approaches in maryland ems quality improvement john new director, miemss quality management prepared...

Approaches in Maryland Approaches in Maryland EMS EMS

Quality Improvement Quality Improvement

John NewJohn NewDirector,Director, MIEMSS Quality MIEMSS Quality

ManagementManagement

Prepared ForPrepared For: QA Officer Training : QA Officer Training

Day 2, Session 3 – 9:00 to 10:30.Day 2, Session 3 – 9:00 to 10:30.

Copyright 2007 All Rights Reserved

Quality Catalyst OverviewQuality Catalyst Overview Brief History of QMBrief History of QM Essential Parts of Quality Essential Parts of Quality

OrganizationsOrganizations MIEMSS ExperienceMIEMSS Experience Practical ExamplePractical Example Assessing “Quality” OrganizationsAssessing “Quality” Organizations Moving OnMoving On

EMS Quality ApproachesEMS Quality Approaches


A Leadership Guide To Quality ImprovementA Leadership Guide To Quality ImprovementA Leadership Guide to Quality Improvement for A Leadership Guide to Quality Improvement for Emergency Medical Services (EMS) Systems.Emergency Medical Services (EMS) Systems.

This publication is distributed by the US This publication is distributed by the US ...... www.nhtsa.dot.gov/people/injury/ems/Leaderguide/ - www.nhtsa.dot.gov/people/injury/ems/Leaderguide/ - 101k 101k

NHTSA (July 1997)(July 1997)

Maryland’s EMS Quality Maryland’s EMS Quality Catalysts for ChangeCatalysts for Change

http://www.nhtsa.dot.gov/people/injury/ems/Leaderguide/


““A Leadership Guide to Quality A Leadership Guide to Quality Improvement for Emergency Medical Improvement for Emergency Medical Services SystemsServices Systems” – ” – NHTSA (July 1997)(July 1997)

Title 30 MIEMSS Regulations Title 30 MIEMSS Regulations (Dec. 1999)(Dec. 1999)

Subtitle 03 EMS OperationsSubtitle 03 EMS Operations Chapter 04 02 Quality Assurance PlanChapter 04 02 Quality Assurance Plan Chapter 04 03 Medical Review CommitteeChapter 04 03 Medical Review Committee Chapter 04 08 Quality Assurance Officer Chapter 04 08 Quality Assurance Officer (Oct. 2007)(Oct. 2007)



““A Leadership Guide to Quality A Leadership Guide to Quality Improvement for Emergency Improvement for Emergency Medical Services SystemsMedical Services Systems” – NHTSA ” – NHTSA (July 1997)(July 1997)

Title 30 MIEMSS Regulations Title 30 MIEMSS Regulations (Dec. 1999)(Dec. 1999) Subtitle 03 EMS OperationsSubtitle 03 EMS Operations

Chapter 04 02 Quality Assurance PlanChapter 04 02 Quality Assurance Plan Chapter 04 03 Medical Review CommitteeChapter 04 03 Medical Review Committee Chapter 04 08 Quality Assurance Officer Chapter 04 08 Quality Assurance Officer (Oct. 2007)(Oct. 2007)

MManaging anaging FFor or RResults (MFR)esults (MFR) (June 1997)(June 1997)



Leadership’s Role in defining EMS Leadership’s Role in defining EMS “Quality”“Quality”

Accountability through Goal Accountability through Goal Setting and MeasurementSetting and Measurement

A Need to be Proactive towards A Need to be Proactive towards “Improvement” “Improvement”

Shift from Parochial Interests Shift from Parochial Interests (silos) to Cooperative Excellence (silos) to Cooperative Excellence (system) (system)

Catalyst CommonalitiesCatalyst Commonalities


A Series of Scientific and Humanistic Processes

Evolutionary and Blended FocusEvolutionary and Blended Focus


A A ProcessProcess That Integrates: That Integrates: Strategic Planning and Leadership Strategic Planning and Leadership

