A PRODUCT THAT BEARS ON ABILITY TO SATISFY NEEDS OR WANTS
CQI • CONTINUOUS QUALITY IMPROVEMENT • IF IT AIN’T BROKE IT CAN STILL BE IMPROVED • IF IT ISN’T PERFECT MAKE IT BETTER
CONTINUOUS QUALITY IMPROVEMENT • PROACTIVE APPROACH THAT ASSUMES ALL PROCESSES CAN BE IMPROVED • ASSUMES A REASONABLE LEVEL OF QUALITY TO BEGIN WITH • ASSUMES YOU ARE DOING THE RIGHT THINGS ALREADY
ELEMENTS OF CQI • ORGANIZATION WIDE • PROCESS FOCUSED • TEAM-BASED • PROSPECTIVE AND ONGOING • USES OUTPUT OR INSPECTION MEASURES • CUSTOMER DRIVEN
GOAL OF PROCESS IMPROVEMENT • DO IT RIGHT THE FIRST TIME • CORRECTIONS ARE EXPENSIVE • 99% IS NOT GOOD ENOUGH • 6000 STEPS TO BUILDING A CAR • 60 THINGS WRONG WITH YOUR CAR • SOME WILL BE FATAL FLAWS
DEMING • POOR QUALITY • IS THE RESULT OF BADLY DESIGNED OR MALFUNCTIONING PROCESSES • CAN BE PREVENTED • PREVENTED BY REDUCTION OF VARIABILITY
JURAN • QUALITY IS FITNESS FOR USE - FREE FROM DEFICIENCIES AND MEETING CUSTOMER NEEDS • QUALITY TRILOGY • PLANNING • CONTROL • IMPROVEMENT
CROSBY • QUALITY IS FREE – WHAT COSTS IS NONQUALITY PRODUCTION • COST OF QUALITY • NONCONFORMANCE – COST TO FIX IT • CONFORMANCE – COST TO EVALUATE AND IMPROVE
OUTLIERS • UNDESIRABLE • PREVENT FUTURE OCCURRENCES • DESIRABLE • CAN IT BE DUPLICATED?
HEALTHCARE QUALITY • YOUR BODY IS NOT A CAR • ALL TREATMENTS HAVE RISKS • ALL TREATMENTS HAVE FAILURES • EVERYONE IS GOING TO DIE
Organizational Change • Any discernable modification in any aspect of an organization’s purpose or objectives. culture, strategies, tasks, technologies, people, or structures.
Managing Change • Four stage model • Identification • Planning • Implementation • Evaluation
Why Change • Organizations, like people, are always growing or dying. • Changes carry a variety of costs and should never be undertaken unless reasons are compelling.
Resistance to Change • When people are part of the status quo, even minor changes are disruptive. • Individuals pay selective attention to the environment according to their interests and selectively interpret the information they receive. • All change is personal and personnel.
Reasons for Resistance • Insecurity or uncertainty • Inconvenience • Implies the current situation is bad • Relationships change • Individual and group status changes • Economic losses • Resentment of exercise of power • Union opposition
Personal & Personnel • RIF & pay cuts • Hiring freeze • Downsizing means more work for fewer people. • New jobs go to new people • Survivor guilt
Reducing Resistance • Education and communication • Participation • Support adjustment • Negotiate agreement • Manipulate or co-opt the opposition • Coercion – inappropriate?
Platitudes/Truths • Diapers and politicians should be changed regularly and for the same reason. • No one likes to be changed but a baby. • All change is stressful.
