Quality of Healthcare PDF

TOTAL QUALITY MANAGEMENT Total Quality Management: means that the organiza on supports customer sa sfac on through an integrated system of tools, techniques, and training; involves the con nuous improvement of organiza onal processes, resul ng in high quality products and services / Organiza on wide...

TOTAL QUALITY MANAGEMENT Total Quality Management: means that the organiza on supports customer sa sfac on through an integrated system of tools, techniques, and training; involves the con nuous improvement of organiza onal processes, resul ng in high quality products and services / Organiza on wide management philosophy for con nuously improving the quality of services and its processes / The art of managing the whole to achieve excellence / A way to con nuously improve performance at every level of opera on in every func onal area of organiza on using all available human and capital resources aiming to reduce waste and cost of poor quality / a management system for a customer- focused organiza on that involves all employees in con nual improvement. - Con nuous quality improvement is the responsibility of everyone who is involved in the produc on services offered and hence is interested in its quality Total - made up of the whole Quality - degree of excellence service provides Management - act, art or manner of planning, controlling, direc ng… TQM as a Management Philosophy Aims to: ↑ Customer service ↑ Produc vity ↑ Profits ↑ Market share ↓ Cost Main Elements of TQM: The customer: determina on of quality The teamwork: as a mean of achieving quality, The scien fic approach: to decision-making based on data collec on and analysis. Main Objec ves (1) total client sa sfac on: through quality products and services (2) con nuous improvements: to processes, systems, people, suppliers, partners, products, and services. Principles of TQM  Customer-focused: The customer ul mately determines the level of quality. No mater what an organiza on does to foster quality improvement—training employees, integra ng quality into the design process, or upgrading computers or so ware— the customer determines whether the efforts were worthwhile. Total employee involvement: All employees par cipate in working toward common goals. Total employee commitment can only be obtained i. a er fear has been driven from the workplace, ii. when empowerment has occurred, iii. when management has provided the proper environment Process-centred: A fundamental part of TQM is a focus on process thinking. i. A process is a series of steps that take inputs from suppliers (internal or external) and transforms them into outputs that are delivered to customers (internal or external). ii. The steps required to carry out the process are defined, and performance measures are con nuously monitored to detect unexpected varia on. The TQM System Goals of Healthcare TQM working according to specifica ons providing effec ve services with a minimum use of resources to sa sfy customers: in TQM Everyone is a customer, either internal or external Con nuous Quality Improvement Important elements: External and internal customer sa sfac on Management leadership Involves all personnel Uses sta s cal methods Focuses on improvements Quality: Carrying out interven ons correctly according to pre-established standards and procedures, with an aim of sa sfying the customers of the health system and maximizing results without genera ng health risks or unnecessary costs Oxford English Dictionary: the degree or grade of excellence The Community Health Accredita on: the degree to which consumers progress toward a desired outcome Characteris cs of Quality: Having high degree of excellence Doing right things right first me and every me Is cost - reduc on, not a cost Doing the right things (what) To the right people (to whom) At the right me (when) And doing things right first me and every me Evalua on of Quality: I. Inspec ng the Past: Finding mistakes/errors External assessment/control Culture of mistrust II. Looking Into Past & Plan For the Future: avoid mistakes personal responsibility / ownership culture of trust III. Systemic Fulfilment of Customer Requirements IV. Par cipa on of All Members of an Organisa on for Con nuous Improvement Stages of TQM What’s Wrong in Healthcare? Avoidable errors Underu liza on of services Overuse of services Varia on in services Communica on problems Lack of Evidence Dissa sfied clients Advantages Improves reputa on- faults and problems are spoted and sorted quicker. Develop new innova ons, and a reputa on as a Performance which will meet or exceed customer expecta ons. Higher employee morale- workers mo vated by extra responsibility ,team work and involvement indecisions of TQM. Lower cost. Decrease waste as fewer defec ve products and no need for separate. Disadvantages Ini al introduc on cost. Benefits may not be seen for several months. Workers may be resistant to change. A Simple Process Improvement Plan The ini al step is to develop a simple process improvement plan. This can be done by answering three ques ons: 1. What process should we try to improve?  - can be answered in different ways: by listening to pa ent complaints; or by examining clinical, opera onal, or financial data. Why do pa ents complain? Because they must wait too long to be scheduled for an x-ray? Because the wai ng me in the emergency department is too long? Because their interac ons with physicians are unacceptable? Do physicians complain that it is taking too long to get the results? Is the number of medical errors a cause for concern? 2. How will we know that a change will be an improvement? - we begin by asking what aspect of the iden fied process needs improvement. Just ask: What aspect of a process are we trying to improve? For example, if pa ent safety is the process we wish to improve, what will be the aspect of safety we wish to improve? Pa ent falls ? Medica on errors? Misdiagnoses? If pa ent sa sfac on is low, should we be focusing on accessibility to care? Or wai ng me in the x ray areas or in the emergency department? 3. What change can we make to effect that improvement? It is critical to agree on the way in which we will quan fiably measure the process. Some refer to this as the operational definition. The aim of an opera onal defini on is clear communica on between everyone. It reduces variability in data collec on. It should be developed before data are gathered. The final step in determining that a change made an improvement involves plo ng data over me and analysing the type of varia on. Establish Quality Project Iden fy priori es, goals and customers Set up working groups Describe service according to: - consumer and client needs - make plans for evalua on A Simple Process Improvement Plan (PDSA) cycle What is Con nuous Improvement? Method of making small, incremental improvements to contribute to increased compe veness, produc vity, teamwork, employee engagement, and reduced costs It’s a series of asking, “How can we op mize the current process?” Plan – Study the current system; iden fying problems; tes ng theories of causes; and developing solu ons. Do – Plan is implemented on a trial basis. Data collected and documented. Study – Determine whether the trial plan is working correctly by evalua ng the results. Act – Improvements are standardized and final plan is implemented. Seven Steps or Phases 1. Iden fy the opportunity 2. Analyse the current process 3. Develop the op mal solu on(s) 4. Implement changes 5. Study the results 6. Standardize the solu on 7. Plan for the future Design & Planning 1. Organiza on and General rules 2. Requirements Iden fica on 3. Priority Iden fica on 4. Baseline Assessment 5. Gap Analysis 6. Ac on Planning Priority Iden fica on o Of processes or services o According to one or a combina on of the following criteria: High risk High volume Problem – prone Cost or resources Impact on performance A SIMPLE IMPROVEMENT PLAN The Deming Cycle / PDCA Cycle Three Characters of Quality Process 1) Measurable quality o Clinically these standards may take the form of prac ce guidelines or protocols, or they may establish acceptable expecta ons for pa ent outcomes and organiza on performance o At their best, however, standards serve as guidelines for excellence 2) Apprecia ve quality o Is the comprehension and appraisal of excellence beyond minimal standards and criteria o Peer review bodies o Quality or no quality of specific pa ent-prac oner interac ons 3) Percep ve quality o Is that degree of excellence that is perceived by the recipient or the observer of care rather than by the provider of care o The physical environment and technical competence Customer / Supplier Chain Con nual Improvement Collec ng and Measuring Ac vi es PI 18. Wai ng mes are monitored. PI 19. Pa ent assessment is monitored. PI 20. Surgical and invasive procedures are monitored. PI 21. Use of anaesthesia and moderate and deep seda on is monitored. PI 22. Use of medica ons is monitored. PI 23. Use of blood and blood products is monitored. PI 24. Medical records, including availability and content are monitored. PI 25. Infec on control, surveillance and repor ng are monitored. PI 26.Medica on errors and adverse outcomes are monitored. Process Improvement: A systema c, data-based method for improving the quality of work processes; it uses team decision-making to improve processes that affect the quality of products and services for a customer. o Process improvement involves process analysis, study an exis ng process to understand its ac vi es o Process models include descrip ons of tasks, ac vi es, roles, communica ons, deliverables and other processes o Produce an abstract model of the process. You should normally represent this graphically. Several different views (e.g. ac vi es, deliverables, etc.) may be required o Analyse the model to discover process problems. Involves discussing ac vi es with stakeholders o