CommitmentCommitment An Empowered Work ForceAn Empowered Work Force Recognition of Customers, Stakeholders, Recognition of Customers, Stakeholders,

ProcessorsProcessors Data Utilization and AnalysisData Utilization and Analysis Results Based ManagementResults Based Management

Quality ControlQuality Control Quality ImprovementQuality Improvement

Quality Management (QM) DefinedQuality Management (QM) Defined


The traditional The traditional approach:approach:“top - down”“top - down”

Employees

Leadership

Performance Model for Moving Performance Model for Moving Maryland ForwardMaryland Forward


The consultant’s The consultant’s perspective:perspective:“bottom - up”“bottom - up”

Employees

Leadership

Performance Model for Moving Performance Model for Moving Maryland ForwardMaryland Forward

Copyright 2007 All Rights ReservedCustomer Feedback + Learning

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VisionLeadership

Human Resources

Strategic Planning

Information & Analysis

CUSTOMER

$Customer

QCustomer

Customer

Customer

FOCUS

Performance Model for MovingPerformance Model for MovingMaryland ForwardMaryland Forward


CQI - Continuous Quality CQI - Continuous Quality ImprovementImprovement

TQM - Total Quality ManagementTQM - Total Quality Management TQS - Total Quality SystemsTQS - Total Quality Systems QSI - Quality Systems ImprovementQSI - Quality Systems Improvement TQ - Total QualityTQ - Total Quality QI - Quality ImprovementQI - Quality Improvement

What’s In A Name?What’s In A Name?


Traditional Quality AssuranceTraditional Quality Assurance Tasked FocusedTasked Focused One Right WayOne Right Way Tough On PeopleTough On People Control/Micro ManagementControl/Micro Management

Quality Management Is NotQuality Management Is Not


InternalInternal Reasons for Change Reasons for Change Improve Planning ProcessImprove Planning Process

Budget (Show direct/indirect savings)Budget (Show direct/indirect savings) Resources Assessment (Identify justifiable items)Resources Assessment (Identify justifiable items)

Meet Greater Needs of OrganizationMeet Greater Needs of Organization Increase Productivity Increase Productivity Increase Employee Morale, Recruitment, Increase Employee Morale, Recruitment,

RetentionRetention

Why Change Management Why Change Management PhilosophyPhilosophy


ExternalExternal Reasons for Change Reasons for Change Tighter Fiscal AllotmentsTighter Fiscal Allotments

Expectation of Tax Cuts not Tax IncreasesExpectation of Tax Cuts not Tax Increases Cost of Living is Going UpCost of Living is Going Up

Improve Accountability of Given ResourcesImprove Accountability of Given Resources What’s expected is metWhat’s expected is met

Market ForcesMarket Forces Competition form Other EMS ServicesCompetition form Other EMS Services

Potential and Actual Patient Expectation Potential and Actual Patient Expectation ChangesChanges

Demographics and TechnologyDemographics and Technology

Why Change Management Why Change Management PhilosophyPhilosophy


““LESS OBVIOUS”LESS OBVIOUS”

Cost of Poor Quality Cost of Poor Quality IcebergIceberg

““OBVIOUS”OBVIOUS”

ArgumentsArguments

OvertimeOvertime InspectionInspection

5, 35 Day Forms5, 35 Day Forms

Validation Errors

Validation ErrorsComplaintsComplaints UnsatisfiedUnsatisfied

Customer Customer DissatisfactionDissatisfaction

Job-hoppingJob-hopping

Rush Development CostsRush Development Costs

Unnecessary Field Unnecessary Field ServiceService

Low MoraleLow Morale

More MeetingsMore Meetings

Duplication of EffortDuplication of Effort

Job Burn-outJob Burn-out

Departmental and OtherDepartmental and Other Agency Turf Battles Agency Turf Battles

