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Different Quality tools in hospitals & its implementation
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White Paper
on
63rd RFHHA Sunday Panel discussion on 23 Apr 2017
Different Quality tools in hospitals & its implementation

Dr Madhav Madhusudan Singh AFMS
Dr Arvind Kumar Singh , AFMS
Dr Saantwana Vernekar, Nationally Acclaimed Quality Professional and Clinical Biochemist
©RFHHA www.rfhha.org Page 1

63rd RFHHA Sunday Panel discussion on 23 Apr 2017 , 1000- 1300 hrs
Topic: Different Quality tools in hospitals & its implementation ?
The discussion will be held on Whatsapp / Google Allo / Telegram ( +919560852592 )
10.00 – 10.30 Hrs : Basic tools of Quality in hospitals
10.30- 11.00 hrs : QTools Bundle , Plan-Do-Study-Act plus Q Tools , Fishbone Diagram , Run Chart ,
Pareto Chart , Flowchart , Scatter Diagram , Check Sheet & 5 Whys : introduction
11.00 -11.30 hrs : Applications of Quality tools in hospitals
11.30 -12.00 hrs: ways to improve Quality in hospitals by using these tools
12.00 – 13.00 hrs : Questions from members
All members are requested to invite your hospital administrators / Quality managers / management
students to join this discussion on social media platform of RFHHA. To join this forum please sends your
request on 9560852592. Anybody interested to join as panelist , you are welcome.
Dr M M SINGH
https://www.facebook.com/AIIMS.RFHHA/
The sessions started with the some video on Quality tools in Healthcare :
Learn What the 7 Quality Control Tools Are in 8 Minutes
https://www.youtube.com/watch?v=LdhC4ziAhgY
Basic Tools in Quality Control
https://www.youtube.com/watch?v=hUHiDPKXcw4
7-QC Tools
https://www.youtube.com/watch?v=a6QdZXY0v0I
The seven Quality Tools that every quality professional should Master
https://www.youtube.com/watch?v=Amr2L4I-BcA
Learn What 5S is and How it Applies to Any Industry
https://www.youtube.com/watch?v=c0Q-xaYior0
TOOLS AND TECHNIQUES FOR QUALITY MANAGEMENT
https://www.youtube.com/watch?v=wbKnbdXr2xQ

Introduction
“The Old Seven.”
“The First Seven.”
“The Basic Seven.”
Quality pros have many names for these seven basic tools of quality, first emphasized by Kaoru
Ishikawa, a professor of engineering at Tokyo University and the father of “quality circles.”
"Although there is some debate over which quality improvement tools should be used in certain
situations, there is growing evidence that quality improvement efforts have made a positive impact on
the healthcare industry as a whole.
For example, Canel et al. conducted a study on quality improvement methodologies and tools used to
improve medical records assembly processes for several hospitals. The authors concluded that the
application of quality improvement tools and methodologies contributed to the improvement of the
medical records assembly process, which in turn led to a reduction in the amount of time it took to file a
patient's record. "
The Seven Basic Tools of Quality (also known as 7 QC Tools) originated in Japan when the country was
undergoing major quality revolution and had become a mandatory topic as part of Japanese’s industrial
training program. These tools which comprised of simple graphical and statistical techniques were
helpful in solving critical quality related issues. These tools were often referred as Seven Basics Tools of
Quality because these tools could be implemented by any person with very basic training in statistics
and were simple to apply to solve quality-related complex issues.
7 QC tools can be applied across any industry starting from product development phase till delivery. 7QC
tools even today owns the same popularity and is extensively used in various phases of Six
Sigma (DMAIC or DMADV), in continuous improvement process (PDCA cycle) and Lean management
(removing wastes from process).
Dr M M Singh

