Quality in Healthcare Management

Quality Expectations

• Consumers expect the best healthcare for themselves and their loved ones.
• CS technicians serve internal customers, like physicians, nurses, and other professionals.
• Success of CS depends on satisfying the needs of internal customers.

Impact of Emerging Antibiotic Resistant Bacteria on CS

• The increasing complexity of surgical instruments makes it more challenging for CS personnel to provide quality products and services.
• The ultimate goal of quality is high quality patient care.

Quality in Healthcare Facilities

• Quality is not a quick fix.
• Achieving world-class quality requires a multiyear plan.
• Top-level administrators must emphasize quality because their support is critical for success.
• Most problems affecting employee performance are caused by systems and procedures implemented by top-level leaders.
• Departmental quality should be multidisciplinary.

Empowerment

• Empowerment drives decision-making and implementation down the chain of command.
• Employees assigned to specific work areas must know how to properly perform all work tasks before they can be empowered.

Quality Control Indicators

• CS quality control indicators are used to determine if the department meets its objectives.
• Several indicators should be monitored periodically.
• Some examples include:
  • Customer departments receive STAT (urgent) medical supplies within five minutes of request.
  • Only sterile supplies with current dates are available on unit supply carts.
  • Sterilization processes meet acceptable standards based on physical, chemical, and biological indicators.
  • Instrument sets contain clean, functional, and correct contents.
  • Patient care equipment and supplies are available and in proper working condition.

Failure Mode and Effects Analysis (FMEA) and Root Cause Analysis (RCA)

• FMEA and RCA are widely used methods to analyze issues discovered within quality systems.
• Both concepts are important tools that can be used in a quality program.

FMEA (Failure Mode and Effects Analysis)

• FMEA identifies and prevents problems with products and processes before they occur.
• FMEA has its origins in the military and industrial fields.
• It aims to define the topic that must be addressed.
• FMEA is a highly disciplined and complex process that focuses on developing and delivering near-perfect products and services.

DMAIC (Define, Measure, Analyze, Improve, and Control) and DMADV (Define, Measure, Analyze, Design, and Verify)

• DMAIC procedures monitor and improve existing processes.
• DMADV process is used to develop new processes.

Lean

• Lean is a production practice that preserves value with less work (eliminates waste).
• Eliminating wasteful processes reduces production time and costs.
• Lean's strength is its fast implementation.
• Immediate benefits relate to productivity, error reduction, and customer lead times.
• Long-term benefits include improvements to financial performance, customer satisfaction, and staff morale.

Quality at Work

• Being an active participant in any quality process ensures workable solutions for everyone.
• Taking the time to examine processes and identify opportunities for improvement is worthwhile.

Standardized Survey

• The standardized survey allows meaningful comparisons of hospitals from the patient's perspective.
• Public reporting of HCAHPS results creates incentives for hospitals to improve their quality of care.
• Public reporting enhances accountability in healthcare.

Value-Based Purchasing (VBP)

• The VBP initiatives compare a hospital's HCAHPS scores in a baseline period to those in a later performance period.
• Healthcare facilities that do not reach HCAHPS goals are penalized through reduced government reimbursement.

Magnet Status

• Magnet status is an award given to hospitals for quality patient care, nursing excellence, and innovations in professional nursing practice.

International Standards Organization (ISO) 9000

• ISO 9000 is an international standard that companies use to ensure their quality system is effective.
• This process is believed to guarantee that a company consistently delivers quality services and products.

Quality Central Service Procedures

• Attaining and maintaining high quality CS standards is everyone's responsibility.
• Every technician should play an active role in the department's quality program.
• It is also each technician's responsibility to help or report others who are struggling with a process.
• Keeping the patient as the focus means helping ensure everyone is properly trained and performing at optimum levels.
• Allowing a known defective product out of the department is inexcusable and can be very dangerous for patients.

Tools for Quality Technicians

• Performing departmental audits of each area of the department on a regular basis helps keep the department and its functions at optimal levels.
• If a CS professional is unsure about a completed project, they should ask someone to check their work.
• If a CS professional can't perform to a 100% level, they should not do the project.
• Recheck all work.
• Always help other staff members.
• Report inoperative or damaged equipment.
• Attend educational in services, seminars, infection prevention, service technician and vendor-sponsored programs.
• Always follow established departmental policies, procedures, and protocols.

Conclusion

• Quality in the healthcare environment is everyone's responsibility.
• Quality must remain at the core of central service operations.
• A team-based approach to quality can improve patient care and on-the-job satisfaction.