RetrainingRetraining

Workplace Workplace HasslesHassles

Lost TimeLost Time

Wasted EffortWasted Effort

GrievancesGrievances

AbsenteeismAbsenteeism

Equipment FailureEquipment Failure

11th Hour Jobs11th Hour Jobs

Poor Poor CommunicationCommunication

Doing a Lot,Doing a Lot,Finishing LittleFinishing Little


Capitalistic Capitalistic Caveat Emptor (Caveat Emptor (Customer is Responsible for QualityCustomer is Responsible for Quality))

If It’s Not Broke, Don't’ Fix ItIf It’s Not Broke, Don't’ Fix It Assumes Quality is a Given (Assumes Quality is a Given (Slow to React to ChangeSlow to React to Change)) Sign of Stability (Sign of Stability (or Sign of Stagnation)or Sign of Stagnation)

MonopolyMonopoly We’re the Only Supplier Around (We’re the Only Supplier Around (Is Usually Short LivedIs Usually Short Lived))

Quality ImperativeQuality Imperative Customer’s Expectations (Customer’s Expectations (Meet and ExceedMeet and Exceed))

Historical “Quality” Mind SetsHistorical “Quality” Mind Sets


Walter Shewart Walter Shewart (1930’s) - (1930’s) - Statistical Quality Statistical Quality ControlControl Developed Developed PPlan, lan, DDo, o, CCheck and heck and AAct cycle ct cycle

(PDCA)(PDCA)

W. Edwards Deming W. Edwards Deming (1950’s) - (1950’s) - HumanismHumanism Production Flaws are rooted in system design, Production Flaws are rooted in system design,

not in the commitment of the work force.not in the commitment of the work force.

Quality Management In IndustryQuality Management In Industry


Joseph Juran Joseph Juran (1950’s) - (1950’s) - Total Total IntegratingIntegrating Stressed inter-dependency of entire Stressed inter-dependency of entire

production process.production process.

Philip Crosby Philip Crosby (1970’s) - (1970’s) - Quality Is FreeQuality Is Free Associated quality with cost or no Associated quality with cost or no

quality=lost $quality=lost $

Quality Management In IndustryQuality Management In Industry


““Eventually I was able to distill into a simple Eventually I was able to distill into a simple set of precepts the philosophy Dad had set of precepts the philosophy Dad had followed in managing the business for 40 followed in managing the business for 40 years:years:

Give full consideration to the individual employee.Give full consideration to the individual employee.

Spend a lot of time making customers happy.Spend a lot of time making customers happy.

Go the last mile to do every thing right.”Go the last mile to do every thing right.”

Thomas J. Watson, Jr.Thomas J. Watson, Jr.President and son of the founder of IBMPresident and son of the founder of IBM

Industrial Quality Management Industrial Quality Management DistilledDistilled


Scientific Side Scientific Side (Analytical Approach)(Analytical Approach)

• Objective Data vs. Anecdotal Decision Objective Data vs. Anecdotal Decision Basis Basis

• Understanding of Complex ProcessesUnderstanding of Complex Processes• Quality Control Quality Control (Determine process gauges)(Determine process gauges)

• Quality Improvement Quality Improvement (Move beyond existing (Move beyond existing limitslimits))

• AKA - Statistical Quality ControlAKA - Statistical Quality Control

QM - Scientific Side QM - Scientific Side


Customer FocusCustomer Focus

• Who Are They?Who Are They?

• Did We Meet Their Requirements?Did We Meet Their Requirements?

• Can We Exceed Their Expectations?Can We Exceed Their Expectations?

• Internal / External Customer FocusInternal / External Customer Focus

• AKA - Participative ManagementAKA - Participative Management

QM - Humanistic Side QM - Humanistic Side


Hawthorne ExperimentHawthorne Experiment

• 1924 - 19321924 - 1932

• Western Electric Plant, ChicagoWestern Electric Plant, Chicago

• Relay Assemblers Relay Assemblers

• Controlled ExperimentControlled Experiment



Hawthorne Experiment ResultsHawthorne Experiment Results

• Output Increases When:Output Increases When:• Improvement in resourcesImprovement in resources

• Have trust / cooperation among supervisor Have trust / cooperation among supervisor and workerand worker

