Lecture 2 TQM 311 lecturer: Noura Al-Afeef Medical Record Department

History of Total Quality Management? Quality pioneers? Key dimensions of Quality?

History of TQM Islamic implement QM shora / teamwork. كلكم راع وكلكم مسئول عن رعيته إن الله يحب إذا عمل أحدكم عملا أن يتقنه وتعاونوا على البر والتقوى Started in Japan 1920 in industrial sector it was successful then implemented in united state they called it Quality Control.

Shewhart wrote the economic control of the quality of the manufactured product 1931 Direct efforts to fix the process rather than products Deming 1930 and juran 1950 two American experts in quality control assisted Japanese after W.W.I.I

CHECK DO ACT PLAN Shewhart cycle

PLAN: Identify process or problem for improvement Establish current statues of process Develop action plan to gather information Do: Implement data gathering and analyze Check: Evaluate impact of the do strategies Make decisions for next step Act: Hold the gains

Two Japanese Ohno and ishikawa improve the quality control. Ohio developed the famed toyota production system,the concept just-in-time production and eliminate waste Ishikawa focus on customer, fix the problem not to blame

1960 crospy : zero defect, focus on prevention 1983 feigenbaum wrote about the application of QC focusing on satisfaction of customer needs. Deming Deming trained Japanese engineers on how to use statistics to improve the product. Japanese initiated Deming reward for quality for companies.

Deming has 14 points for managing quality some Deming points: Drive out fear Institute training on the job Adopt and institute leadership Break down barriers between staff areas

QUALITY PLANNING. QUALITY CONTROL. QUALITY IMPROVEMEN T. JURAN TRILOGY

Juran Fitness for use Quality Trilogy: 1-Quality Planning Identifying the customer needs and expectation Identifying process issue for effective outcomes

2-Quality Control Measuring current performance and its variance from expected performance 3- Quality Improvement Study and improve

Key Dimensions of Quality: 1- Appropriateness: The degree to which the care and services provided are relevant to the patients clinical needs. Is the intervention correct? given the needs? 2-Availability: Is there sufficient access to care?

3- Competency: practitioners ability to produce customer satisfaction and adheres to standards of care Are practitioners qualified to provide the care? 4-Continuity: Are the care provided in continuous way? 5- Effectiveness : Are positive outcomes are reached?

6- Efficiency: The relationship between outcome and the resources used to deliver patient care. Are the treatment provided in manner that conserve resources? 7-Safety : avoid the risks for patients and health care providers 8-Timeliness: provide the health care at the most necessary time