1The Quality Improvement Journey: From TQM to QIHIVQUAL Workshop June 24, 2011Dan Belanger Terry Hamilton Lawrence Hansley2AgendanWelcome and Introductions nSWOT Analysis Small Group Exercise nTotal Quality Management nKey Tools and Techniques nOrigins of Quality Management nHistogram Small Group Exercise nContinuous Improvement n6 Sigma nLean nLean Small Group Exercise nThe Model for Improvement 3Ice Breaker: SWOT Analysis Small Group ExercisenYour HIV QM Committee is considering adding consumers to the HIV QM CommitteenTo understand the pros and cons you decide to do a SWOT Analysis (strengths, weaknesses, opportunities and threats) nUsing the worksheet in your packet, each group brainstorms a SWOT analysis and reports back 4Quality RootsnThe roots of Total Quality Management can be traced to early 1920s production quality control ideas, and concepts developed in Japan beginning in the late 1940s and 1950s, pioneered there by Americans Feigenbaum, Juran and Deming 5Total Quality Management (TQM)nTotal Quality Management features: q the customer-supplier interfaces, (external and internal customers and suppliers) qan organizational commitment to qualityqthe importance of communicating this quality commitmentqthe acknowledgement that the right organizational culture is essential for effective Total Quality Management 6Tools and TechniquesnAn array of tools and techniques is used for identifying, measuring, prioritizing and improving processes critical to quality 7Process Improvement ToolsnThese process improvement tools and techniques include: qPDSA (plan, do, study, act) Cycle qFlow-chartingqCause and effect diagram,qBrainstorming qPareto Analysis 8ActWhat changesare to be made? Next cycle?Plan Objective Questions and predictions (why) Plan to carry out the cycle(who, what, where, when) StudyComplete theanalysis of the data Compare data to predictions Summarize whatwas learnedDoCarry out the plan Document problems and unexpected observations Begin analysis of the data The PDSA cycle for learning and improvement9Commonly Used Flow Chart Symbols: Purpose: Graphic depiction of how a process works Use: 1) visualize and understand a process; 2) consider ways to simplify; 3) recognize unnecessary steps; 4) identify who will be involved in or effected by improvement process Caution: 1) flowchart must reflect real process; 2) people who know the process must be involved; 3) be sure the flowchart focuses on the identified problemTask or StepTerminatorDecisionWait symbolFlow Charts10Flow Chart ExamplePatient arrives at front deskClient in system?Receptionist asks clientto complete paperwork for new clientsand return it to front deskNOAsk client to be seated in the Waiting room YESHR Counselor takes client into Counseling RoomETC.Front Desk Staff Asks Client for Name4th edn, 2002Crosby, P., “Quality is Free: The Art of Making Quality Certain”, McGraw-Hill, 1979Ishikawa, K., “What is Total Quality Control? The Japanese Way”, Prentice Hall, 1985Juran, J., “Juran on Planning for Quality”, Free Press, New York, and Collier Macmillan, London, 198877Special Thanks tonTerry HamiltonnLawrence HansleynHHC78AndThank you!