Page 37 - DMGT524_TOTAL_QUALITY_MANAGEMENT

Total Quality Management

Notes Structure: This pertains to the “physical” aspects of healthcare delivery, including
infrastructure, equipment, and human resources, for example, Equipment requirements
as per services being offered and accessibility of facility.
Process: This pertains to the procedures and protocols that all healthcare personnel, clinical
and non-clinical have to conform to, so as to ensure appropriate and adequate delivery of
healthcare services. E.g. Infection control procedures, protocols for patient case
management.
Outcome: This specifically pertains to the well-being of the patient after delivery of
healthcare provision. E.g. Mortality rates and case specific morbidity rates.
Taking a more detailed perspective, quality in Healthcare can also be divided into two
specific parts: (1) Clinical (2) Non-clinical. Clinical – Looking at the specific clinical aspects
that go into delivery of quality healthcare, such as:
1. Clinical credentialing
2. Clinical audit
3. Clinical risk management (Including Infection Control)
4. Clinical outcome measurement
5. Clinical care pathways
Non-clinical – Looking at service quality aspects that go into delivery of healthcare, such
as:
1. Infrastructure and facilities management
2. Equipment management
3. Supplies and consumable management
4. IT Infrastructure and management
5. Hospitality management
6. Patient satisfaction
Apart from this, there are other specific areas such as non-clinical risk management, and
accreditation. Why should any healthcare organization think of improving their quality?
As part of the KSA-Technopak “Healthcare Outlook” study, senior managers from the
country’s top healthcare providers were quizzed over this, with an overwhelming majority
saying that “with an occupancy rate of 85-100 per cent, we do not feel there is an immediate
need to improve quality; patients come to us because we are already providing good
quality services”. However, the customer’s point of view was a more contrasting picture,
as 54 per cent of those surveyed said they were satisfied with the quality of care, 32 per cent
stated that services provided were below expectations and 14 per cent stated they were
extremely happy with services provided. In the West, implementation of risk management
systems in healthcare has lead to the revelation of some startling facts.
Medical errors are one of America’s leading causes of death and injury. It is estimated that
as many as 44,000 to 98,000* people die in US hospitals each year as the result of medical
errors. This means that more people die from medical errors than from motor vehicle
accidents, breast cancer, or AIDS. In the UK there are approximately 5,000 deaths/year due
to hospital acquired infections (HAI). Hospital admissions up to 7.8 per cent and 15,000
deaths/year are partially attributed to the HAI and cost the NHS approximately 1000
million pounds a year in extended hospital stay and treatment.
In the US, there are approximately 700,000 needle stick injury cases reported per year – 86
per cent of occupational-related infectious disease transmissions result from needle stick
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