Dear Panelist , What are the Basic Quality tools ?
1. Cause-and-effect diagram (also called Ishikawa or fishbone chart): Identifies many possible
causes for an effect or problem and sorts ideas into useful categories.
2. Check sheet: A structured, prepared form for collecting and analyzing data; a generic tool that
can be adapted for a wide variety of purposes.
3. Control charts: Graphs used to study how a process changes over time.
4. Histogram: The most commonly used graph for showing frequency distributions, or how often
each different value in a set of data occurs.
5. Pareto chart: Shows on a bar graph which factors are more significant.
6. Scatter diagram: Graphs pairs of numerical data, one variable on each axis, to look for a
relationship.
7. Stratification: A technique that separates data gathered from a variety of sources so that
patterns can be seen (some lists replace “stratification” with “flowchart” or “run chart”).
Dr A K Singh
Ref : www.asq.org
Dear Panelist , Can you tell us What is a Process , which we always tells in every meeting or
operation ?
The process with respect to work:
• A process is a group of activities, not just one.
• The activities that make up a process are not random or ad hoc; they are related and organized.
• All the activities in a process must work together toward a common goal.
• Processes exist to create results your customers – whether they’re internal (within your organization,
such as a department) or external (outside your organization, such as paying customers) – care about.
A process also can be viewed as a “value chain,” in which each activity or step contributes to the end
result. Some activities directly contribute value, while others may not.
All activities consume enterprise resources, however. The challenge for managers is to eliminate steps
that do not add value and to improve the efficiency of those that do.
Dr M M Singh

Dear Panelist , Can you describe Cause–and–Effect Diagram or Ishikawa Diagram ?
Identifies many possible causes for an effect or problem and sorts ideas into useful categories.
The fishbone diagram identifies many possible causes for an effect or problem. It can be used to
structure a brainstorming session. It immediately sorts ideas into useful categories.
It has some variation known as cause enumeration diagram, process fishbone, time–delay fishbone,
CEDAC (cause–and–effect diagram with the addition of cards), desired–result fishbone, reverse fishbone
diagram
Dr Saantwana Vernekar
Nationally Acclaimed Quality Professional and Clinical Biochemist
Doctorate in Management (DMS)– Pathology Laboratory Management – “A” Grade
Ref : Nancy R. Tague’s The Quality Toolbox, Second Edition, ASQ Quality Press, 2005, pages 247–249
Dear Panelist , When to Use a Fishbone Diagram & what will be the procedure ?
When to Use a Fishbone Diagram
 When identifying possible causes for a problem.
 Especially when a team’s thinking tends to fall into ruts.
Fishbone Diagram Procedure
Materials needed: flipchart or whiteboard, marking pens.
1. Agree on a problem statement (effect). Write it at the center right of the flipchart or
whiteboard. Draw a box around it and draw a horizontal arrow running to it.
2. Brainstorm the major categories of causes of the problem. If this is difficult use generic
headings:
o Methods
o Machines (equipment)
o People (manpower)
o Materials
o Measurement
o Environment

3. Write the categories of causes as branches from the main arrow.
4. Brainstorm all the possible causes of the problem. Ask: “Why does this happen?” As each idea is
given, the facilitator writes it as a branch from the appropriate category. Causes can be written
in several places if they relate to several categories.
5. Again ask “why does this happen?” about each cause. Write sub–causes branching off the
causes. Continue to ask “Why?” and generate deeper levels of causes. Layers of branches
indicate causal relationships.
6. When the group runs out of ideas, focus attention to places on the chart where ideas are few.
Nationally Acclaimed Quality Professional and Clinical Biochemist
Doctorate in Management (DMS)– Pathology Laboratory Management – “A” Grade
Ref : Nancy R. Tague’s The Quality Toolbox, Second Edition, ASQ Quality Press, 2005, pages 247–249
Dear Panelist , What is check sheet , when it is used and its procedure?
A check sheet is a structured, prepared form for collecting and analyzing data. This is a generic tool that
can be adapted for a wide variety of purposes. it is also known as defect concentration diagram .
When to Use a Check Sheet
 When data can be observed and collected repeatedly by the same person or at the same
location.
 When collecting data on the frequency or patterns of events, problems, defects, defect
location, defect causes, etc.
 When collecting data from a production process.
Check Sheet Procedure
1. Decide what event or problem will be observed. Develop operational definitions.
2. Decide when data will be collected and for how long.
3. Design the form. Set it up so that data can be recorded simply by making check marks or Xs or
similar symbols and so that data do not have to be recopied for analysis.
4. Label all spaces on the form.

