managing quality Flashcards
Primary role of foodservice in healthcare:
ensure high quality patient care through the provision of high-quality food products and service
Health care organizations have become value-driven
Value: focus on delivering the highest quality at the lowest possible cost
What is a Quality Food Service
Food which has been selected, prepared and served in such a manner as to retain or enhance natural flavour and identity; to conserve nutrients; and to be acceptable, attractive, and microbiologically and chemically safe” (American Dietetic Association)
Aspects of Quality
Service, quality- speed, friendliness, on time delivery
Cost
Safety –safe, sanitation, cleanliness
Taste
Nutrition
Consistency –service, food (temperature, texture-, standardized)
Timeliness
Dr. Deming’s 14-point system to help companies increase quality-
Create consistency of purpose towards improvements of products & services
- Adopt new philosophy of quality
- Cease dependence on inspection to achieve quality
- Do not choose supplier solely on price
- Constantly improve production & service systems
- Extensive on-the-job training
- Shift from production numbers to quality
Drive out fear
- Break down barriers among departments
- Eliminate slogans & targets for workplace
- Eliminate numeric quotas for workforce
- Remove barriers that rob employees of pride or workmanship and eliminate annual rating or merit systems,
- Program of education & self-improvement
- Work to accomplish preceding points
Quality Assurance
Output oriented Defining measurable quality standards Controls in place to ensure standards are met Reactive process Predicated on follow-up and inspection
Total Quality Management (TQM)
improving the performance of an organization in response to customer needs and expectations.
Components TQM :
Intense focus on the customer
Focus on process, not people
Empowerment of employees
Improvement in quality of everything the company does
Use a team approach to accomplish change
Accurate measurement
Control processes through sequential steps
Concern for continual improvement; Expect a long-term organizational
Designed to look at problems, improvements across departmental boundaries
Provides the techniques, concepts, and tools to analyze data for application in CQI
Statistics-based process control
Tools for problem identification and problem analysis
Total Quality Management
Theory that quality can be improved on a continuous, or never-ending basis
Emphasizes quality management through a proactive approach
Stresses the relationship of interdisciplinary team cooperation in making the process work
Creating a CQI Culture
3 key principles
CQI requires integrating a quality focus into all aspects of the organization Three key principles: Customer satisfaction Evidence base Team approach (organization-wide)
Customer Satisfaction
Organization recognizes that a customer orientation is integral to a value-based approach to providing services
Reasons customers leave:
Poor service
Lack of organization
Internal and external customers should be considered in health care
Evidence Based
Assessed through informal, formal surveys of patients
During meal service
At discharge
Surveys, focus groups of employees
Conducted in-house or by a consultant
Patient representatives can meet with patients who have serious issues
Team Approach
Encourages accountability Included in job descriptions, performance appraisals Intra- or interdepartmental teams Active participation, vesting important Typical structure: Team facilitator Team leader Team members
Other Characteristics of Successful CQI Organizations
Focus on work processes – not individuals – to solve inefficiencies, problems
Experiment
Nurture creativity
Recognize, reward employees for involvement and successes
Components of a Foodservice CQI Plan
Control quality to ensure safe, wholesome products
Provide satisfactory customer service
Develop a clinical quality assessment program
Quality Control
Measures systems for handling, preparing, and serving food
Measured against standards for infection control, aesthetic appeal, and safety
Feedback tools:
Sanitation, safety reports
Food, refrigerator temperatures
Cart delivery time, downtime measures
Customer Service
Gauged by addressing quality from the customer’s point of view
Food temperature, appearance, taste
Employees must recognize that they have customers and be trained to meet their needs
Food may be one of the few things during a patient’s experience that is familiar, so can impact overall perception strongly
Quality Assessment
Measures the overall quality of care delivered to patients
Minimum requirements:
Use indicators, performance measures
Monitor over time
Benchmark against standards
Use multidisciplinary teams, individual peer review for evaluations
Review, update plan annually
Kaizen
Good change Emphasis on making continuous and small, incremental improvements in process on a daily basis rather than large, revolutionary changes Based on Teamwork Discipline Improved morale Quality circles Suggestions for improvement 5S is a key component
Lean
Lean-Using less resources to make products customers want with few defects in mass production
Less human effort, less space, less capital, and less time to make and at far less costs with much fewer defects delighting Customers, compared with traditional business systems.
Why Lean? Lean management optimizes the flow of products and services through the entire value streams to create processes that need
Tools Used in Process Management
benchmarking, cause analysis, process analysis, data collection and analysis, and project planning and implementation.
Benchmarking
involves comparing one’s performance with those believed to be “best in class.” Such comparisons assist managers in identifying areas on which to focus improvement efforts.
Compare one’s performance with “best in class” or “industry leaders”
Assist managers to focus improvement efforts
Companies compile data for this comparison
The process includes:
Gaining internal commitment
Identifying processes to be benchmarked
Identifying best practice providers
Standardised data collection methods
Review differences and discuss reasons
Identify opportunities for improvement/ new standards
Cause analysis
determines why a certain outcome is occurring.
Termed Ishikawa or fishbone diagrams- looks like fish bone
Process analysis i
includes tools such as flowcharts, failure mode and effects analysis, and value stream mapping.
Data collection and analysis
tools include check sheets, control charts, histograms, and scatter diagrams.
Project planning and implementation
occurs after the process has been identified and analyzed
Cause Analysis Pareto chart:
A Pareto chart is simply a bar graph used to prioritize problems and determine which should be solved first.
There are a vital few causes that if identified & corrected can have the greatest impact on improving quality
Process AnalysisFlowchart: Late Tray Process
A flowchart details all of the elements in a process and the sequence in which these elements occur.
Flowcharts can be used to visualize processes and to identify duplicate steps and steps that can be combined or performed in a different order to prevent unnecessary feedback loops
Control charts
are a graphical record of process performance over a period of time.
Values of upper and lower control limits (often set as two or three standard deviations from the mean) are drawn to help identify potential problems.
charts that allow the use of probability and statistics to set upper and lower control limits for tasks to study those above or below the norm. A control chart assists in determining which variations are acceptable and to be expected versus those that are unacceptable
Histograms
are bar graphs that are used to display graphically the frequency distribution of data.
Using histograms provides a visual way to examine patterns in data that might not be evident when just looking at the numbers themselves.
Scatter diagrams
provide a visual way to examine possible relationships between two variables.
Data from the two variables are plotted on a horizontal (X) and vertical (Y) axis.
The purpose is to display what happens to one variable when the other variable changes
