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Lessons learned in developing a total quality management process.

While the barriers to TQM implementation are many and the lessons learned can be very painful, we are convinced the results are well worth the effort. TQM implementation is a long term strategic approach and while results can be fairly quick, organizational cultural change and strategic redirection take time. Progress can be very slow. By reducing waste, rework, and variation we can both improve quality and reduce cost. The ultimate goal of TQM is to have organizational members using the quality tools in their daily work life. As an increasing number of health care organizations move through the four phases of implementation, sharing lessons learned can help us understand how to evaluate our quality processes and sustain the improvement process.

Consumer Behavior↗

Applying total quality management to a pharmacist intervention program.

Intervention documentation continues to be a valuable tool for both documenting pharmacist impact on patient care and justifying new clinical pharmacy services. Utilizing TQM principles to improve documentation has yielded many long-term benefits. Not only has intervention documentation been streamlined, but pharmacists at the staff level were an integral part of the changes that were made and the improvements to come. Their familiarity with the pitfalls of the former system provided solutions to the problems that might have been overlooked without their input.

Academic Medical Centers↗

Total quality management in the critical care environment. A primer.

Quality management has become issue No. 1 in organizations throughout the country. Hospitals have joined this crusade and are embarking on their own programs to maintain their competitive edge. TQM or CQI has been identified as showing great success in achieving quality. As TQM systems begin developing in hospitals, CCUs will be called on to join in these efforts. By understanding what TQM is, how it is used, and how it can be applied, CCU staffs will be able to incorporate TQM in their own practices. By choosing projects carefully, using scientific measurement in clinical and nonclinical areas, and developing a team-based approach, the CCU staff can achieve improved clinical outcomes as well as improved procedures that result in better staff and patient satisfaction.

Critical Care↗

Computers in total quality management. Statistical process control to expedite stats.

We developed a system of computer programs to gather and then display data on turnaround time for stat tests. The data were those generated by the testing process itself so that no additional data entry was necessary. The system provided daily as well as longitudinal data for statistical process control implemented in the laboratory. The median and 90th percentile turnaround times were calculated for high-volume tests (complete blood cell count and Chem6 [six chemical serum component concentrations, ie, sodium, potassium, chloride, carbon dioxide, glucose, and urea nitrogen]), and a graphic display was automatically generated. These parameters and visual aids permitted evaluation of stat processing in the laboratory. The impact of management decisions on the stat process could be measured. Intralaboratory processing procedures were modified, and phlebotomy personnel were repositioned. Our various measurements showed which decisions improved stat turnaround time.

Blood Chemical Analysis↗