1. Implementing a Quality Management System Approach
Catholic Health Australia National Conference
20 August 2012
Marise Goddard-Jones
GGJ Consultants

2. Community care context ...
Australia’s population is living longer and there are more frail aged people needing care in the community.
The Intergenerational Report 2010
Presently there are over 3 million Australians aged 65 years or older (15.3% of the population). This is projected to rise to around 7.5 million (26% of the population) by 2055.
Australian Bureau of Statistics / Living Longer Living Better Report 2012
91% of Australians want to remain as independent as possible as they grow older and remain in their own homes, with the support of professional services.
Australian Housing and Urban Research Institute May 2010

3. Community care context
There is clearly a need to ensure quality services are delivered to community care clients
Quality standards are a key strategy: they are an indicator that service providers are delivering quality services
They provide a framework and impetus for service providers to continuously improve services

4. Do Standards make a difference to client outcomes?
Not on their own!
An integrated quality management system (QMS) approach is required to ensure that the Standards and organisation processes are implemented effectively.

5. What is a QMS approach?
The International Organisation for Standardization (ISO) Quality Management Systems Requirements ISO 9001:2008 describes organisations applying a QMS approach can:
Demonstrate the ability to consistently provide product/service that meets customer and applicable regulatory requirements, and
The QMS aims to enhance customer satisfaction through the effective application of the system, including processes for continual improvement of the system and the assurance of conformity to customer and applicable regulatory requirements.

6. What does a QMS look like?
Systematic, integrated and structured
Demonstrates an understanding of regulatory, legislative and customer requirements
Documentation and records are maintained
Processes and risks are measured and monitored
Competence, training, skills, and experience of staff are demonstrated
Services are linked to customer needs
Equipment and materials are suitable
Continual improvement is demonstrated
A QMS approach is a health tonic for your business – it makes everything work better.
You may notice some similarities between these elements and the CCCS – in developing the Standards we ensured alliance with the QMS requirements of the International Standard.

7. What else is required? Involved leadership
An understanding of quality, the business and continuous improvement
Commitment and enthusiasm
Knowledge and skills to implement systems, measurement and monitoring
Creativity to engage others and
The drive to seek out relevant standards and other resources
A leadership team that does not display and interest in the systems, processes and outcomes of them will not reach its potential.
Leadership needs to be displayed by executive management and management that sets the example, is involved and involves and enthuses others.
An understanding of what quality means for the organisation, the requirements of Standards, the businesses’ systems and processes and continuous improvement.
Commitment and enthusiasm to improve and apply the quality systems.
Knowledge and skills to improve through the involvement of all stakeholders and to implement systems to monitor and measure the quality system and its outcomes, such as the implementation of a robust internal audit program.
Creativity: often people say that a quality management system approach limits innovation and creativity. That is not my experience; once systems and processes are in place, including monitoring processes, they then have the freedom to trial and implement improvements. You need creativity to engage with people both within and outside of your organisation to get them on board.
Application of other relevant standards an other resources: the health sector more broadly has been implementing standards and quality management systems for years – we can learn from the resources developed by these other health sectors.

8. Sector concerns Standards stifle innovation
Standards and ‘quality’ stop us doing our real work – delivering services and support to clients
Standards are all about paperwork and nothing about giving better services to clients
It is all about processes and not outcomes
Staff and volunteers will leave
We don’t have enough time to do all this
We don’t have the expertise…..

9. Be prepared for change…
“It is not the strongest of the species that survive, nor the most intelligent, but the ones most responsive to change.” Darwin
Implementing a quality management system approach necessitates change:
New ways of doing things
Processes and structures to promote consistency
Insistence on documentation, monitoring, internal audit
Go slow!

10. Critical elements to make your QMS work
Policy and procedures matched to practice
Efficient work processes
Staff knowledge and competence
Records – eg client, training, incidents, staff, reports eg KPIs
Collect data/conduct surveys/research
Seek ongoing customer feedback
Review of environment/products

11. EG: Complaints and feedback
P & P: description of how feedback and complaints are handled with timeframes
Processes for collection: forms, surveys, forums, collecting ‘hidden’ feedback, trending feedback
Staff: all staff trained in complaints/feedback management
Records: evidence of timely, appropriate action and improvements based on feedback
Evaluation: internal audit of policy, procedures and practices; is there customer satisfaction with the outcome?; are the processes efficient?

12. Standards and other resources
Be informed and seek info:
Community Care Common Standards
Information from funders and peak agencies
ISO 9001:2008 Quality management system requirements
Specific Australian Standards
Australian Commission on Safety and Quality in Health
Evidence based practices
Technology

13. It’s too hard…..
Measure your progress on other health sector performance:
1st 3 years – formative (systems implemented)
2nd 3 years – consolidation (status quo and testing/monitoring)
Next 3 years – streamlining (an integrated system that demonstrates improvements easily)

14. What are the outcomes of a QMS approach?
Sustainable business that can provide ongoing high quality services
Implementation of client ideas and preferences leading to services more in tune with client needs
Enthusiastic and committed workforce
Potential for growth and diversity in service provision
And more…

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