Measurement should be used to answer specific ques ons Sta s cal Quality Control Seven Process Improvement Tools o Flowcharts i. The sequence of all the steps, including feedback paths ii. Clear data collec on points  iii. Ideas for improvement iv. An understanding of how a process works v. Can show an exis ng process, a new process, or a change to a process vi. Graphical representa on of steps involved in a process. vii. Flow charts give in detail the sequence involved in the material, machine and opera on that are involved in the comple on of the process. viii. Excellent means of documen ng the steps that are carried out in a process. o Cause-and-Effect Diagrams / Fishbone Diagram i. The cause-and-effect diagram is an inves ga ve tool. It is also known Fishbone diagram. ii. There is a systema c arrangement of all possible causes which give rise to the effect in Fishbone diagram. iii. It is necessary to list down all possible causes through a brainstorming session so that no important cause is missed. The causes are then divided into major sources or variables.  iv. This is very much helpful when one wants to find out the solu on to a par cular problem that could have a number of causes for it and when we are interested in finding out the root cause for it. v. Used for complex problems that likely have more than one root cause vi. All poten al causes categorized in 6 groups: Machine, Man, Material, Method, Measurement, Environment o Checklists / Check Sheet i. check sheets are forms that can be used to systema cally collect data. ii. used to gather data for later analysis iii. used to confirm that process tasks are complete iv. both simple yes/no and branching ques ons o Pareto Analysis i. Pareto chart create a bar chart of the causes of the problem in order from most to least frequent so that you can focus aten on on the most important elements or combina on of elements ii. ver cal axis labelled with # defects iii. horizontal axis (nominal) labelled with defect cause types o Histograms i. frequency bar graph ii. ver cal axis is # defects iii. horizontal axis has ordinal or interval type labels iv. a histogram describes the past, but does not predict future performance. v. help in understanding the varia on in the process. It also helps in es ma ng the process capability. o Scater Diagrams o Control Charts i. control chart is the best method to es mate process capability. ii. upper and lower control limits (dashed lines) are drawn to alert the user when dependent measure is out of control iii. control charts show whether a process is stable so that valid comparisons can be made. iv. It can also be used with any process (clinical, opera onal or financial) and any type of data (measurement data, count data, percentages, or ra os). v. As long as the points remain between the lower and upper control limits, we assume that the observed varia on is controlled varia on and that the process is in control vi. The process is out of control. Both the fourth and the twel h observa ons lie outside of the control limits, leading us to believe that their values are the result of uncontrolled varia on. vii. Even control charts in which all points between the control limits might suggest that a process is out of control. In particular, the existence of a pattern in eight or more  consecutive points indicates a process out of control, because an obvious pattern violates the assumption of random variability  First, gather sufficient data for a minimum of 20 subgroups.  Second, ascertain whether the process is stable and predictable, that is, has only common cause varia on.  How do we do this?  Then use the mean and upper and lower control limits to describe process capability.  Control limits then serve as “performance boundaries. Varia on: result from the process itself i. They are inherent in the design, implementa on, and opera on of the process. ii. Common cause varia on remains the same from day-to-day. come from sources outside the process. i. They relate to some special event. ii. It is sensible to inves gate the actual reason for the varia on. Detec ng Special Causes A special cause is indicated when eight or more successive values fall on the same side of the centrelines. Factors Influencing the Quality of Medical Services Social Factors Affec ng Quality of Medical Care 1. Socioeconomic status 2. Educa onal level 3. Gender 4. Health 5. Ethnicity (origin) 6. Culture customs, and norms Physician Competency 1. He / she has the skills, resources and condi ons necessary to improve the health status of the pa ent. 2. Technical competence, effec veness and safety. 3. Upda ng health care with recent technical status. 4. Accountable to professional standards. 5. Safe and clean work place Health Worker Mo va on & Maintenance Investments of Healthcare Quality 1. Physical Physical capital refers to any non-human resources as money and materials which used in the produc on of products and services. Quality is not free. High quality resources are needed to provide high quality services. Healthcare organiza ons should provide their staff with the resources they need to deliver high quality services. 