Why is it important to get the patient’s assessment of health care quality? Does the patient have the expertise to judge the health care he or she receives? The patient is the customer. If the patient “perceives” that the health care received is inadequate, then he or she may go elsewhere the next time these services are needed. Although patients may not have the expertise to judge some aspects of 2 health care, they can judge appearances of competence, improvements in the way they feel, how they are treated, the cleanliness and comfort of the environment, and timely responses to service requests. . How might a hospital measure quality? Measuring quality in a service setting such as a hospital can sometimes be dif? cult. One obvious way is to keep track of the number of patient complaints—or even lawsuits. Some other measures that could be used include, but are not limited to, the following: ¦ Average time for nurses to respond to a patients’ call ¦ Average time spent by patients in intensive care ¦ Average recovery time after surgery ¦ Average condition of patients upon discharge ¦ Change in patient condition between admission and discharge ¦ Number patients per staff member 3.
Using the steps in the table in the case discuss how each might apply to FCGH. To answer this question, one must remember that the product provided by FCGH is health care. However, it must also be remembered that the hospital’s staff (nurses, physicians, lab technicians, etc. ) are the suppliers of that service. Thus, quality of service will depend a great deal on the staff—their motivation, attention to details, morale, level of caring, etc. Quality to the Customer: ¦ Is conformance of the service provided compared to established quality standards? Is quality of the hospital’s health are service compared with that of competitors? Quality Costs: ¦ Have the costs of quality been measured and have possible areas for cost savings been identi? ed? Design Review: ¦ Do procedures exist to review patient treatment for quality? Are these procedures being carried out? Product Quali? cation: ¦ Have procedures been established and followed to qualify new treatments before they are used on patients? Product Liability: ¦ Has each treatment been scrutinized regarding safety and are appropriate records kept? Does a written plan exist for dealing with major problems regarding patient?
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Process Capability: ¦ Has the effectiveness and risk of each treatment been measured, and is that information used in selecting treatments? Incoming Inspection: ¦ Is incoming material inspected? Are staff members evaluated before being hired? Are records of these evaluations kept? Supplier Quality: ¦ Are suppliers and staff members made aware of their quality responsibilities? Are records kept on nonconformance? Process Control: ¦ Has the hospital developed policies for controlling treatments and lab tests? Have employees been trained to follow these policies? Inspection and Test Planning: Do inspection and test plans exist for all services provided and are records maintained on the results? Are all test procedures and equipment regularly checked for accuracy? Quality Performance Indicators: ¦ Are quality performance indicators regularly published throughout the hospital and made available to employees? Employee Involvement Program: ¦ Are employees involved in quality improvement through some process such as quality circles? Multifunctional Quality Improvement Team: ¦ Has a quality improvement team covering all functional areas been established to monitor quality work and to work o improve it? Quality Business Plan: ¦ Has quality been integrated into the hospital’s business plan—and from there into the overall strategic plan? 4. How can the value of a human life be included in the cost of quality control? Placing a cost on a human life is, of course, dif? cult. However, even companies that manufacture goods must deal with this if there is the possibility that a defective product could result in death. In a hospital setting death is always a possibility due to unforeseen complications or adverse drug reactions. The best approach for FCGH may be to follow whatever policies and rocedures will produce the least chance of patient death. 5. There are certain parallels between the evaluation of health care quality and educational quality. How are customer surveys used to evaluate the quality of teaching at your institutions? How are the results used? Are any other measures available to assess educational quality? What improvements would you suggest to the current system? Teaching evaluations are the “customer surveys” of education. They are used by faculty and administrators to improve curriculum and teaching methods, to evaluate faculty performance, and to bestow teaching awards.
There is general agreement, however, that student evaluations of teaching are insuf? cient assessments of education quality in and of themselves. Students may give high marks to teachers based on personality, lax administration of the class, or the level of dif? – culty of the course (easy grades). Further, how can students (who are just learning) judge whether the appropriate material is being taught? On the other hand, the student perceptions should not be ignored. A professor who is very knowledgeable about a subject, but who cannot communicate that knowledge is of little use to the educational process.
Therefore, in assessing educational quality, multiple measures of performance should be used, including: ¦ Teaching evaluations completed by students ¦ Peer evaluations by faculty ¦ Surveys of employers ¦ Surveys of alumni ¦ Ranking of departmental performance by other deans or industry ¦ Placement data ¦ Overall student evaluations based on assessments of total curriculum, rather than individual courses or teachers. QUALITY CLEANERS This case can be used to address several issues and objectives: ¦ All employees throughout the process must be involved. ¦ Employees must be accountable for the quality of their work. In service organizations, determining the attributes that de- ?ne quality service, and the corresponding question of how to measure quality can be dif? cult, but must be done, ¦ The student should have suf? cient understanding of SPC to determine when, where, and how it should be applied. ¦ Small increases in prevention and appraisal cost will result in large decreases in total cost of quality. ¦ Records are kept to maintain accountability of the employee to determine bonuses, additional training required, or possible dismissal.
Another problem area identi? ed would include quipment (cleaning machine, presses) not functioning properly. These records would also indicate areas where future improvements should be directed. Given below are some points that should be included in the case analysis. 1. Inspections should occur throughout the process with each worker checking his or her work and previous activities also. The astute students will also recognize the capability of using the customer as an inspector. When the garment(s) is brought into the store, the customer should be asked if there are any spots or stains that may require special attention, repairs eeded, special requests, etc. Getting this information from the customer will greatly increase the probability that the service provided meets the customer’s expectations. The counter person and the marker should be checking the garments closely for foreign objects, rather than leaving this for the cleaner, because this has the greatest potential damage in terms of dollars and dissatis? ed customers. A load ruined by an ink pen would impact 10–20 customers and cost several thousand dollars in claims. 2. Allow for some student creativity. Possibilities would include he counter person, marker, and assembler initialing the ticket at a designated point. The cleaners and pressers could use special shaped (circle, square, triangle, etc. ) punches to punch the identi? cation tag pinned in the garment. Another option would be for the cleaners and pressers to use small plastic tags (as sometimes seen on bakery items) placed on the hanger. Whatever the solution, it should achieve the objective of accountability and require limited time and supplies cost. 3. The additional workload must be tracked over time. Time consumed must be matched with the number of complaints.