• Fear in the workplace is eliminatedFear in the workplace is eliminated

• Monotony is reducedMonotony is reduced



Total Quality

Organizational Mission, Vision, & Principles

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Characteristics of Quality Characteristics of Quality OrganizationsOrganizations


Leadership RoleLeadership Role• Establishing Organization’s Quality Establishing Organization’s Quality

Plan at All Program Levels Plan at All Program Levels • Encourage a System of Participative Encourage a System of Participative

ManagementManagement• Utilize Tools and Methods in Reaching Utilize Tools and Methods in Reaching

GoalsGoals• Walk the Walk, Talk the TalkWalk the Walk, Talk the Talk

QM - LeadershipQM - Leadership


QM - LeadershipQM - Leadership

Leadership By Example Leadership By Example Imperial Imperial Trans-Antarctic ExpeditionTrans-Antarctic Expedition 1914, Cpt. Ernest Shackleton & crew of 1914, Cpt. Ernest Shackleton & crew of

the Endurance leave for Antarcticathe Endurance leave for Antarctica• 300 miles from land, trapped in ice pack300 miles from land, trapped in ice pack• 28 men spend 20 28 men spend 20

months on ice packmonths on ice pack• Move or Stay PlanMove or Stay Plan• ““Gold Watch”Gold Watch”


SS trengths - trengths - internal system plusesinternal system pluses

WW eaknesses - eaknesses - internal system negativesinternal system negatives

OO pportunities - pportunities - external to system plusesexternal to system pluses

TT hreats - hreats - external to system negativesexternal to system negatives

Used to establish original Maryland EMS Plan Used to establish original Maryland EMS Plan (1998)(1998) and subsequent updates and subsequent updates (2000, 2004, 2006)(2000, 2004, 2006)

Environmental AssessmentEnvironmental Assessment


StrengthsStrengths Comprehensive Statewide System Comprehensive Statewide System - -

Designated trauma and specialty centersDesignated trauma and specialty centers Human ResourcesHuman Resources - - Well-trained and Well-trained and

committed prehospital care providers operating committed prehospital care providers operating under uniform protocolsunder uniform protocols

CommunicationsCommunications - - Statewide system Statewide system integrated with local personnel trained to EMD integrated with local personnel trained to EMD standardsstandards

Med-Evac SystemMed-Evac System - Operated under Maryland - Operated under Maryland State Police with full state coverageState Police with full state coverage

Maryland EMS Environment (2004)Maryland EMS Environment (2004)


Strengths Strengths (continued)(continued)

SupportSupport - - Strong legislative and Strong legislative and executive support of EMSexecutive support of EMS

Lead AgencyLead Agency - - Effective state agency Effective state agency that has established a broad network of that has established a broad network of communications among provider groupscommunications among provider groups

Quality Assurance/Quality Quality Assurance/Quality ImprovementImprovement - - Established program Established program with access to datawith access to data



WeaknessesWeaknesses Resource CapacityResource Capacity - - Insufficient hospital Insufficient hospital

response to surgesresponse to surges Med-Evac SystemMed-Evac System- R- Reliance on weather eliance on weather

dependent and overuseddependent and overused resourceresource FundingFunding - - Unresolved financial issuesUnresolved financial issues Disaster TrainingDisaster Training - - Insufficient inter-agency Insufficient inter-agency

trainingtraining Communication ResourcesCommunication Resources - No statewide EMRC - No statewide EMRC Inter-Agency CommunicationsInter-Agency Communications - - Poor Poor

communications among fire, police, & EMS in the communications among fire, police, & EMS in the event of an emergencyevent of an emergency



Weaknesses Weaknesses (continued)(continued) Public AwarenessPublic Awareness - - Lack of sufficient EMS public Lack of sufficient EMS public

awareness and prevention measuresawareness and prevention measures Quality Assurance/ Quality ImprovementQuality Assurance/ Quality Improvement - -

Insufficient use of data and incomplete post care Insufficient use of data and incomplete post care knowledgeknowledge