5. Test the check sheet for a short trial period to be sure it collects the appropriate data and is easy
to use.
6. Each time the targeted event or problem occurs, record data on the check sheet.
Dr A K Singh
Dear Panelist , What is Control Chart ?
Control chart is the best tool for monitoring the performance of a process. These types of charts can be
used for monitoring any processes related to function of the organization.
These charts allow you to identify the following conditions related to the process that has been
monitored.
 Stability of the process
 Predictability of the process
 Identification of common cause of variation
 Special conditions where the monitoring party needs to react
The control chart is a graph used to study how a process changes over time. Data are plotted in time
order. A control chart always has a central line for the average, an upper line for the upper control limit
and a lower line for the lower control limit. These lines are determined from historical data. By
comparing current data to these lines, you can draw conclusions about whether the process variation is
consistent (in control) or is unpredictable (out of control, affected by special causes of variation).
Control charts for variable data are used in pairs. The top chart monitors the average, or the centering of
the distribution of data from the process. The bottom chart monitors the range, or the width of the
distribution. If your data were shots in target practice, the average is where the shots are clustering, and
the range is how tightly they are clustered. Control charts for attribute data are used singly.
Dr M M Singh

Dear Panelist , When to Use a Check Sheet & its procedure to do ?
When to Use a Check Sheet
 When data can be observed and collected repeatedly by the same person or at the same
location.
 When collecting data on the frequency or patterns of events, problems, defects, defect
location, defect causes, etc.
 When collecting data from a production process.
Check Sheet Procedure
1. Decide what event or problem will be observed. Develop operational definitions.
2. Decide when data will be collected and for how long.
3. Design the form. Set it up so that data can be recorded simply by making check marks or Xs or
similar symbols and so that data do not have to be recopied for analysis.
4. Label all spaces on the form.
5. Test the check sheet for a short trial period to be sure it collects the appropriate data and is easy
to use.
6. Each time the targeted event or problem occurs, record data on the check sheet.
Dr A K Singh
Dear Panelist , What is Histogram & its procedure to follow ?
Histograms or Frequency Distribution Diagrams are bar charts showing the distribution pattern of
observations grouped in convenient class intervals and arranged in order of magnitude. Histograms are
useful in studying patterns of distribution and in drawing conclusions about the process based on the
pattern.
Histogram is used for illustrating the frequency and the extent in the context of two variables. Histogram
is a chart with columns. This represents the distribution by mean. If the histogram is normal, the graph
takes the shape of a bell curve. If it is not normal, it may take different shapes based on the condition of
the distribution. Histogram can be used to measure something against another thing. Always, it should
be two variables.
The Procedure to prepare a Histogram consists of the following steps :
 Collect data (preferably 50 or more observations of an item).

 Arrange all values in an ascending order.

 Divide the entire range of values into a convenient number of groups each representing an
equal class interval. It is customary to have number of groups equal to or less than the square
root of the number of observations. However one should not be too rigid about this.
 Note the number of observations or frequency in each group.
 Draw X-axis and Y-axis and decide appropriate scales for the groups on X-axis and the number of
observations or the frequency on Y-axis.
 Draw bars representing the frequency for each of the groups.
 Provide a suitable title to the Histogram.
 Study the pattern of distribution and draw conclusion.
Dr M M Singh
Dear Panelist , When to Use a Histogram ?
 When the data are numerical.
 When you want to see the shape of the data’s distribution, especially when determining
whether the output of a process is distributed approximately normally.
 When analyzing whether a process can meet the customer’s requirements.
 When analyzing what the output from a supplier’s process looks like.
 When seeing whether a process change has occurred from one time period to another.
 When determining whether the outputs of two or more processes are different.
 When you wish to communicate the distribution of data quickly and easily to others.
Dr M M Singh
Dear Panelist , what is a Pareto Diagram and how it is made ?
Pareto Diagram is a tool that arranges items in the order of the magnitude of their contribution, thereby
identifying a few items exerting maximum influence. This tool is used in SPC and quality improvement
for prioritizing projects for improvement, prioritizing setting up of corrective action teams to solve
problems, identifying products on which most complaints are received, identifying the nature of
complaints occurring most often, identifying most frequent causes for rejections or for other similar
purposes. The origin of the tool lies in the observation by an Italian economist Vilfredo Pareto that a
large portion of wealth was in the hands of a few people.
He observed that such distribution pattern was common in most fields. Pareto principle also known as
the 80/20 rule is used in the field of materials management for ABC analysis. 20% of the items
purchased by a company account for 80% of the value. These constitute the A items on which maximum

