MANAGING AND IMPROVING QUALITY 83
What You Know Now • Total quality management is a philosophy committed to excellence throughout the organization. • Continuous quality improvement is a process to improve quality and performance. • Six Sigma is another quality management program that uses measures, has goals, and is a management
system. • Lean Six Sigma provides tools to improve flow and eliminate waste. • DMAIC is a Six Sigma process improvement method to define, measure, analyze, improve, and control
performance. • A culture of safety and quality permeates efforts at the national level. • Cost may increase or decrease with quality initiatives. • Evidence-based practice, electronic medical records, and dashboards can be used to improve and monitor
quality. • Reducing medication errors is a priority for health care organizations and policy makers. • A risk management program focuses on reducing accidents and injuries and intervening if either occurs. • A caring attitude and prompt attention to complaints help to reduce risk. • A just culture is more likely to encourage reporting of adverse events, including near misses, as well as
point out unsafe practices.
Tools for Managing and Improving Quality 1. Remember: Quality management is a system. When something goes wrong, it is usually due to a
flaw in the system. 2. Become familiar with standards and outcome measures and use them to guide and improve your
practice. 3. Strive for perfection, but be prepared to tolerate failure in order to encourage innovation. 4. Be sure that performance appraisals and incident reports are not used for discipline but rather are the
bases for improvements to the system and/or development of individuals. 5. Remind yourself and your colleagues that a caring attitude is the best prevention of problems.
Following an incident:
1. Meet with the risk manager and hospital attorney to review documentation and determine which staff will be interviewed regarding the incident.
2. Provide any requested information to administration in a timely manner. 3. Audit documentation and processes to determine if an incident is part of a pattern or an isolated
incident. 4. Provide the results of any audits or discussions with staff to appropriate administrators. 5. Educate staff as appropriate. 6. Determine if disciplinary action is required. 7. Follow up with risk management, nursing administration, and human resources as appropriate. 8. Continue to cooperate with the hospital attorney if the incident results in litigation.