Human ResourcesHuman Resources - - Insufficient ALS providers in Insufficient ALS providers in rural areasrural areas

Skills RetentionSkills Retention - Challenge in maintaining skills - Challenge in maintaining skills within all EMS services (prehospital/clinical) within all EMS services (prehospital/clinical)

Specialty PatientsSpecialty Patients - More attention to - More attention to pediatric/geriatric needspediatric/geriatric needs

Uncompensated CareUncompensated Care - High levels - High levels



OpportunitiesOpportunities FundingFunding - - In response to terrorismIn response to terrorism ResearchResearch - - Comprehensive system with unique Comprehensive system with unique

characteristicscharacteristics Public PerceptionPublic Perception - - Positive image of EMS services Positive image of EMS services Successful ModelsSuccessful Models - Use trauma system template - Use trauma system template

to improve other health care delivery componentsto improve other health care delivery components TechnologyTechnology - Combine telemedicine methods with - Combine telemedicine methods with

existing communications system to improve existing communications system to improve prehospital triageprehospital triage

Interagency CollaborationInteragency Collaboration - Build upon strong - Build upon strong specialty ctr. relationships to develop/improve other specialty ctr. relationships to develop/improve other collaborative effortscollaborative efforts



ThreatsThreats FiscalFiscal - - Increased uninsured population / Increased uninsured population /

uncompensated careuncompensated care Human ResourcesHuman Resources - - Recruitment and Recruitment and

retention of all healthcare provider typesretention of all healthcare provider types Patient CarePatient Care - - Increase in barriers to Increase in barriers to

definitive patient caredefinitive patient care Special InterestSpecial Interest - - Needs prioritized based Needs prioritized based

upon parochial or territorial interestsupon parochial or territorial interests Trauma SystemTrauma System - - Financial issues Financial issues

concerning regional and state trauma concerning regional and state trauma systemsystem



MissionMission PhilosophyPhilosophy StructureStructure Trivialized Trivialized

SummarySummary Tools OverviewTools Overview ResultsResults

QM - At MIEMSSQM - At MIEMSS


As the lead emergency medical services (EMS) agency, As the lead emergency medical services (EMS) agency, MIEMSS will provide the MIEMSS will provide the leadership, direction, leadership, direction, expertise, and coordination expertise, and coordination of resources to of resources to continuously improve continuously improve the efficient and effective the efficient and effective provision of EMS throughout the provision of EMS throughout the state of Marylandstate of Maryland. . This includes all phases of emergency care: This includes all phases of emergency care: prevention, out of hospital, hospital and prevention, out of hospital, hospital and rehabilitation.rehabilitation.

Resource rather than a regulatorResource rather than a regulator Embrace the QM philosophyEmbrace the QM philosophy Comprehensive - statewide and continuum of careComprehensive - statewide and continuum of care

MIEMSS Mission StatementMIEMSS Mission Statement


Question 1Question 1. . What’s the difference What’s the difference betweenbetween QM and other management types?QM and other management types? Others can stress “Bad Apples” for poor Others can stress “Bad Apples” for poor

performances performances QM attempts to understand failure from a QM attempts to understand failure from a

system point of view.system point of view. Document the processDocument the process Measure the system feature (timeliness, access, etc.) Measure the system feature (timeliness, access, etc.) Make improvement recommendation(s)Make improvement recommendation(s) Implement best improvement(s) Implement best improvement(s) Measure it againMeasure it again

Philosophy ImplementationPhilosophy Implementation


Question 2Question 2. . So, I’m not responsible for So, I’m not responsible for my my mistakes now - right? mistakes now - right? This is not unconditional surrender to the This is not unconditional surrender to the

work force work force All employees accept responsibility for:All employees accept responsibility for:

Quality training (Leadership first, real time application)Quality training (Leadership first, real time application) Quality methods understanding and use (Apply the Quality methods understanding and use (Apply the

science)science) Support one and other (Feelings of uneasiness/fear of Support one and other (Feelings of uneasiness/fear of

failure)failure) Leave your ego’s at the door (This is not a lynching)Leave your ego’s at the door (This is not a lynching)