attention is paid. Dr.Juran suggested the use of this principle to quality control for separating the "vital
few" problems from the "trivial many" now called the "useful many".
Procedure :
The steps in the preparation of a Pareto Diagram are :
1. From the available data calculate the contribution of each individual item.
2. Arrange the items in descending order of their individual contributions. If there are too many items
contributing a small percentage of the contribution, group them together as "others". It is obvious that
"others" will contribute more than a few single individual items. Still it is kept last in the new order of
items.
3. Tabulate the items, their contributions in absolute number as well as in percent of total and
cumulative contribution of the items.
4. Draw X and Y axes. Various items are represented on the X-axis. Unlike other graphs Pareto Diagrams
have two Y-axes - one on the left representing numbers and the one on right representing the percent
contributions. The scale for X-axis is selected in such a manner that all the items including others are
accommodated between the two Y-axes. The scales for the Y-axes are so selected that the total number
of items on the left side and 100% on the right side occupy the same height.
5. Draw bars representing the contributions of each item.
6. Plot points for cumulative contributions at the end of each item. A simple way to do this is to draw
the bars for the second and each subsequent item at their normal place on the X-axis as well as at a level
where the previous bar ends. This bar at the higher level is drawn in dotted lines. Drawing the second
bar is not normally recommended in the texts.
7. Connect the points. If additional bars as suggested in step 6 are drawn this becomes simple. All one
needs to do is - connect the diagonals of the bars to the origin.
8. The chart is now ready for interpretation. The slope of the chart suddenly changes at some point. This
point separates the 'vital few' from the 'useful many' like the A,B and C class items in materials
management.
Dear Panelist , When to Use a Pareto Chart ?
 When analyzing data about the frequency of problems or causes in a process.

 When there are many problems or causes and you want to focus on the most significant.
 When analyzing broad causes by looking at their specific components.
 When communicating with others about your data.
Dr M M Singh

Dear Panelist , What is scatter diagram graphs & its use ?
The scatter diagram graphs pairs of numerical data, with one variable on each axis, to look for a
relationship between them. If the variables are correlated, the points will fall along a line or curve. The
better the correlation, the tighter the points will hug the line. Also called: scatter plot, X–Y graph
When to Use a Scatter Diagram
 When you have paired numerical data.
 When your dependent variable may have multiple values for each value of your independent
variable.
 When trying to determine whether the two variables are related, such as…
o When trying to identify potential root causes of problems.
o After brainstorming causes and effects using a fishbone diagram, to determine

objectively whether a particular cause and effect are related.
o When determining whether two effects that appear to be related both occur with the
same cause.
o When testing for autocorrelation before constructing a control chart.
Dr M M Singh
Dear Panelist , What is stratification and when to use stratification ?
Stratification is a technique used in combination with other data analysis tools. When data from a
variety of sources or categories have been lumped together, the meaning of the data can be impossible
to see. This technique separates the data so that patterns can be seen.
When to Use Stratification
 Before collecting data.
 When data come from several sources or conditions, such as shifts, days of the week, suppliers
or population groups.
 When data analysis may require separating different sources or conditions.
Stratification Procedure
1. Before collecting data, consider which information about the sources of the data might have an
effect on the results. Set up the data collection so that you collect that information as well.

