Applying Quality Management in Healthcare

by Kelly, Diane L.

• ISBN13: 9781567932065
• ISBN10: 1567932061
• Format: Hardcover
• Copyright: 2003-07-01
• Publisher: HLTH-AD

Author Biography

Diane L. Kelly, Dr.P.H., M.B.A., R.N., is adjunct assistant professor at the University of North Carolina at Chapel Hill

Table of Contents

Section I The Fundamentals of Quality Management
Concepts of Quality Management	3	(14)
Managers' Perception of Quality	4	(1)
Definitions	5	(4)
Medical Quality	5	(1)
Quality Assurance	6	(1)
Quality Improvement	7	(1)
Total Quality	8	(1)
Quality Management	9	(1)
Quality Continuum for Managers	10	(2)
Conclusion	12	(1)
Companion Readings	13	(1)
References	13	(2)
Exercise	15	(2)
Three Principles of Total Quality	17	(14)
Principle 1: Customer Focus	17	(2)
Dual Nature of Quality	17	(1)
Defining Customers and Stakeholders	18	(1)
Customer Requirements	19	(1)
Principle 2: Continuous Improvement	19	(4)
Day-to-Day Actions	19	(1)
Managerial Functions	20	(1)
Support for an Improvement Project	20	(3)
Principle 3: Teamwork	23	(2)
Management Philosophy	23	(1)
Management Functions	24	(1)
Conclusion	25	(1)
Companion Readings	26	(1)
References	26	(1)
Exercise	27	(4)
Continuous Quality Improvement Tools	31	(28)
Improvement Tools	32	(19)
Identifying Customer Expectations	33	(1)
Documenting a Process	34	(8)
Diagnosing the Problem	42	(6)
Monitoring Progress	48	(3)
Conclusion	51	(1)
Companion Readings	51	(1)
References	51	(2)
Exercise	53	(6)
Section II The Systems Approach
A Systems Perspective of Quality Management	59	(14)
Systems Thinking	60	(1)
Dynamic Complexity	60	(8)
Change	61	(1)
Trade-Offs	62	(2)
History Dependency	64	(1)
Tight Coupling	65	(1)
Nonlinearity	66	(2)
Conclusion	68	(1)
Companion Readings	68	(1)
References	68	(2)
Exercise	70	(3)
Systems Models for Healthcare Managers	73	(16)
Organizational Systems Design Model	73	(3)
Lessons for Healthcare Managers	74	(2)
Three Core Process Model	76	(3)
Lessons for Healthcare Managers	78	(1)
Socioecological Framework	79	(2)
Lessons for Healthcare Managers	80	(1)
The BNQP Healthcare Criteria for Performance Excellence	81	(3)
Lessons for Healthcare Managers	83	(1)
Conclusion	84	(1)
Companion Readings	85	(1)
References	85	(2)
Exercise	87	(2)
Systemic Structure	89	(20)
A Systems Metaphor for Organizations	89	(2)
Lessons for Healthcare Managers	91	(4)
Lesson 1: Systemic Structure Influences Behavior	92	(1)
Lesson 2: Systemic Structure Is Invisible	93	(1)
Lesson 3: Information Is Essential to Identifying Systemic Structure	94	(1)
Lesson 4: Successful Change Requires Going Below the Waterline	95	(1)
Going Below the Waterline	95	(5)
Understanding History	95	(2)
Being Aware of Mental Models	97	(1)
Integrating Double-Loop Learning	98	(2)
Conclusion	100	(1)
Companion Readings	100	(1)
References	101	(2)
Exercise	103	(6)
Section III Achieving Quality Results in the Complex Systems
Goals	109	(12)
Importance of Setting Goals	109	(2)
Clinical Interventions	109	(1)
Managerial Interventions	110	(1)
Relationship Between Goals and Results	111	(1)
Approaches to Setting Goals	112	(3)
Use Intermediate Goals	113	(1)
Define Implicit Goals	113	(1)
Reformulate Goals As Needed	113	(1)
Set Multiple Goals	114	(1)
Types of Goal Statements	115	(1)
Conclusion	115	(1)
Companion Reading	115	(2)
References	117	(1)
Exercise	118	(3)
Purpose	121	(12)
The Importance of Purpose	122	(5)
Setting Direction	122	(2)
Addressing the Right Problem	124	(1)
Fostering Common Ground	125	(1)
Promoting Breakthrough Ideas and Solutions	126	(1)
The ``Purpose Principle''	127	(1)
From Concept to Practice	127	(3)
Conclusion	130	(1)
Companion Reading	130	(1)
References	130	(1)
Exercise	131	(2)
Performance Measurement	133	(20)
The Foundation for Organizational Effectiveness	134	(1)
Lessons for Healthcare Managers	134	(7)
Choose a Balanced Set of Measures	136	(1)
Translate Data into Information	137	(2)
Evaluate Results and Ongoing Results	139	(1)
Understand the Relationship Between System and Component Measures	139	(2)
Process Variation	141	(6)
Statistical Process Control Charts	142	(5)
Conclusion	147	(1)
Companion Readings	147	(1)
References	148	(2)
Exercise	150	(3)
Organizational Traction	153	(14)
Initiating Change	154	(4)
Creative Tension	155	(3)
Maintaining an Ongoing Environment of Quality and Performance Improvement	158	(3)
Context	158	(3)
Context and Vision	161	(1)
Conclusion	161	(1)
Companion Readings	162	(1)
References	162	(2)
Exercise	164	(3)
Implementation Lessons	167	(14)
Operational Considerations	168	(3)
Measurement System	168	(2)
Unintended Consequences	170	(1)
Staff Issues	170	(1)
Relationship Between Mental Models and Implementation	171	(1)
Framework for Implementation	172	(5)
Conclusion	177	(1)
Companion Readings	177	(1)
References	178	(1)
Exercise	179	(2)
Team Strategies	181	(14)
Designing Teams	182	(4)
Purpose	182	(1)
Process	183	(2)
Structure	185	(1)
Team Effectiveness	186	(2)
Talents and Differences	186	(1)
Operational Teams	187	(1)
Project Teams	188	(1)
Conclusion	188	(1)
Companion Readings	189	(1)
References	189	(1)
Exercise	190	(5)
Epilog	195	(2)
Practice Exercises	197	(18)
Journal Exercise	215