Question 3Question 3. . Isn’t this really Quality Isn’t this really Quality Assurance we’re talking Assurance we’re talking about?about? Traditional QA is based on reaction to failure Traditional QA is based on reaction to failure

and can tend to focus on punitive results. and can tend to focus on punitive results. Quality Control gets us a “stable process”Quality Control gets us a “stable process” Quality Improvement moves us beyond stable Quality Improvement moves us beyond stable

and provides gains along key features.and provides gains along key features. EffectivenessEffectiveness EfficiencyEfficiency TimelinessTimeliness



Link MIEMSS Programs with EMS Community Established Confidentiality Agreements/Data Inventory Initiate QI Teams – Establish System “Gauges” for:

MIEMSS Administration Medical Aeromedical Pediatric Trauma Prehospital Education & Training Regional/Jurisdictional Councils

Maryland EMS Quality Leadership Maryland EMS Quality Leadership CouncilCouncil


Maryland EMS Quality Leadership Council Relationships

SEMSACMaryland EMS QLCChair: R. Bass

Staff: J. NewResearch: (C. Handley)

IT: “Vacant”Legal: S. Sette

Focus Area:

Regional/Jurisdict.

QIC

MIEMSS(Adm.)

QIC

PediatricQIC

TraumaQIC

MedicalQIC

Education(Prehospital)

QIC

AeromedicalQIC

Chair:Staff:

(S. Alban)(R. Dubansky)

(J. Wright)(C. Wright-Johnson)

(M. Merers)(M. Beachley)

(R. Alcorta)(R. Schaefer)

(Vacant)(A. Trohanis)

(D. Floccare)

(L. Berg)(M. Warner)

EMS Board


1%1% Plan (Structure for Getting There)Plan (Structure for Getting There)1%1% Knowledge (Teams, Tools and Methods)Knowledge (Teams, Tools and Methods)1%1% Commitment (Leadership and Employee Buy Commitment (Leadership and Employee Buy

In)In)1%1% Communication (Intra and Inter Agency)Communication (Intra and Inter Agency)1%1% Recognition (Mission, Customers, Consumers)Recognition (Mission, Customers, Consumers)1%1% Respect (For job, for co-workers)Respect (For job, for co-workers)94%94% Common Sense Common Sense

(How would you like to be serviced?) (How would you like to be serviced?)100% Customer, Employee, and Manager Satisfaction100% Customer, Employee, and Manager Satisfaction

MIEMSS QM View MIEMSS QM View (trivialized)(trivialized)


QI Teams (Group of process knowledge experts)QI Teams (Group of process knowledge experts) Team Leader, Facilitator, Timer, RecorderTeam Leader, Facilitator, Timer, Recorder Team Charter and By-Laws Team Charter and By-Laws

(What you do/how you do it) (What you do/how you do it) Brainstorm (Get Ideas/Problems Out Into The Open) Brainstorm (Get Ideas/Problems Out Into The Open) Process Flow Diagrams Process Flow Diagrams

(Document Process Complexity) (Document Process Complexity) Fishbone Diagrams (Identify Cause)Fishbone Diagrams (Identify Cause) Histograms (Measure Impact of Cause/Results)Histograms (Measure Impact of Cause/Results) Run Charts (Measure Feature Over Time)Run Charts (Measure Feature Over Time)

Quality Improvement ToolsQuality Improvement Tools


Increase MAIS Information Increase MAIS Information Access TimeAccess Time

Report the time interval between Report the time interval between runsheet completion in the field and runsheet completion in the field and time when data is finally loaded into time when data is finally loaded into the central database at MIEMSS.the central database at MIEMSS.

MIEMSS MAIS Timeliness MIEMSS MAIS Timeliness Part 1Part 1

Average Number of Days between MAIS Field Completion and MIS Scanning

Calendar Year 1994

January

February

March

April

May

June

July

August

September

October

November

December

.

