HQS510_PPT_Module 1.pptx

The History of Continuous Quality Improvement (CQI) HQS510  Learning Outcomes 1. Examine how quality improvement developed from manufacturing to healthcare. 2. Compare quality assurance and continuous quality improvement (CQI). 3. Apply the PDSA cycle of quality improvement. 4. Examine...

The History of Continuous Quality Improvement (CQI) HQS510  Learning Outcomes 1. Examine how quality improvement developed from manufacturing to healthcare. 2. Compare quality assurance and continuous quality improvement (CQI). 3. Apply the PDSA cycle of quality improvement. 4. Examine healthcare quality in the context of Saudi Vision 2030. The History of Continuous Quality Improvement (CQI) ► Definitions  Safe. Delivering health care that minimizes risks and harm to service users, including avoiding preventable injuries and reducing medical errors.  Effective. Providing services based on scientific knowledge and evidence-based guidelines.  Timely. Reducing delays in providing and receiving health care. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Definitions (cont.)  Efficient. Delivering health care in a manner that maximizes resource use and avoids waste.  Equitable. Delivering health care that does not differ in quality according to personal characteristics such as gender, race, ethnicity, geographical location, or socioeconomic status.  People-centered. Providing care that takes into account the preferences and aspirations of individual service users and HQ5S10 the culture of their community. Course Code and Title The History of Continuous Quality Improvement (CQI) ►Quality Assurance Quality assurance (QA) is closely related to, and sometimes confused with, CQI. QA focuses on conformance quality, which is defined as “conforming to specifications; having a product or service that meets predefined standards” (McLaughlin & HQS510 Kaluzny, 2006). Course Code and Title The History of Continuous Quality Improvement (CQI) ►Continuous Quality Improvement (CQI)  “The combined efforts of everyone— health care professionals, patients and their families, researchers, payers, planners and educators—to make changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)” (Batalden & Davidoff, HQS510 2007). Course Code and Title The History of Continuous Quality Improvement (CQI) ►Characteristics of CQI A link to key elements of the organization’s strategic plan A quality council made up of the institution’s top leadership Training programs for personnel Mechanisms for selecting improvement opportunities HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Characteristics of CQI (cont.) Formation of process improvement teams Staff support for process analysis and redesign Personnel policies that motivate and support staff participation in process improvement Application of the most current and rigorous techniques of the scientific method and statistical process control HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ►Continuous Quality Improvement (CQI) Institutional Improvement 1. Localized improvement efforts 2. Organizational learning 3. Process reengineering 4. Evidence-based practice and management HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ►Continuous Quality Improvement (CQI) Societal Learning  Concern for quality and cost is a matter of public policy.  Professional Responsibility  Professional development as a potential engine of quality improvement. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Rationale and Distinguishing Characteristics: Customer Focus System Focus Measurement and Decision Making HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Elements of CQI  Philosophical Elements Structural Elements Health Care–Specific Elements HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Evolution of the Quality Movement  Like the field itself, its name has evolved from total quality management (TQM) to continuous quality improvement (CQI), or simply quality improvement (QI).  From TQM to CQI-  Represents a fundamental change in how organizations have come to recognize the importance of ensuring that changes are improvements and that the improvement processes are ongoing, requiring learning and involvement in the process at all levels, HQS510 from the individual to the organization level. Course Code and Title The History of Continuous Quality Improvement (CQI) ► Ongoing Evolution in Japan  Recent Contributions of Japanese Quality Engineers 1. Total participation is required of all members of an organization (quality must be company-wide). 2. The next step of a process is its “customer,” just as the preceding step is its “supplier.” 3. Communicating with both customer and supplier is necessary (promoting feedback and creating channels of communication throughout the system). 4. Emphasis is placed on participative teams, starting with “quality circles.” HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Ongoing Evolution in Japan Recent Contributions of Japanese Quality Engineers (cont.) 5. Emphasis is placed on education and training. 6. Instituted the Deming Prize to recognize quality improvement. 7. Statistics are used rigorously. 8. Instituted “just in time” processes. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Cross-Disciplinary Thinking CQI: Philosophy Process Tools Mission Mission Goals Goals Outcomes Outcomes HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► Shewart (PDSA) Cycle Act: Adopt the change or Plan: a change abandon it or or a test aimed run through the at improvement cycle again Study the Do: carry out results- what the change or did we learn? test, on a small What went scale wrong? HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► The Evolution Across Sectors of Health Care ►Now includes all segments of the health care system and has become woven into the education of future practitioners, including not only administrators and physicians but also nurses, public health practitioners, and a wide array of other health professionals. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► The Big Bang—The Quality Chasm Quality improvement was acknowledged to be a professional responsibility, a quality-of-care issue rather than a managerial tactic. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► From Industrialization to Personalization  Craft requires that the individual improve with experience and use the tacit knowledge produced to develop a better individual reputation and group reputation. Craft activities can be leveraged to a limited extent by a community of cooperating and teaching crafts- persons.  Mass production requires the discipline that produces conformance quality in high volume at low cost. Critics sometimes refer to this approach using terms such as industrialization or the deskilling of the profession and occasionally mention Henry Ford’s assembly lines as a negative model. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► From Industrialization to Personalization  Process enhancement requires that processes be analyzed and modified to develop a best-practice approach using worker feedback and process-owning teams within the organization.  Mass customization requires that the organization takes that best practice, modularizes and supports it independently, and then uses those modules to build efficient, low-cost processes that are responsive to individual customer wants and needs. HQS510 Course Code and Title The History of Continuous Quality Improvement (CQI) ► The Scientific Method of CQI  Key features of PDSA application: 1. The use of repeated iterative cycles 2. Prediction-based test of change (developed in the plan stage) 3. Small-scale testing (build as confidence grows—adapting according to feedback and learning) 4. Use of data over time (to understand the impact of change) 5. Documentation (to support local learning and transferability to other settings) HQS510 Course Code and Title  The History of Continuous Quality Improvement (CQI) ► The FOCUS-PDCA Model 1. What are we trying to accomplish? 2. How will we know when that change is an improvement? 3. What changes can we predict will make an improvement? 4. How shall we pilot test the predicted improvements? 5. What do we expect to learn from the test run? 6. As the data come in, what have we learned? 7. If we get positive results, how do we hold on to the gains? 8. If we get negative results, what needs to be done next? 9. When we review the experience, what can we learn HQS510 about doing a better job in the future? Course Code and Title The History of Continuous Quality Improvement (CQI) ► Conclusions The trend is continuing on a global scale. The institutionalization of CQI in public health continues to grow due to various influences that mirror other health care sectors, such as national and local accreditation efforts. HQS510 Course Code and Title