Applying Quality Management in Healthcare: A Systems Approach

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  • Edition: 3rd
  • Format: Hardcover
  • Copyright: 2011-07-01

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Quality management is a complex process, especially in healthcare. Managers in today's environment need more than just an understanding of the historical concepts of quality. They need to understand how to achieve quality within the structure and relationships of the complex system of a healthcare organization.

Author Biography

Diane L. Kelly, DrPH, MBA, R, teaches at the University of North Carolina at Chapel Hill Public Health Leadership Program and Duke University School of Nursing. Dr. Kelly is a former member of the editorial advisory board for the Joint Commission Journal on Quality and Patient Safety and the national Baldrige Performance Excellence Program Board of Examiners.

Table of Contents

Forewordp. xiii
Prefacep. xvii
Acknowledgmentsp. xxi
Quality Management: A Systems Approach
Fundamentals of Quality Managementp. 3
Why Focus on Management?p. 4
What Is Quality?p. 5
Creating a Shared Definition of "Quality"p. 7
Three Principles of Total Qualityp. 9
Quality Continuum for Managersp. 12
Summaryp. 15
A Systems Perspective of Quality Management: Characteristics of Complex Systemsp. 19
Systems Thinkingp. 21
Dynamic Complexityp. 22
Summaryp. 29
Understanding System Behavior: Systemic Structurep. 31
A Systems Metaphor for Organizationsp. 31
Lessons for Healthcare Managersp. 33
Going Below the Waterlinep. 38
Summaryp. 44
Visualizing System Relationships: Models for Health Services Managersp. 47
Three Core Process Model48
The Baldrige Performance Excellence Program in Health Care Criteriap. 51
Systems Model of Organizational Accidentsp. 55
Socioecological Frameworkp. 59
Summaryp. 62
Achieving Quality Results in Complex Systems
Establishing System Directionp. 67
Purposep. 68
The Purpose Principlep. 73
Visionp. 79
Contextp. 82
Summaryp. 85
Establishing Improvement Goals in Complex Systemsp. 87
Relationship Between Goals and Resultsp. 89
Setting Improvement Goals in Complex Systemsp. 91
Types of Goal Statementsp. 94
Critiquing Goal Statementsp. 96
SMART Goals and Complex Systemsp. 99
Corollaries to Purpose and Goalsp. 100
Summaryp. 101
Understanding Customer and Stakeholder Requirementsp. 103
Patient Requirementsp. 104
Implications for Managersp. 107
Summaryp. 113
Understanding the Role of Policy in Promoting System Changep. 119
Health Policy: An Overviewp. 120
Public Policy Promoting Systems Changep. 125
Private Policy Promoting Systems Changep. 129
Lessons for Managersp. 133
Summaryp. 136
Improving Processes and Implementing Improvementsp. 139
Systematic Critical Thinking in Designing Improvementsp. 140
Process Improvement Toolsp. 143
Root Cause Analysisp. 148
Prospective Analysisp. 149
Implementing Improvementsp. 151
Summaryp. 158
Measuring Process and System Performancep. 165
Preserve the Contextp. 166
Bundle and Unbundle Data According to the User's Purposep. 168
Differentiate Types of Measures and Their Usesp. 173
Select a Balanced Set of Measuresp. 175
Analyze Process and System Performancep. 178
Performance Management Measures and the Quality Continuump. 184
Summaryp. 185
Postering Teamwork: Below-the-Waterline Considerationsp. 191
Team Designp. 192
Mental Models Affecting Team Designp. 194
Mental Models About Talents and Differencesp. 196
Mental Models About Improvement or Project Teamsp. 199
Tools for Effective Teamsp. 201
Summaryp. 202
Practice Lab
Reflective Journalp. 207
The Manager's Rolep. 209
Dynamic Complexityp. 211
Mental Modelsp. 213
System Relationshipsp. 215
Systems Error Case Study and Analysisp. 217
Customer Requirementsp. 219
Improvement Case Studyp. 221
Team Guidelinesp. 225
Generational Differencesp. 227
Organizational Self-Assessmentp. 228
Improving a Performance Gap in My Organizationp. 238
Improving a Performance Gap: A Case Studyp. 245
Glossary of Termsp. 255
Referencesp. 261
Indexp. 275
About the Authorp. 284
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