0 20 40 60 80 100 120

Field Completion to MIEMSS Submission MIEMSS Reciept to Completed Scanning


Measure the number of forms Measure the number of forms scanned per month by scanned per month by MIEMSS MIS Department.MIEMSS MIS Department.

Report the volume of forms Report the volume of forms submitted by month.submitted by month.


Number of Forms Scanned by Month

July 1992 through May 1995

Jul A S O N DJan F M A M J J A S O N DJan F M A M J J A S O N DJan F M AMay .92 93 94 95

0

10000

20000

30000

40000

50000

60000

70000


Examine variation by JurisdictionExamine variation by Jurisdiction Brainstorm cause(s) for delays Brainstorm cause(s) for delays

and makeand make recommendations for recommendations for improvement.improvement. Standardize forms submission regionallyStandardize forms submission regionally Inform Non MIEMSS processors of Inform Non MIEMSS processors of

delays.delays. Eliminate pre-sorting by MIEMSS staff Eliminate pre-sorting by MIEMSS staff

through Optical Scanning and archivingthrough Optical Scanning and archiving Measure againMeasure again


Number of Forms Scanned by Month

July 1992 through June 1996

JulA S O N DJanF M A M J J A S O N DJanF M A M J J A S O N DJanF M A M J J A S O N DJanF M A M J92 93 94 95 96

0

10000

20000

30000

40000

50000

60000

70000


Check Your ResultsCheck Your Results

Maintain a Run Chart of Process Maintain a Run Chart of Process Measure.Measure.


Average Number of Days between MAIS Field Completion and MIS Scanning

Calendar Years 1994 to 1996

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

0

50

100

150

200

250


Get Leadership to Buy-InGet Leadership to Buy-In Not just approval, but to be trained, to use QMNot just approval, but to be trained, to use QM

Develop Strategic Quality PlanDevelop Strategic Quality Plan Long/Short term organizational objectivesLong/Short term organizational objectives Identify ways to achieve those objectivesIdentify ways to achieve those objectives Measure effectivenessMeasure effectiveness

Ensure Customer and Stakeholder Ensure Customer and Stakeholder SatisfactionSatisfaction External and internal organizational satisfactionExternal and internal organizational satisfaction

Crucial Steps to Success Crucial Steps to Success (Baldrige Model)(Baldrige Model)


Utilize Information and AnalysesUtilize Information and Analyses Use valid data to “manage by fact”Use valid data to “manage by fact”

Provide Human Resource Development Provide Human Resource Development Develop full potential of work forceDevelop full potential of work force

Understand and Improve ProcessesUnderstand and Improve Processes Ensure good relationships across all process Ensure good relationships across all process

ownersowners Focus on System ResultsFocus on System Results

Assess quality results and the organization’s Assess quality results and the organization’s success at achieving quality improvementsuccess at achieving quality improvement

Crucial Steps to Success Crucial Steps to Success (Baldrige Model)(Baldrige Model)


Initiate Quality Council (charter, rules)Initiate Quality Council (charter, rules) Identify key process(es), key Identify key process(es), key

indicator(s).indicator(s). Plan quality improvement strategiesPlan quality improvement strategies MeasureMeasure Initiate improvementsInitiate improvements Measure againMeasure again

$Customer

QCustomer CustomerCustomer

Implementation Steps To ConsiderImplementation Steps To Consider


““The The RaceRace For Quality Has For Quality Has No Finish Line”No Finish Line”

David T. Kearns – David T. Kearns – Former Chairman of XEROXFormer Chairman of XEROX

(Winner of the Malcolm Baldrige National Quality Award)(Winner of the Malcolm Baldrige National Quality Award)

When Are We There?When Are We There?


ConclusionConclusion

QuestionsQuestions

CommentsComments

Thank You!Thank You!Department of Quality

Management

approaches in maryland ems quality improvement john new director, miemss quality management prepared...

Documents

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