University of Arkansas System
Type of paper: Thesis/Dissertation Chapter
Statistical and managerial techniques for six sigma methodology theory and application
Quality improvement (QI) comprises of continuous and systematic actions that result to measurable improvement in the health care as well as the health status of patients groups that are targeted. According to the institute of Medicine’s, which is a recognized advisor and leader on the nation’s health care improvement, health care quality comprises of a direct correlation between the desired health outcomes and the level of improved health services of populations and individuals (Shan 2008). The process of QI involves the application of a defined and a deliberate process of improvement. It involves ongoing and continuous efforts designed to achieve measurable improvements in the effectiveness, efficiency, accountability, outcomes, performance, and other indicators of quality in processes or services which improves the community health and achieves equity.
Methodologies used in integrating QI strategies in the health care performance
Methodology describes theoretical analysis of the appropriate methods to a given field of study or to the body of principles and methods particular to a branch of knowledge (Barone 2012). On the other hand, a strategy refers to the science and art of marshaling and planning resources for an efficient and effective use (Menon 2010).
It involves monitoring, designing and improving process that eliminate or minimize waste while increasing financial stability and optimizing satisfaction. The performance of a process is applied in measuring improvement through comparing the process capability with the capability of baseline process after the potential solution piloting for quality improvement. It uses two primary methods. One method is responsible in inspecting process outcome and counts on the defects, calculates the rate per million of a defect, and applies a table of statistics in the conversion of defect rate per million in relation to a sigma metric. The second estimates the variation of the process to predict the performance through calculating a sigma metric from the observed variations of the process. It uses a five-phased process that is disciplined rigorous, referred to as DMAIC approach. It begins by identifying the project, reviewing the historical data, and lastly defining the scope of the expectations. Next, the standards of continuous total quality performance are selected objectives of the performance are defined, and definition of sources of variability. Data are collected for assessment of how well the process was improved by changes as a new project is implemented.
Customer inspired quality methodology
It concentrates on the process as well as the results of an organization. This methodology needs the service to be thorough as it focuses on the customers’ perspective. It identifies customer measures, reviewing and improving processes and getting the feedback of customers. This methodology enables the organization to realize the customer needs and works towards integrating them to the customer services. The methodology becomes continuous as the patients’ needs change with time. The organization sets down procedures which act as a reference to the organization. This calls for regular training of the staffs so as to enhance better services delivery to the customers.
Studies and projects based on QI aimed at bringing positive changes in the processes of delivering health care services can apply PDSA for favorable outcomes. This method has been widely used by healthcare institute for rapid cycle improvement. The model has a unique feature that is the cyclical nature of assessing and impacting change. It is most accomplished effectively through frequent and small PDSAs instead of using slow and big ones before wide changes are made in the system.
The aim of PDSA efforts in quality improvement is to establish a casual or functional relationship between outcomes and changes in processes specifically capabilities and behaviors (Provost 2011). Three questions are proposed before applying the PDSA cycles: what is the aim of the project? How will it be revealed that the set aims were achieved? What is going to be done to achieve the aim? The cycle starts by with determining the scope and the nature of the problem, what is to be measured in order to understand the effect of change, and where the strategy is to be targeted. A change is implemented, and information and data are collected. Results from the study are interpreted and assessed through reviewing several key measurements showing failure or success. Lastly a change on QI is implemented based on the results obtained.
Clinical Decision Support System (CDSS)
It occupies a significant part in the field of management technologies of clinical knowledge through their capacity to support the use of knowledge and the clinical process, from investigation and diagnosis through treatment and long-term care. These support systems are “systems of active knowledge using two or more patient data items for the generation of case-specific advice (Danniels 2010). CDSS is designed typically to integrate a medically based knowledge, an inference engine and patient data for case specific advice generation.
For health care providers to meet the increasing quality demands of their patients, they are required to focus on innovation technology. Examples of IT that can be applied include object oriented technologies, use of specific components of IT, and the computerized system records (Qi 2013). Object oriented technology ensures all different systems in the organization are connected to a unified system of management. Patient’s records are computerized to prevent damage or loss. For specific IT components, it ensures easier monitoring of quality performance in the organization.
IT applications in improving performanceObject oriented technology
Links the components of quality management system to the entire management system of the enterprise, it is obtained through connection of these components via interface of a standard framework. It ensures that medical records are not lost, and there is faster delivery of services.
Computerized system of patient records
It has great effects on the profitability of the organization. It minimizes time and labor that is used during data entry. The stored data is easily propagated once it has been keyed into the system (Clancy 2003).
Specific IT components
It helps in sufficing the demands of the diversified population of patients. It ensures consistency in the organizations operations. It enables the organization to achieve the safety of patients and have fast service delivery. Nurses and other health workers learn fast on how to use such systems as they are specific.
Use of milestones and benchmarks in quality indicators management
In quality improvement, quality indicators are used as a guide to the performance evaluation in an organization. Walshe et al (2001) stated that performance should be continually evaluated and at the end of the organizational projects. Benchmarks are operations and programs that are set out in order assess the organizational performance (Catalano 2008). This is achieved through running some trial tests and standards. It ensures a review of information technology performance of an organization. Milestones mark the end of a stage or a project. Performance is continually monitored, improved and evaluated through this process.
For the plan of QI, future event, benchmarks system level and application benchmarks will be applied. Benchmarks help the organization in achieving the set goals. The benchmarks system level is meant in evaluating how computer programs and applications are performing in overall. According to Obadiah & Boudriga (2009), use of information technology improves the organizational computer programs and systems. The application of benchmarks applies actual application programs. In the delivery of health care services, the aim is ensuring that each patient gets quality health services. The vision, mission and strategic plan of the health organization are to give satisfactory services to patients. The organization also plans to be the leading store and drug suppliers. Improvement of performance is in line with the organizational plans as they facilitate achievement of patients’ satisfaction and quality improvement. This results to increased sales, competitiveness and revenue (Walshe et al 2001).
Performance and quality improvement are very essential in an organization. It is achieved through the use of improved information technology system, and methodologies of performance improvement. Improvement of performance being a continuous process leads to increase in the organizational profit and customer loyalty.
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