Quality in Family Medicine Saudi Diploma in Family

Quality in Family Medicine Saudi Diploma in Family Medicine Center of Post Graduate Studies in Family Medicine Dr. Zekeriya Aktürk zekeriya. akturk@gmail. com www. aile. net 1 / 25

Objectives • At the end of this session, the trainees should be able to; – – – – define terms related with quality express the benefits of quality explain the quality diagram Plan-Do-Check-Act discuss ways to improve quality in primary care describe quality circles/peer review groups describe workflow describe processes 2 / 25

The Story of Drugs 2000 BC: Eat this root. . . 1000 AC: The root is useless, come do this prayer. . . 1850 AC: Prayer is superstition. . . Take, drink this elixir. . . 1940 AC: The elixir is snake oil. . . Use this drug. . . 1985 AC: The drug is ineffective. . . Take this antibiotic. . 2000 AC: Antibiotics are not working. . . “Eat this root. . . " 3 / 25

What is Quality? 4 / 25

Quality • peculiar and essential character • an inherent feature • degree of excellence • a distinguishing attribute Websters Dictionary 5 / 25

Quality • Appropriateness for work. (Dr. J. M. Juran) 6 / 25

Quality • Appropriate for the conditions. (P. B. Crosby) 7 / 25

Quality • The level you can cover the needs. 8 / 25

Quality • Meeting the requirements at the first time, all the times and at the correct time. 9 / 25

Quality • Customer satisfaction. 10 / 25

Some terms • • • ISO 9001: 2000 Quality assurance Quality improvement Total quality management Process Procedure Instructions Documentation Quality circles 11 / 25

Stakeholders Patients Managers QUALITY Workers 12 / 25

Quality Cycle W. Edwards Deming 13 / 25

Quality is a process 14 / 25

Quality approaches Corrective system 1 Analyze customer needs 4 Corrective actions 2 Marketing 3 Control the process 15 / 25

Preventive System 1 Analyze customer needs 4 Marketing 2 Design and improve 3 Control the process 16 / 25

Benefits of TQM Benefits to Customers An external customer is the person or organization who receives and pays for a product, a service, or information. For example, the external customer of a movie theater is the moviegoer; the external customer of a car dealership is the new car buyer. An internal customer is an employee or department within an organization who receives an output in the form of a product, service, or information from another employee or department in that same organization. For example, the internal customer of a graphic designer may be the marketing representative who requests a new product brochure. Or the internal customer of a welder may be the operator performing 17 / 25 final assembly.

Toplam Kalite Yönetiminin Yararları Benefits to Organizations Logically, healthy profits are critical to any organization’s survival and must be factored into key business decisions, including the decision to implement quality. Though quality’s benefits extend beyond the financial realm, organizations should ultimately implement quality because it makes good business sense. 18 / 25

Toplam Kalite Yönetiminin Yararları Benefits to Employees • Product quality leads to: • Greater pride in products and services. • Sense of satisfaction in a job well done. • Process quality leads to: • Improvements in internal communication. • Reduction in frustration caused by repetitive problems and rework. • Streamlined work processes that make sense to the employees who use them. 19 / 25

• Customer satisfaction leads to: – Opportunity to serve real versus perceived customer needs. – Happier customers who are more gratifying to serve. – Strengthened relationships with repeat customers. • Profit leads to: – More stable organizations. – Greater job security. – Potential for enhanced employee benefits (higher compensation, better health coverage, more competitive investment plans, etc. ). – An additional benefit to learning and applying quality practices is that, in doing so, employees gain valuable knowledge and skills desired by other quality-minded 20 / 25 organizations in the job market.

Three areas in quality • Structure – The structure of health system is important. Economical and political restrictions will effect the quality of services • Process – What are we doing for our patients in reality? Can we accomplish our responsibilities? • Outcomes – Is our practice really making any change? What about patient satisfaction, mortality, morbidity…? 21 / 25 Rajakumar MK. Asia Pacific Family Medicine 2002; 1: 74– 78

22 / 25

Summary • What is quality? • Describe the quality cycle • How did Donabedian define Structure, Process, and Outcome? • What is ISO? • What are quality circles? 23 / 25

Question Which one is not a feature of preventive quality approach? a. Customer need analysis b. Design and improvement c. Correcting encountered errors d. Process control e. Marketing 24 / 25

• “I think I have said enough to show we have progressed and how each one of us is only a link in a chain that began long before us and will continue long after we have gone. Therefore, we must honor our predecessors and delight in those who shall follow. ” • “Quality is very simple. It is love – love of knowledge, love of man, and love o God. ” Avedis Donabedian Spanish Journal of Health Care and Quality, 1999 25 / 25