Quality Improvement in Health Services Organizations by Adam Silumbwe BSc, MPH - Health Services Management-unza

Quality Improvement in Health Services Organizations Adam Silumbwe BSc, MPH Lecture Overview Background and history Creating a learning health service organisation Quality management in health service organisations Benchmarking in healthcare services organisations Definition of Quality A dynamic state associated with products, services,people, processes, and environments that meets or exceeds expectations and helps produce super value Quality is defined by the client, and as such will change over time, often in unpredicatable ways Quality is assocaited with creating customer value As a complex concept, quality can only be addressed by the whole organization working together Cont’d If quality is the endpoint, then quality management is the approach and process of getting there If we are concerned with providing value to customers, we must consider how we can improve customer value There are number of principles that are central to the practice of quality management Principles Central to Pracrtice of quality Management Client focus: if we need to create value for our customers, we need to become obssessive about understanding our customers and their requirements and expectations Strategic focus: if organisations survive and thrive through deliverying value for their clients, then they must treat this as a key strategic objective Leadership focus: Nothing happens in the organisation without the commitment of the leaders Process focus: Emphasis needs to move from assessment of outcome performance to the development and control of processes to deliver customer value. Continual improvement, innovtion and learning: disatsfaction with the status quo. Proactively seeking to learn about customers, prcesses and behaviours Learning Organization “A learning organization is an organization skilled at creating, acquiring, and transferring knowledge, and at modifying its behavior to reflect new knowledge and insights” “New ideas are essential if learning is to take place” “Without accompanying changes in the way that work gets done, only the potential for improvements exist” Organization and Qualities Meaning Plausible, well-grounded definition, actionable and easy to apply. Management Clear guidelines for practice, filled with operational advice rather than high aspirations. Measurement Tools for assessing organizations rate and level of learning to ensure gains have been made. Organization and qualities Three distinct stages Cognitive Exposed to new ideas, expand their knowledge and begin to think differently Behavioral Employees internalize new insights and alter behavior Performance Improvement Changes in behavior leading to measurable improvements in results. Building Blocks Systematic problem solving Experimentation Learning from experience Learning from others Transferring knowledge Measuring learning Each is accompanied by a distinctive mindset, tool kit and pattern of behavior. Systematic Problem Solving Rely on scientific method for diagnosing problems “plan, do, check, act” Data Statistical analysis Generating ideas and collecting information Reaching consensus Analyzing and displaying data Planning actions Experimentation On-going programs Series of small experiments Steady flow of new ideas Incentive system Need managers and employees trained in evaluating and performing experiments Experimentation Demonstration Projects First projects to embody principles and approaches company hopes to adopt on a larger scale Establish policy guidelines and decision rules for later projects Encounter severe tests of commitment from employees (testing rule change) Limited impact on rest of organization (until implemented) Learning from Experience HSOs revive successes and failures Assessment done systematically and in an open and accessible forum “Those who cannot remember the past are condemned to repeat it” Learning from Others “Most powerful insights come from looking outside ones’ immediate environment to gain a new perspective” SIS-Steal ideas shamelessly Benchmarking Ongoing investigation and learning experience that ensures the best industry practices are uncovered, analyzed, adapted and implemented. Transferring knowledge Knowledge must be spread quickly and efficiently throughout the organization Maximum impact when shared broadly Written reports Oral reports Site visits and tours Personnel rotation programs Standardization programs Education and training programs Measuring Learning “If you can’t measure it, you can’t manage it” Actual data comparison Learning or experience curves Incomplete measures, ignore other competitive variables, like quality, delivery or new product introductions Summing it up…, Foster an environment that is conducive to learning Open boundaries and stimulate the exchange of ideas The are not about "more training", rather involve the development of higher levels of knowledge and skill. Management in learning organizations focuses more on how individuals think, what they truly want, and how they interact and learn …