2. Human: Human capital refers to the skills, experience and knowledge gained by an employee to perform the job well. 3. Social: Social capital refers to one’s responsibility and accountability to society and human beings. 4. Cultural: - A significant change in opinions, a tudes and beliefs of physicians with regard to quality. - Team-work and collabora on should be adopted. - Good communica on, coopera on among healthcare providers support providing effec ve and efficient medical services. - Shared responsibility for pa ent care 5. Leadership o Leadership capital is the leader’s ability to direct an organiza on forward in a posi ve direc on. o This by building a shared vision and decision making as well as se ng a clear direc on for the organiza on. 3 Components of Healthcare Services Health care service is usually composed of : Input, process and output  Each one of these components have required to setle down standards to measure accordingly. Quality of health services is measured by assessment for these three components : ( 1 ) Quality of inputs ( 2 ) Quality process ( 3 ) The system outcome/result Rela onship Between Inputs, Processes & Outputs of Health Services Taxonomy: prac ce and science of categoriza on classifica on especially a hierarchical classifica on Taxonomy of a system is simply; an orderly arrangement of systems according to their supposed features and rela onships. Taxonomy differen ates from classifica on that taxonomies describe rela onships between items while classifica on simply arranged in groups or s as colours, sex… Standard (Key) Quality of Care Standards of care: General statement about what is expected to be provided to ensure high quality care. Each standard has been carefully defined and is considered essen al to provide quality service. Descrip on & Use of Technical Process Standards ACCREDITATION Accredita on: a recognized evalua on process used to assess and improve the quality, efficiency, and effec veness of health care organiza ons / It is a process by which a separate, non- governmental nonprofit organiza on assesses the healthcare facility to determine if it meets a set of requirements (standards) designed to improve the safety and quality of care - consist of periodic assessments of organiza onal and clinical prac ces and the measurement of their performance against pre-established, evidence-based standards Accredita on Organisa ons: There is a wide list of na onal and interna onal healthcare accredita on organiza ons that are responsible for the accredita on of hospitals and other healthcare services 1. Na onal Accredita on Organisa on Most countries have their own accredita on organiza on system. In Egypt The General Authority for Healthcare Accredita on & Regula on (GAHAR) is the organiza on responsible for accredita on of hospitals and any healthcare facility. 2. Interna onal Healthcare Accredita on Organisa ons Joint Commission interna onal (JCI) in USA Accredita on Canada Interna onal (ACI), Interna onal Society for the Quality in Healthcare (ISQua) : Which is the umbrella organiza on responsible for accredi ng the JCI and ACI, as well as accredita on organiza ons in the United Kingdom and Australia. 3. Egyp an Accredita on Organisa on (GAHAR) The General Authority for Healthcare Accredita on & Regula on (GAHAR) developed its Accredita on Standards, aiming for con nuous improvement, which can raise the quality of care and create a culture of sustainable improvement in health care. Items of GAHAR GAHAR evaluates organiza on structure, process, and/or outcome by se ng standards that address these concepts. It composes of 3 sec ons; i. Sec on 1: Accredita on Prerequisites and Condi ons This sec on aims at providing a clear ethical framework that a hospital must follow to comply with the GAHAR survey process. Scores of these standards are always to be met to con nue the survey process. ii. Sec on 2: Pa ent-Centred Standards  Pa ent-centred care (PCC) represents a paradigm shi in how pa ents, healthcare professionals, and other par cipants think about the processes of treatment and healing. Pa ent-centred care is defined as the act of providing care that is respec ul of, and responsive to, individual pa ent preferences, needs and values, and ensuring that pa ent values guide all clinical decisions. PCC has recognized as a dimension of the broader concept of high-quality healthcare. Principles of Pa ent-centred Care 1. Respect for pa ents’ values, preferences and expressed needs Involve pa ents in decision-making. Treat pa ents with dignity, respect and sensi vity to his/her cultural values and autonomy. 