QUALITY ASSURANCE & IMPROVEMENT

1. QUALITY ASSURANCE & IMPROVEMENT STRATEGIC MANAGEMENT IN HEALTHCARE MARCH 9, 2006

2. CUSTOMERS • PAYORS • PATIENTS • ANY DOWNSTREAM USER OF OUTPUT – VERY COMPLEX

3. QUALITY • DOING THE RIGHT THINGS RIGHT, THE FIRST TIME & EVERY TIME • Quality of conformance – absence of defects • Quality of design – customer satisfaction

4. HEALTHCARE QUALITY • MEDICAL OUTCOMES • PATIENT SATISFACTION • CLIENT SATISFACTION

5. 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

6. CQI • CONTINUOUS QUALITY IMPROVEMENT • IF IT AIN’T BROKE IT CAN STILL BE IMPROVED • IF IT ISN’T PERFECT MAKE IT BETTER

7. CQI • 90% OF US HOSPITALS HAVE A PROGRAM • 65% HAVE MORE THAN 6 CQI PROJECTS

8. ELEMENTS OF CQI • ORGANIZATION WIDE • PROCESS FOCUSED • TEAM-BASED • PROSPECTIVE AND ONGOING • USES OUTPUT OR INSPECTION MEASURES • CUSTOMER DRIVEN

9. DEMING • POOR QUALITY • IS THE RESULT OF BADLY DESIGNED OR MALFUNCTIONING PROCESSES • CAN BE PREVENTED • PREVENTED BY REDUCTION OF VARIABILITY

10. JURAN • QUALITY IS FITNESS FOR USE - FREE FROM DEFICIENCIES AND MEETING CUSTOMER NEEDS • QUALITY TRILOGY • PLANNING • CONTROL • IMPROVEMENT

11. CROSBY • QUALITY IS FREE – WHAT COSTS IS NONQUALITY PRODUCTION • COST OF QUALITY • NONCONFORMANCE – COST TO FIX IT • CONFORMANCE – COST TO EVALUATE AND IMPROVE

12. 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

13. OUTLIERS • UNDESIRABLE • PREVENT FUTURE OCCURRENCES • DESIRABLE • CAN IT BE DUPLICATED?

14. HEALTHCARE QUALITY • YOUR BODY IS NOT A CAR • ALL TREATMENTS HAVE RISKS • ALL TREATMENTS HAVE FAILURES • EVERYONE IS GOING TO DIE