chapter 20 quality
TRANSCRIPT
Chapter 20
Define “quality” in the context of Central Service operations, and tell how to identify it
Describe components in a quality Central Service program
Discuss quality control indicators:
◦ Administrative indicators◦ Customer satisfaction indicators◦ Technical indicators
Explain the basics of Failure Mode and Effects Analysis and Root Cause Analysis
Discuss common quality programs:◦ Quality assurance and process
improvement◦ Continuous quality improvement◦ Total quality management◦ Other quality programs and standards
Review quality procedures in the Central Service Department
Physicians, Nurses and professional personnel served by Central Service staff members
To be successful, Central Service Technicians must look at what they do from their customers’ perspectives
The degree or grade of excellence of a product or service The consistent delivery of products and services according
to established standards Quality is not a Quick-Fix Achieving World-Class Quality requires a multi-year plan. Top Level Administrators must emphasize and support
Quality Quality requires effort from everyone in the facility
EmpowermentLeadershipStandard DataPlanning Tools and Procedures
Staff MembersProcess Management
The act of granting authority (power) to employees to make decisions within their areas of responsibility
Decisions that may have been made by managers in the past are made by front line employees and supervisors. In other words, those most familiar with the details of the process
Define standards to be attained
Help:◦ Manage Data◦ Plan Opportunities◦ Establish Priorities◦ Empower People
Help create and maintain standards Ensure that coaching occurs daily for all
employees Set Priorities Undertake problem-solving and quality planning Be responsible for error-proofing Address three types of error:
◦ Inadvertent◦ Intentional◦ incompetence
Department Leaders, Shift Supervisors, Lead Technicians should be first line “Guardians” of the quality program
All employees should adhere to standards are priorities set by managers
Should help their teammates follow established guidelines
Financial Data Organizational Data (i.e. Turnover
Data) Patient and Employee Satisfaction
Levels Number of Defects Cycle Times
Collect
Compile for Analysis
Reduces Existing Problems
Prevents Potential Problems
Identify Factors that are important to customers
Study the competition
Do everything better than (or at least equal to) the competition
Remember that the process (not people) is the cause of most problems
Think about how to improve
1. Identify needs and requests of the department’s customers
2. Identify an ideal process to consistently address each need/request
3. Compare actual steps and outcomes for each process to the ideal outcome. (for example, 100% error free trays)
4. Plan process control activities to improve the system
5. Measure Defects. With a good process the defects should decrease
Define traits of successful employees
Provide employees with knowledge, skills and tools
Empower employees to participate in solutions
Patient Focus
Process Management
Continuous Quality Improvement
Fact-based Decisions
Senior leaders must be involved in process management
Studying processes is critical
Process problems cause defects
Reducing defects increases quality and helps meet quality standards
Administrative Indicators
Customer Satisfaction Indicators
Technical Indicators
What do we do?
How are we doing it?
Response time for STAT requests No outdates Sterilization Quality Assurance Monitors Correct and Complete Instrument Sets Customer Satisfaction Levels Availability of Patient Items Logging and Documentation Flash protocols are followed Case Cart contents are correct
Regulated by policies, procedures and other administrative actions to assure safe and efficient departmental operations:
◦ Management Control Monitors◦ Inspection Control Monitors◦ Facility Meeting Information
Department Management
Policies & Procedures
Training and Education System
PoliciesProceduresWork Assignment Lists (with expected timelines and outcomes)
Written documentation helps assure consistency
A technical, statistical sampling method that measures the quality of production.
Technical, statistical sampling which measures the quality of production
“Checks your work”
MeasurablePerformed Regularly
“Relates to an outcome of patient care or employee safety”
Inspection of a sample from a larger lot to decide whether the lot should be accepted
A table of numbers generated in an unpredictable, hap-hazardous sequence that is used to create a random sample
Safety Inspections
Regulatory Inspections
Accreditation Surveys
Committee Minutes
Safety Committee Information
Infection Control Committee Information
Staff Meeting Minutes
SpeedAccuracy
Customer Surveys
Incident Reports
Tray Cards
Customer Complaints
Staff Complaints
Process control measures utilized to assure that planned technical conditions within sterilizers and aerators are met
Should be used in all areas that perform sterile processing, including sterilization activities that occur outside of Central Service
Mechanical Indicators Chemical Indicators Biological Indicators
FMEAFailure Mode and Effect Analysis
A process designed to predict the adverse outcomes of various human and machine failures to prevent adverse outcomes
RCARoot Cause Analysis
A process that “looks backwards” at an event to help prevent its future
occurrence
A comprehensive and measured effort to provide total quality. Also a technical, statistical sampling method that measures production quality
The strategy of finding solutions to eliminate the root causes of process performance problems
The concept of measuring the current output of a process or procedure, and then modifying it to increase the output, increase efficiency, and/or increase effectiveness
Input Throughput Output Outcome
Recognizes that improvement can occur with individuals, teams, organizational units (departments) and the organization itself
A quality process which applies statistical methods to improve work processes.
CQI Audits:◦ assist in assessment and identification of
problems◦ promote communication
A quality process that focuses on delivering near-perfect products and services
Six Sigma Goal: Deliver high performance, reliability, and value to the end customer
DefineMeasureAnalyzeDesign Verify
DefineMeasureAnalyzeImproveControl
Industry-Driven Organization
Ensures standards are set, monitored, and maintained
Routine or unannounced inspections (called surveys) are used to monitor a healthcare facility’s performance
Award given by the American Nurses Credentialing Center to hospitals that satisfy factors that measure the strength and quality of nursing care
International Standards Organization
An international standard used by participating organizations to help assure that they consistently deliver quality products and services
Always wear PPE Disassemble all items that are meant to
be disassembled Measure Chemicals properly Load and operate washers properly Follow procedures Clean as you were trained to Check equipment before using to insure
it is working
Check for holes and lint when using linen
Check for holes in all disposable wrappers and filters
Never use a wrapper, filter, or instrument that has fallen on the floor
Always follow count sheets Check instruments for functionality,
cleanliness, alignment, proper assembly and sharpness
Always load sterilizer carts as trained
Always verify mechanical and chemical indicators after each sterilization cycle
Do not touch sterilized items until cool
Properly complete all documentation
Always follow established pick sheets
Check product packaging for holes, expiration dating, and appropriate color changes
Carefully load items on shelves, carts, and other storage units to ensure they stay intact
Pay attention to what you are doing. Avoid distractions like excessive talking, loud music, etc.
Don’t do anything that you haven’t been trained to do If you are unsure about a completed project, ask someone to check
your work If you get distracted, check the entire project to ensure it was done
correctly If you can’t perform at 100%, don’t do the project. Don’t start
projects that you can’t finish Re-check all work Remember, neatness counts! Always help other staff members, even if they don’t think they need
help If you think something is wrong, speak up Report inoperative or damaged equipment
Attend all the educational in-services, seminars, infection control, service technician, and vendor-sponsored programs that you can. The more education you can obtain, the better Central Service Technician you will become
Always follow the rules Question anything about which you are
unsure