2. Coordina on and integra on of care Pa ents iden fied 3 areas in care coordina on that can reduce feelings of vulnerability: - Coordina on of clinical care, Coordina on of ancillary and support services and Coordina on of front-line pa ent care 3. Informa on and educa on Hospitals can focus on three kinds of informa on to counter pa ent fear: - Informa on on clinical status, progress and prognosis - Informa on on processes of care 4. Physical comfort Three areas were reported as par cularly important to pa ents: - Pain management - Hospital surroundings and environment 5. Emo onal support and allevia on of fear and anxiety Caregivers should pay par cular aten on to: - Anxiety over physical status, treatment and prognosis - Anxiety over the impact of the illness on themselves and family - Anxiety over the financial impact of illness 6. Involvement of family and friends Family dimensions of pa ent-centred care were iden fied as follows: - Involving family and close friends in decision making - Suppor ng family members as caregivers - Recognizing the needs of family and friends 7. Con nuity and transi on Mee ng pa ent needs in this area requires the following: - Understandable, detailed informa on regarding medica ons, physical limita ons, dietary needs, etc. - Coordinate and plan ongoing treatment and services a er discharge - Provide informa on regarding access to clinical, social, physical and financial support on a con nuing basis.  8. Access to care The following areas were of importance to the pa ent: - Access to the loca on of hospitals, clinics and physician offices. - Availability of transporta on. - Ease of scheduling appointments. - Availability of appointments when needed. - Accessibility to specialists or specialty services when a referral is made. - Clear instruc ons provided on when and how to get referrals. iii. Sec on 3: Organiza on-centred Standards Pa ent safety and centred care was the focus of the previous sec on; however, pa ents are not the only customers of healthcare systems, Healthcare professionals face risks as well. Three major aspects may affect worker's wellbeing; safety, stress, and health care facility structure. Components: Environmental and Facility Safety Infec on Preven on and Control Organiza on Governance and Management. Community Assessment and Involvement Workforce Management. Informa on Management and Technology Quality and Performance Improvement Standard’s Components: 1-Name: is writen as a standard statement preceded with a code. 2-Keywords: help organiza ons understand the most important element of standard statements. It answers the ques on of WHAT the standard is intended to measure. 3-Intent: it helps organiza ons to understand the full meaning of the standard (either; -Norma ve: that describes the purpose and ra onale of the standard. It answers the ques on of WHY the standard is required to be met. -Informa ve: help organiza ons iden fy the strategy to interpret and execute the standard. -It answers the ques on of HOW the standard is going to be met. 4-Evidence of compliance (EOCs): indicates what is reviewed and assigned a score during the on-site survey process. 5-Survey process guide :facilitates and assists the surveyors in the standard’s ra ng for the required EOCs Benefits of Accredita on: Improvement of care provided by healthcare facility. Provides a safe and efficient work environment. Increases health care organiza ons’ compliance with quality and safety standards. Contributes to increased job sa sfac on among health care providers. Sustains improvements in quality and organiza onal performance. Enables on-going self-analysis of performance in rela on to standards. Promotes capacity-building, professional development, and organiza onal learning. Improve public trust. Scoring Guide During the survey visit, each standard is scored for the evidence of compliance (EOC). These are mathema cal rules that depend on summa on and percentage calcula on of scores of each applicable EOC as follows: Met: when the average score of the applicable EOCs of this standard is 80% or more with a total score of 2. Par ally met: when the average score of the applicable EOCs of this standard is less than 80% or but not less than 50% with a total score of 1 Not met: when the average score of the applicable EOCs of this standard is less than 50% with a total score of 0. Not applicable when the surveyor determines that the standard requirements are out of the organiza on scope. Scoring of Each Chapter Each chapter is scored a er calcula ng the average score of all applicable standards in this chapter. Look Back Period Comply with the Na onal Safety Requirements during the whole period between receiving the approval of registra on and the actual accredita on survey visit. Na onal Safety Requirements ; those standards which may impact individual’s safety, or in other words; the main killers in hospitals. Comply with the rest of the GAHAR Handbook for hospital standards for at least four months before the surveyor’s visit. Accredita on Decisions Rules  A health care facility can achieve the status of accredita on by demonstra ng compliance with certain accredita on decision rules. These rules mandate achieving certain scores on a standard level, chapter level, and overall level as the accredita on decision is composed of four decisions; Accredita on Decisions - Condi oned accredita on for 2 years - Condi oned accredita on for 1 year - Denial of accredita on 1st Decision: Status of Accredita on for a hospital (3 years) Overall compliance of 80% and more, and Each chapter should score not less than 70%, and No single whole standard is scored as not met, and No single not met NSR standard. 