2. When plotting or graphing the collected data on a scatter diagram, control chart, histogram or
other analysis tool, use different marks or colors to distinguish data from various sources. Data
that are distinguished in this way are said to be “stratified.”
3. Analyze the subsets of stratified data separately. For example, on a scatter diagram where data
are stratified into data from source 1 and data from source 2, draw quadrants, count points and
determine the critical value only for the data from source 1, then only for the data from source
2.
When it comes to the values of two variables, scatter diagrams are the best way to present. Scatter
diagrams present the relationship between two variables and illustrate the results on a Cartesian
plane. Then, further analysis, such as trend analysis can be performed on the values.
In these diagrams, one variable denotes one axis and another variable denotes the other axis.
Dr A K Singh
Dear Panelist , What is FMEA ?
Developed in the 1970s in aviation and automotive industries, an FMEA is a diagnostic process that
includes features of flow-charting, cause-and-effect analysis, and brainstorming.1 “Failure modes”
means the ways, or modes, in which something might fail. Failures are any errors or defects, especially

ones that affect the customer, and can be potential or actual. “Effects analysis” refers to studying the
consequences of those failures.
Failures are prioritized according to how serious their consequences are, how frequently they occur and
how easily they can be detected. The purpose of the FMEA is to take actions to eliminate or reduce
failures, starting with the highest-priority ones. Failure modes and effects analysis also documents
current knowledge and actions about the risks of failures, for use in continuous improvement. FMEA is
used during design to prevent failures. Later it’s used for control, before and during ongoing operation
of the process. Ideally, FMEA begins during the earliest conceptual stages of design and continues
throughout the life of the product or service.
FMEA is a powerful tool but labor intensive. For hospitals who are Joint Commission accredited, it’s
required.
Dr M M Singh
Dear Panelist , When to use FMEA ?
 When a process, product or service is being designed or redesigned.

 When an existing process, product or service is being applied in a new way.
 Before developing control plans for a new or modified process.
 When improvement goals are planned for an existing process, product or service.
 When analyzing failures of an existing process, product or service.
 Periodically throughout the life of the process, product or service
Dear Panelist , How to do FMEA in Hospital ?
1. Build a detailed process flow chart. (Note: Quite often, the first attempt won’t be detailed enough,
and you’ll continue to elaborate on it during the remainder of the process as you recognize the
complexities in the process.)
2. For each process step, identify all possible failure modes (i.e. reasons why the process may not work
as planned).
3. For each failure mode, identify F=frequency on a 1-10 scale where e10 is most frequent.
4. For each failure mode, identify effects that this failure will have on the outcome of the process.
5. For each effect, identify S=severity on a 1-10 scale where 10 is most severe (critical) effect on
outcome.
6. For each effect, identify the current process features and controls that are in place to catch failure
before it has an effect (detection/mitigation).

7. For each, identify D=detectability on a 1-10 scale where 10 is least likely to be detected in normal
operations.
8. Compute the risk priority number (RPN)=FxSxD (range will be 1-1000).
9. Arrange the RPNs in descending order.
10. For any failure mode with severity =10, place an asterisk no matter what the final RPN was.
11. Examine the process failures with the highest RPNs and all those with a severity of 10(identified with
an asterisk) and use to establish priorities for improvement.
Dr M M Singh
Dear Panelist , When not to use FMEA ?
For simpler processes, ordinary brainstorming can be sufficient. Don’t embark on FMEA unless you are
willing to commit the necessary resources to see it through. Recognize that you will identify many failure
modes and will then need to resolve each one---either improve them or determine that they can be
tolerated in the current system (e.g., are sufficiently detectable, infrequent, or have minimal severity).
Dear Panelist , What are the Common Pitfalls in FMEA ?
A FMEA is a fundamentally subjective methodology, with all the strengths and weakness that implies. It
relies on the collective experience, candor, and analytical skills of the group. It is essential to bring
together experienced frontline people who use the process, a strong facilitator, and a resource to keep
the documentation current and accurate. The atmosphere must be one of trust and a willingness to
face--- even to welcome---the identification of potential risks. You cannot perform an FMEA in an
atmosphere of suspicion and blame because staff members must feel free to acknowledge they have
observed process failures or risks of failure.
If there are data that describe the process failures already, bring them to the table, but remember your
goal is to develop a thorough understanding of process failure modes, including those that have not yet
caused detectable problems.
Don’t let the group wrangle over the scoring. Define in advance what you mean by a “severity score of
10” or other points on the scale. In healthcare, it’s all too easy to assign a 10 to almost any failure mode.
For example, you may theorize that any delay in the medication process could lead to a severe outcome,
but if every severity score is 10, then the score is meaningless. The group can establish its own norms to
make the scoring meaningful for this particular process.
Dr A K Singh

