Applying Quality Management in Healthcare

Quality management is a complex process, especially in healthcare. Managers in today's environment need more than just an understanding of the historical concepts of quality. They need to understand how to achieve quality within the structure and relationships of the complex system of a healthcare organization.

Diane L. Kelly, DrPH, MBA, R, teaches at the University of North Carolina at Chapel Hill Public Health Leadership Program and Duke University School of Nursing. Dr. Kelly is a former member of the editorial advisory board for the Joint Commission Journal on Quality and Patient Safety and the national Baldrige Performance Excellence Program Board of Examiners.

Foreword	p. xiii
Preface	p. xvii
Acknowledgments	p. xxi
Quality Management: A Systems Approach
Fundamentals of Quality Management	p. 3
Why Focus on Management?	p. 4
What Is Quality?	p. 5
Creating a Shared Definition of "Quality"	p. 7
Three Principles of Total Quality	p. 9
Quality Continuum for Managers	p. 12
Summary	p. 15
A Systems Perspective of Quality Management: Characteristics of Complex Systems	p. 19
Systems Thinking	p. 21
Dynamic Complexity	p. 22
Summary	p. 29
Understanding System Behavior: Systemic Structure	p. 31
A Systems Metaphor for Organizations	p. 31
Lessons for Healthcare Managers	p. 33
Going Below the Waterline	p. 38
Summary	p. 44
Visualizing System Relationships: Models for Health Services Managers	p. 47
Three Core Process Model48
The Baldrige Performance Excellence Program in Health Care Criteria	p. 51
Systems Model of Organizational Accidents	p. 55
Socioecological Framework	p. 59
Summary	p. 62
Achieving Quality Results in Complex Systems
Establishing System Direction	p. 67
Purpose	p. 68
The Purpose Principle	p. 73
Vision	p. 79
Context	p. 82
Summary	p. 85
Establishing Improvement Goals in Complex Systems	p. 87
Relationship Between Goals and Results	p. 89
Setting Improvement Goals in Complex Systems	p. 91
Types of Goal Statements	p. 94
Critiquing Goal Statements	p. 96
SMART Goals and Complex Systems	p. 99
Corollaries to Purpose and Goals	p. 100
Summary	p. 101
Understanding Customer and Stakeholder Requirements	p. 103
Patient Requirements	p. 104
Implications for Managers	p. 107
Summary	p. 113
Understanding the Role of Policy in Promoting System Change	p. 119
Health Policy: An Overview	p. 120
Public Policy Promoting Systems Change	p. 125
Private Policy Promoting Systems Change	p. 129
Lessons for Managers	p. 133
Summary	p. 136
Improving Processes and Implementing Improvements	p. 139
Systematic Critical Thinking in Designing Improvements	p. 140
Process Improvement Tools	p. 143
Root Cause Analysis	p. 148
Prospective Analysis	p. 149
Implementing Improvements	p. 151
Summary	p. 158
Measuring Process and System Performance	p. 165
Preserve the Context	p. 166
Bundle and Unbundle Data According to the User's Purpose	p. 168
Differentiate Types of Measures and Their Uses	p. 173
Select a Balanced Set of Measures	p. 175
Analyze Process and System Performance	p. 178
Performance Management Measures and the Quality Continuum	p. 184
Summary	p. 185
Postering Teamwork: Below-the-Waterline Considerations	p. 191
Team Design	p. 192
Mental Models Affecting Team Design	p. 194
Mental Models About Talents and Differences	p. 196
Mental Models About Improvement or Project Teams	p. 199
Tools for Effective Teams	p. 201
Summary	p. 202
Practice Lab
Reflective Journal	p. 207
The Manager's Role	p. 209
Dynamic Complexity	p. 211
Mental Models	p. 213
System Relationships	p. 215
Systems Error Case Study and Analysis	p. 217
Customer Requirements	p. 219
Improvement Case Study	p. 221
Team Guidelines	p. 225
Generational Differences	p. 227
Organizational Self-Assessment	p. 228
Improving a Performance Gap in My Organization	p. 238
Improving a Performance Gap: A Case Study	p. 245
Glossary of Terms	p. 255
References	p. 261
Index	p. 275
About the Author	p. 284
Table of Contents provided by Ingram. All Rights Reserved.

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Applying Quality Management in Healthcare

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