2nd Decision: Status of Condi oned Accredita on for a hospital (2 years) Overall compliance of 70% to less than 80%, or Each chapter should score not less than 60%, or Up to one standard not met per chapter, and No single not met NSR standard. 3rd Decision: Status of Condi oned Accredita on for a hospital (1 year) Overall compliance of 60% to less than 70%, or Each chapter should score not less than 50%, or Up to two standards not met per chapter, and No single not met NSR standard. 4th Decision: Rejec on of Accredita on Overall compliance of less than 60%, or One chapter scored less than 50%, or  More than two standards not met per chapter, or Not met NSR standard. Hospitals having status of accredita on or condi oned accredita on with elements of non- compliance are requested to: 1-Submit a correc ve ac on plan for unmet EOCs and standards within 90 days for 1st decision, 60 days for 2nd decision and 30 days for 3rd decision to the email [email protected]. 2-Apply and pass the accredita on survey in 2 years for 2nd Decision and 1 year for 3rd Decision. - Accredita on is valid for 3 years for 1st Decision. - Accredita on may me be suspended or withdrawn if: The Hospital fails to pass follow up surveys in case of condi oned accredita on, The Hospital fails to submit correc ve ac on plans in case of presence of one not met EOC or more, The Hospital fails to pass unannounced survey, Effec ve & Safe Management of Medical Emergency Situa ons Standard’s components 1-Name: ICD.14 Urgent and emergency services are delivered according to applicable laws and regula ons. 2-Keywords: Emergency services 3-Intent: To ensure consistency and coordina on of services with higher levels of care, emergency services offered to the community should be provided within the capabili es of the PHC as defined by law and regula ons. PHCs shall develop and implement a policy and procedures for urgent or emergency services. The Policy a) Qualified staff members are available during working hours. b) Defined criteria are developed to determine the priority of care according to a recognized triage process c) Assessment, reassessment and care management When a PHC provides emergency care, the emergency room register usually includes all pa ent’s data in the emergency sheet: i. Time of arrival and me of departure ii. Conclusions at the termina on of treatment iii. Pa ent's condi on at departure iv. Follow-up care instruc ons 4-Survey process guide : The GAHAR surveyor may trace a pa ent journey and assess implementa on. The GAHAR surveyor may interview pa ents or family members to assess their engagement. The GAHAR surveyor may review a pa ent’s medical record to evaluate compliance with standard requirements. The GAHAR surveyor may review emergency room records to check registra on of emergency pa ents. 5-Evidence of compliance (EOCs): 1. Emergency services are defined according to applicable laws and regula ons. 2. Competent staff members offer emergency services. 3. Pa ents and families are informed of their priority level and expected me to wait before being assessed by a medical staff member. 4. Evidence of registra on of all emergency pa ents treated in the emergency room. KAIZEN Approach to Improve Performance & Quality in Hospitals Kaizen Principle & Concept: Quality is a prominent subject in healthcare, with the ul mate objec ve of maintaining a high level of pa ent sa sfac on and pa ent safety. When a healthcare ins tu on has barriers to reaching goals in mee ng cost-effec ve objec ves and improving pa ent safety, it is vital to iden fy the core causes and take necessary steps as quickly as possible. It is important to respond quickly to an undesirable condi on or problem and analyse the most cri cal contribu ng factors that led to it. Problem: a gap between ideal situa on & current situa on Kaizen: con nuous problem-solving process to improve working environment, process and condi ons / adopted not only to clinical se ng but also several hospital management se ngs in health care facili es / a problem-solving technique, that depends on the plan-do-check-adjust (PDCA) quality cycle. - ongoing or con nual improvement and comprises the following two Japanese words : KAI = CHANGE ZEN = FOR THE BETTER In this transla on Kaizen means "change for the beter" kaizen is defined as: step-by-step, ordered and con nuous improvement, Moreover, it means con nuous improvement in