Thomas John Rose's activity
In group: Quality Management in Healthcare
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Thomas John Rose posted an update in the group Quality Management in Healthcare 3 months, 2 weeks ago
The Q in QMS is not the same Q as in QI. What’s the difference? Please post your thoughts – if you have any.
A Quality management system (QMS) is a management system that manages for quality. Its based on a governance system of polices, processes and procedures (3Ps), that ensures that the service is planned on the basis of a defined quality. It seeks assurances of compliances against the 3Ps and seeks to address the risks of non-compliance. Continuous or I prefer continual improvement seeks to improve the 3Ps. QMS should make services more efficient.
QI is a set of tools to improve the service or product. A service is more complex because the end product of a unique customer satisfaction, is not defined until the services has been completed and is unique to each individual, whilst a product is defined before purchase. The QI process is aiming to improve the product and or service, it can support greater efficiencies ie reducing waste, but often creates more expense in resources.
In my view you cant have a successful QI system unless its part of a over-riding QMS.
A QMS should be capable of producing a Fiat 500 as well as a Bentley Continental, whilst QI is trying to create the Bentley from the baseline of a Fiat500.
Nigel
A grand explanation Nigel, Thanks.
“A QMS should be capable of producing a Fiat 500 as well as a Bentley Continental, whilst QI is trying to create the Bentley from the baseline of a Fiat500.”
Of course that has the assumption that the Bentley Continental is a higher ‘quality’ vehicle to the Fiat 500.
If I were driving them down narrow Italian streets one would likely be of higher quality than the other, a decision that would likely be reversed on the AutoStrada.
The I in QI is not the same as the I in CI either!
I think, and agree, that the point Nigel was getting at was that there are two interpretations of the word ‘quality’ here. One stems from the sales fraternity and that is that a Fiat 500 is of a higher ‘quality’ than a Bentley Continental. That is not true. The Bentley is not higher ‘quality’ it is simply higher ‘specification’. Both can be of lower ‘quality’ in the manufacturing processes were flawed thus creating defects and error in the final product. So ‘quality’ and ‘specification’ are not the same thing. A different set of tools and skills are required for changes in the two i.e. Quality and specification. A true QMS addresses both in managed processes using the right skills and tools. It’s clear to me, from the many QI project reports that I have read, the QI does not even differentiate between the two.
I wasn’t suggesting that a Fiat 500 is a better or less quality car than a Bentley; and from a car satisfaction survey from a few years ago it suggested that the Fiat was the better car. I’ve done a number of training sessions in Quality Management over the years and have asked the question which is the better quality car, a Fiat or a Bentley, The vast majority of people automatically go with the Bentley. I use the analogy to start a discussion about the word “quality”.
The main focus of a quality management system is to ensure products/services meet customer needs. To be blunt, the aim is to meet financial obligations. Once we have identified the customer needs we can define a specification and then design and document processes that meet the spec and therefore meet customer expectations enhancing service provider/patient confidence and trust.
Unfortunately, in the NHS patient expectations are increasing at a faster rate than the expectations of service providers, to me they seem to be going is opposite directions.
So for me its not about whether you introduce a national or internationally recognised quality management systems or not, its about about identifying patient needs so that you can put in places a service that meets those needs, without breaking the bank, the NHS will then gain the confidence and trust of the people who use and rely on it. I believe a QMS is an excellent formal way of doing that. In my experience QI efforts fail in the medium to long term because they are not part of a QM system.
Nigel