Dear Panelist , Now a days people are often using term Lean & Six Sigma , What it is ?
You will often hear these two terms in conjunction with each other. Lean is a tool used to achieve Six
Sigma. Lean is a systematic and analytical process of thoroughly understanding your current state before
moving on to developing an “ideal” future state.
It focuses on the elimination of “waste” and increasing value for the customer (patient). The goal is to
create standardization of processes so that the exact same result can be created consistently, thus
reducing variation in the process. The term “Six Sigma” is a measurement of the reliability of a process
or product. Sigma refers to a standard deviation, and a process operating at Six Sigma will experience
3.4 errors per billion events. There is no process in healthcare service delivery that approaches this level
of reliability.
Dr M M Singh
Dear Panelist , How Organization can do lean & six sigma in healthcare ?
Most who claim to be performing Six Sigma process improvement are not, in fact, expecting to reach
actual Six Sigma levels of variability. However, their work is characterized by passionate attention to
reducing variability to the lowest level possible. Many resources are available to assist in training green
belt and black belt Six Sigma experts (the distinction is based on the number and scope of projects they
have completed and the commitment of their time).
Dr A K Singh
Question from member
Dear Panelist , How to Engage the Physicians in Quality Improvement ?
It’s usually not feasible to expect physicians to participate fully on teams. Meetings that last several
hours don’t accommodate a clinician’s schedule. Instead, identify where the physician’s contribution is
essential. Use the following strategies:
 Include physicians on a team only when they have a substantive role in analyzing past
performance and designing new systems, and then include them only at critical points.
 Meet with physicians individually, at their convenience, to rapidly and comprehensively outline
the problem, progress, and conclusions to date. Don’t allow the physician to veto all that has
occurred, but do listen to any concerns raised.
 Focus in particular on physician input on evidence-based guidelines for practice and care
decisions and interpretation of the literature.
 Focus on physician input when redesigning the system at points that involve the physician—(e.g.
communication, orders, and results) and that affect patients directly.
 Insist on vigorous physician leadership involvement when it is genuinely needed.
Dr M M Singh

Question from member
Dear Panelist , What all should be done , if I am calling our first Quality meeting in my hospitals ?
Dear Member you can follow following steps while Holding the Quality Meeting
Remember, the quality meeting must be substantive, efficient, well-planned, and well attended. Take
the following steps for holding and documenting a quality meeting:
1. Prepare the agenda
2. Prepare data and materials for the meeting:
- Prepare/monitoring/performance data for discussion, such as quality metrics and patient/customer

satisfaction.
- Collect reports from intra-departmental or interdepartmental process improvement teams
- Identify sentinel, critical, or other special events requiring discussion
- Collect other information for discussion from sources such as the risk, employee safety, infection
control, and support departments’ quality updates and other updates.
- Focus on information that requires action
3. Hold the meeting and document attendance
4. Document the group’s conclusions, recommendations, and planned follow-up on departmental

indicators
5. Document other discussions briefly (e.g., improvement teams’ efforts, sentinel events, and safety
issues)
6. Route all or part of the minutes to the next level of administration as stipulated in your organization’s
flow and procedures.
Dr M M Singh
Conclusion
Above seven basic quality tools help you to address different concerns in an organization. Therefore, use
of such tools should be a basic practice in the organization in order to enhance the efficiency. Trainings
on these tools should be included in the organizational orientation program, so all the staff members
get to learn these basic tools.