sonal life, on social and work pla orm. KAIZEN in workplace means con nuing improvement involving everyone, managers and workers alike. Healthcare Kaizen is a lean tool that focuses on small, con nuous improvements throughout the workplace. Each small change results in a minor improvement. As me passes, these minor improvements add up to significant steps forward in efficiency, quality, safety, and workplace culture. It is NOT “INNOVATION” (not big changes) Target is “your work,” not others! It is small changes on your way of working Small changes and litle by litle improvement Kaizen is based on the idea that small, incremental changes can lead to significant, long- term improvements. Concept of 5S Kaizen -The Kaizen methodology is a unique approach that combines organiza onal advantages of the 5S system, with the con nuous improvement. -This method emphasizes the importance of maintaining an organized and effec ve workplace environment, especially in healthcare se ngs where efficiency and accuracy are essen al. 1. Sort (Seiri); removing items from workspaces to minimize distrac ons. 2. Set in Order (Seiton); Organize everything needed in proper order for easy work. 3. Shine (Seiso); cleaning rou nes to uphold a safe and pleasant working atmosphere. 4. Standardize (Seiketsu); establish procedures and worksta ons for uniformity and predictability. 5. Sustain (Shitsuke); cul va ng behaviors and prac ces that Requirements During Planning Phase During the planning, 5W1H need to be clarified against the theme or topic as shown: Why are we undertaking the project? What are we going to do? What data is required? Who is responsible for each task? Who should be involved? Where can we find relevant data and facts? When must a task be complete? When do we need to give feedback? How must it be accomplished? How do we review? Entry Point of KAIZEN- Change Culture of Organisa on 1. Teamwork - All employees should work collabora vely to achieve one end goal 2. Personal Discipline - Kaizen insists that all employees must increase their self- discipline in all aspects related to their work ( me management, spending of material and financial resources) 3. Improve Morale - All employees should strive to increase their confidence and enthusiasm. 4. Quality Circles Quality circles refer to a group of employees that o en get together to discuss and create solu ons for improving working processes. Employees can share their ideas and thoughts, knowledge and exper se, and other useful resources. Collabora on and coopera on within these quality circles will enable employees to measure the effec veness of their performance.  Consequently, this will enable them to further improve. 5. Sugges ons for Improvement All employees should be given the freedom to offer their ideas and sugges ons for improving opera onal processes. In other words, if there is enough me, money, and resources, the idea/sugges on should be implemented. How to Implement KAIZEN for Problem Solving KAIZEN is the approach of solving problems that exist in workplace. KAIZEN process was established as a sequen al process of events based on PDCA (Plan-Do- Check-Ac on) cycle, so-called “Quality Control story.” QC story is a basic procedure for solving problems scien fically, ra onally, efficiently and effec vely. Tradi onal vs KAIZEN Approach 1- Scope of improvement: Tradi onal approaches o en emphasize large-scale radical improvements designed to significantly modify processes or systems, ini a ng them periodically with dedicated resources and me for planning and execu on. On the other hand, KAIZEN™ emphasizes small-scale, incremental changes implemented con nuously with employee involvement from all organiza onal levels focusing on gradually making adjustments that improve efficiency, quality, and overall 2- Approach to Change Management Tradi onal approaches require extensive change management efforts due to the scale and magnitude of proposed improvements, such as restructuring departments or introducing significant process redesigns. Conversely, KAIZEN emphasizes employee involvement through botom-up approaches where employees ac vely iden fy problems, suggest improvements, and implement changes. 3-Dura on Tradi onal improvement projects span mul ple months or years and involve extensive planning, analysis, and implementa on phases. By contrast, KAIZEN™ approaches focus on quick and frequent improvements by making small-scale changes within short me frames that yield immediate results while crea ng momentum for further changes. Benefits of Kaizen  Eliminate waste in organiza on. Increase produc vity. Improve quality. Customer sa sfac on. Growth of the organiza on. Eliminate any abnormali es & stopping of limits. Develop self-personality Pit Falls in KAIZEN Lack of proper procedure to implement. Too much sugges on may lead to confusion and me wastage. Difficult to implement in large scale process, where analysing requires a lot of me. Resistance to change.