Quality improvement into practice
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m865 (Published 31 March 2020) Cite this as: BMJ 2020;368:m865Read the full collection
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Dear Editor
Quality Improvement [1] is a buzz word in modern healthcare organizations and it is the core and most important aspect of services rendered by any healthcare facility.
Quality guru Joseph Juran [2] described quality as “FIT for USE”, which indicates that the success and failure of any service /product can be measured through its fitment in the systems of the organisation and the premise of customer base. Healthcare settings are a complex matrix system [3] in which simple intervention could affect the outcome. According to the Donabedian model [4], in every quality initiative, the basis for measuring quality improvement are the structures, processes and the outcomes (or inputs, processes and the output). The output or the efficiency always depends upon inputs and the processes. The structures or inputs are expensive affairs as they they are resource demanding (resources are always limited in any organisation). Therefore, the primary focus for improving quality should be on processes improvement. In process improvement, one needs the organizational involvement in creating their own standard operating procedures (SOPs)
Creating customized standard operating procedures (SOPs) is the first step of any quality assurance initiative.The development of Institutional SOPs needs the involvement of staff, continuous support and mentoring. As Aristotle said, ”Quality is not an act but a habit”. Ensuring standard practices and adherence to standards, changing behavior and attitude of the staff is not an easy task. It needs rigorous monitoring tools, continuous support and engagement of the staff and, most importantly, the ownership of the staff working at the facility for implementation and sustainability of the Q.I efforts.
References
1. http://nabh.co/ National Accreditation Board for Hospital and Healthcare providers, 3rd Edition, accessed On 25- 8-2015
2. Juran M. Juran on Planning for Quality. New York: Free Press; 1988.
3. McGibony. R. John. Principal of Hospital Administration, 2nd Edition
4. Donabedian A. Explorations in quality assessment and monitoring. 2. The criteria and standards of quality. Ann Arbor, MI: Health Administration Press; 1982.
Competing interests: No competing interests
Re: Quality improvement into practice reference 22
Dear Editor
I appreciate my PhD thesis which the Sheffield Microsystem Coaching Academy (MCA) references regularly in their improvement capability programs. The statement "Improvement in healthcare is 20% technical and 80% human," reference #22 is inaccurate. My PhD mixed method analysis and thesis reports the 20% technical and 80% human findings. I am flattered to see this reference and would like to provide the accurate original source--it may be in a report about the MCA, but the source is my doctoral research.
Competing interests: No competing interests