Dear Members
This conclude 63nd RFHHA Sunday Panel discussion on 23 Apr 2017 , 1000- 1300 hrs
Topic : Different Quality tools in hospitals & its implementation ? Next week we will meet again on
same other topic on Quality in Healthcare administration. I request all members to invite your Seniors
and juniors to join this forum to share their experience and practical problems.
I thank all panelists to provide tech input and Administrative staff for all adm support. Your critical input
good or bad are essentially required to improve this unique platform.
Please register yourself for medico legal conclave.
Regards
Dr M M Singh
http://rfhhaconclave.blogspot.in/
Dear Colleagues,
Are you worried about legal issues in your hospital?
Join us on
AIIMS – RFHHA Conclave on “Legal and Ethical Challenges in Healthcare Ecosystem” from 18th to 20th
May, 2017 at New Delhi. For further details, please visit: www.rfhhaconclave.blogspot.com
Call : 9560687350 , 9643035278
Bibliography and Resources
1. American Society for Quality- www.asq.org

2. Barnard, Cynthia, and Barbara J. Hannon. Quality Improvement for Nurse Managers. HCPro, Inc.
2010.
3. Khanna, Lisa. Patient Safety Officer’s Handbook.
4. Langley, Gerald et al. The Improvement Guide. San Francisco. Jossey-Bass. Second edition.
2009.
5. Meyer, Gregg et al. National Quality Forum (NQF). Safe Practices for Better Healthcare–2009
Update: A Consensus Report. Washington, DC: NQF; 2009.
6. Tague, Nancy. The Quality Toolbox. ASQ Quality Press. Second edition.2004.
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Different Quality tools in hospitals & its implementation

Book · April 2017

Madhav Madhusudan Singh Ph.D

The user has requested enhancement of the downloaded file.

63rd RFHHA Sunday Panel discussion on 23 Apr 2017

Different Quality tools in hospitals & its implementation

Dr Arvind Kumar Singh , AFMS

Dr Saantwana Vernekar, Nationally Acclaimed Quality Professional and Clinical Biochemist

©RFHHA www.rfhha.org Page 1

The discussion will be held on Whatsapp / Google Allo / Telegram ( +919560852592 )

10.00 – 10.30 Hrs : Basic tools of Quality in hospitals

11.00 -11.30 hrs : Applications of Quality tools in hospitals

12.00 – 13.00 hrs : Questions from members

Learn What the 7 Quality Control Tools Are in 8 Minutes

Basic Tools in Quality Control

Learn What 5S is and How it Applies to Any Industry

TOOLS AND TECHNIQUES FOR QUALITY MANAGEMENT

©RFHHA www.rfhha.org Page 2

“The Old Seven.”

“The First Seven.”

“The Basic Seven.”

©RFHHA www.rfhha.org Page 3

The process with respect to work:

• A process is a group of activities, not just one.

©RFHHA www.rfhha.org Page 4

Nationally Acclaimed Quality Professional and Clinical Biochemist

Doctorate in Management (DMS)– Pathology Laboratory Management – “A” Grade

When to Use a Fishbone Diagram

 When identifying possible causes for a problem.

 Especially when a team’s thinking tends to fall into ruts.

Fishbone Diagram Procedure

Materials needed: flipchart or whiteboard, marking pens.

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When to Use a Check Sheet

 When collecting data from a production process.

Check Sheet Procedure

1. Decide what event or problem will be observed. Develop operational definitions.

2. Decide when data will be collected and for how long.

4. Label all spaces on the form.

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Dear Panelist , What is Control Chart ?

 Stability of the process

 Predictability of the process

 Identification of common cause of variation

 Special conditions where the monitoring party needs to react

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When to Use a Check Sheet

 When collecting data from a production process.

Check Sheet Procedure

1. Decide what event or problem will be observed. Develop operational definitions.

2. Decide when data will be collected and for how long.

4. Label all spaces on the form.

Dear Panelist , What is Histogram & its procedure to follow ?

The Procedure to prepare a Histogram consists of the following steps :

 Collect data (preferably 50 or more observations of an item).

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Dear Panelist , When to Use a Histogram ?

 When the data are numerical.

 When analyzing whether a process can meet the customer’s requirements.

Dear Panelist , what is a Pareto Diagram and how it is made ?

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