Improving Processes

Dr: Dina Ramadan

Microbiologist
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Quality Manager ,Central Health Laboratory
 Continual Improvement
(ISO 15189:2022)
develop plan
for
identify improvement
potential
sources
of error

implement
adjust the action
 plan
modify the system
review the
effectiveness
of action
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 PDSA
Step 1:
Develop the Quality Improvement Plan;
It refers to a continuous and ongoing effort to achieve
measureable improvements
Step 2:
Implement the Quality Improvement Plan
 Use the Plan as the roadmap for implementing an integrated quality
program system
Step 3:
Evaluate the Quality Improvement Plan
 Did you do what you said you were going to do?
 Why? Why not?
 What were the results?
 How can next year be better?
Step 4:
 Act on the lessons learned to revise the Quality Improvement Plan for
the next year
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 Planning
Errors?
Consider: Benefits?
root causes of error Failures?
Priorities?
risk management

failures and potential

failures and near-misses

costs, benefits, and priorities

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 Quality Improvement Activities
Correct or prevent poor practices

Report progress to
management and
laboratory staff
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 Quality Improvement
Activities
Use available information to
study:
customer’s suggestions or complaints
identified errors from occurrence
management program
problems identified in internal audits
What are the steps to create a quality
improvement plan?
A quality improvement plan (QIP) is a document that outlines how an
organization or a team will address a specific problem or goal related
to quality, efficiency, or effectiveness.
It can help to identify the root causes of the issue, set measurable
objectives, implement changes, and monitor the results.
Define the problem
• The first step to define the problem or the gap that you want to address.
• You need to describe the current situation,
• and the impact of the problem on your customers, stakeholders, or
processes.
Tools used : data, feedback, surveys, or audits to support your problem
statement.
steps to create a quality improvement
plan (con)

Analyze the causes

identify the factors that contribute to the issue,
use tools such as fishbone diagrams, Pareto charts, or root cause analysis
involve the people who are affected by or involved in the problem
One method that can be used to identify and analyze causes is by asking
"why" repeatedly (typically five times) until you identify the root cause of a
problem.
steps to create a quality improvement
plan (con)
Develop the objectives
The third step is to develop the objectives for your quality improvement plan.
define what you want to achieve,
how measure it,
when you will achieve it.
use SMART criteria to make your objectives specific, measurable, achievable,
relevant, and time-bound.
 steps to create a quality improvement
plan (con)
Plan the changes
The fourth step is to plan the changes that you will implement to achieve your
objectives.
identify the actions, resources, roles, and responsibilities that are required for each
change.
You should also consider the potential risks, barriers, and benefits of each change,
tools such as action plans, Gantt charts, or flowcharts to help you organize and
visualize your plan.
steps to create a quality improvement
plan (con)
Implement the changes
The fifth step is to implement the changes that you have planned.
execute your actions, monitor your progress, and document your results.
You should also communicate regularly with your team and stakeholders,
and provide feedback and support.
tools such as checklists, dashboards, or reports to help you track and report
your implementation.
 steps to create a quality improvement
plan (con)

Evaluate the results

The final step is to evaluate the results of your quality
improvement plan.
compare your actual outcomes with your expected outcomes
analyze the differences.
You should also assess the impact of your changes on your
customers, stakeholders, or processes,
and identify the lessons learned and the best practices.
use tools such as surveys, audits, or interviews to help you collect
and analyze your data.
 Use Quality Tools

lean
Six Sigma
 indicators KPT

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 Improvement Tools
Path of workflow and maintenance by
blood culture technologist

Pre Lean Post Lean

Optimizing space, time, and activity

to improve the physical paths of workflow
 New Trends-Improvement Tools

Six Sigma
six Sigma at many organizations simply means a
measure of quality that strives for near perfection.
It is data-driven approach and methodology for
eliminating defects (driving toward six standard
deviations between the mean and the nearest
specification limit) in any process
To achieve Six Sigma, a process must not produce more than
3.4 defects per million opportunities.

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 Measuring Performance

To measure the performance and quality improvement we must use

indicator

Definition
Established measures used to determine how well an organization
meets needs and operational and performance expectations.
ISO 9001:2000 (5.4.1; 8.4)
ISO 15189:2007 (4.12.4)

• Quality Indicators can help in:

 indicate performance
 determine quality
 identify areas needing further study
 track changes over time
 Quality Indicators Examples
System Pre exam. -Examination- Post exam.
test order patient accuracy of critical values
accuracy and identification point-of-care testing reporting
appropriateness adequacy
turnaround time

clinician accuracy of cervical clinician

satisfaction sample cytology/biopsy satisfaction
information correlation
clinician clinician follow-
follow-up up

diabetes
monitoring

hyperlipidemia
screening
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blood culture contamination
 Remember

• fewer quality indicators are better

• link to factors needed for success
• based on customer and stakeholder needs
• start at the top flow down
• change with changing environment and
strategy
• have targets or goals based on research rather
than arbitrary values
Mark Graham Brown

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Quality Indicators and Timing

Use an indicator only as

long as it provides
useful
information.
Don’t get tied to
your indicators.

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 Keeping Score
“Many organizations spend thousands of hours
collecting and interpreting data. However
many of these hours are nothing more than
wasted time because they analyze the
wrong measurements, leading to inaccurate
decision making.”
Mark Graham Brown 1996
Using the Right Metrics to Drive World Class Performance

Data is a lot like garbage.

You have to know what you are going to
do with the stuff BEFORE you start
collecting it.”
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Mark Twain
 Summary

Each step is
Plan essential to keep
the quality cycle
cycling.

Act Do

CHECK

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