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, 3 weeks ago
Putting a MS into you QMS:
See: https://www.catmalvern.co.uk/Lectures/Lecture10/
Without a MS how do you manage (M) Quality (Q)?
Thanks for sharing this wide-ranging resource, @thomasjohnrose – and thanks for a great QMS Zoom session with you and @jemramazanoglu on Monday. Around 65 people joined us (the recording of it will be up on the Q YouTube channel soon).
You link out to the ELFT QMS. Does this mean that ELFT has a complete and effective management system as part of its QMS?
Or are there still parts of its QMS that have a way to go to get close to achieving that, would you say? (Do any healthcare orgs round the globe reach what you’re advocating? Or, if not, which one gets closest?)
And do you think that ELFT should aim for the ISO 7101 healthcare quality management standard, or is that not appropriate for such an organisation? (Any idea which were the healthcare orgs that helped to develop that 2023 standard?)
There a graphic of ELFT’s 10 years of Quality Improvement here: https://qi.elft.nhs.uk/about-us/our-progress/
Are those the Quality Management-related numbers you’d want to see, or would you want to see additional numbers collected to, to evidence improved Quality or an effective management system?
And, if ELFT has not yet reached the full Quality Management goal in their first 10 years, how many more years do you think their journey might require? What should be their current focus, and their next focus?
One point I would make is that this resource you shared will, for many, be an awful lot of info for someone in a busy NHS role to digest.
Are there any simple make-or-break questions you would suggest that people can ask themselves that would help them to gauge whether their org’s QMS includes an effective management system, or not (yet)?
PS One final question! Is there any evidence out there comparing the quality between similar types of healthcare orgs where one has a well established QMS and the other doesn’t? Basically, what is the best evidence that a QMS does what we need? (Sorry if that’s a naive question, but I did hear recently that such proof doesn’t exist).
None of the NHS examples that I have included are Management Systems. I have included some text on what a management system should look like. Annex SL sets this out very clearly.
Annex SL and supporting documentation describes, very clearly, what a Management System for managing particular characteristics, e.g. Quality, should look and function like. If ELFT do have a QMS then they do need to explain how it works. I have said many times that the Q in a QMS is not the same the Q in QI. I’m sure that many people in the NHS don’t understand what I mean. QI is not the same as quality management and 100 years of QI will never be quality management never mind just 10. If the NHS want to manage quality they need to take heed of BS ISO 7101:2023 instead of wasting time on QI projects.
There is NO comparison with the ELFT quality management system and a management system designed for managing quality. The ELFT efforts may be the most cited QMS within the NHS but nevertheless it comes nowhere near compliance to the requirements of BS ISO 7101:2023. To manage quality you need to say what you do and do what you say – with an audit trail to prove it!
Regarding a simple question: Within your Workgroup can you first list your key work processes? and second can you list, sequentially, each task required to complete each process? Please produce your answers in writing. Understanding and documenting processes and tasks is a prerequisite for quality management. Please let me know how you get on with this question Matthew.
In answer to your final question: No NHS Trust has a quality management system other than in specific, regulated, areas. On of the key characteristics of a QMS is that it produces an audit trail to prove that it does what it says it does. This audit trail is Audited to provide quality assurance. A list of QI projects, as published by ELFT, is certainly not an audit trail for quality management. Hence no comparisons for Trusts regarding quality management can be made. Quality Professionals and over 100 years of experience from the CQI, do not need more evidence that real quality management works. My 8 years + of effort with the NHS regarding quality management has been ignored by healthcare leaders so I guess you will never get the evidence you think that you need. It’s now much more than Quality and Patient Safety – it’s survival!
Though even one of the most cited QMSs around the UK – ELFT – do, I recently heard, apparently say that they feel like they’re quite early on in the journey and impact will grow much more in future. (NB I didn’t hear this directly from Amar Shah or anyone at ELFT, I must admit).
But do they frame the future of their Quality journey as being around more fully embedding an effective Management System, as you say is vital?
If they do, then they’re actually on broadly the same page as you, I guess.
There is NO comparison with the ELFT quality management system and a management system designed for managing quality. The ELFT efforts may be the most cited QMS within the NHS but nevertheless it comes nowhere near compliance to the requirements of BS ISO 7101:2023. To manage quality you need to say what you do and do what you say – with an audit trail to prove it!
How would you reform the CQC in line with Quality Management now the report is coming stating its not fit for purpose? https://www.bbc.co.uk/news/articles/cjk3p4jnnl6o
In an ideal world would you advocate for aligning BS ISO 7101:2023 with NHS Trusts and CQC inspection as a quality assurance measure?
How can the CQC operate and add value to quality management in the meantime as most of us are a decade or more away from this?
At GOSH we’ve developed a single set of standards that align ISO 7101, 9001, 31000, NHS Impact, CQC standards
would be really interested in discussing that work @jitolk if you are open to it?
Trusts should self assess compliance with BS ISO 7101:2023 once it is established in the Trust. It would be great if the CQC also conducted compliance audits to the standard along with their clinical audits but that is a bit of a pipe dream.
ISO 7101, 9001 and 31000 are already aligned through Annex SL. NHS Impact and CQC Standards have very different aims. It will be interesting to see your set of standards.
Similar to @Matthulley very Interested to know more @jitolk
I think Tom made an interesting comment about Trusts in relation to CQC. I do agree that there should be some alignment to ISO 7101:2023 where Trusts conduct a gap analysis to see where they are against the ISO standards and move to address that and then CQC could embark on the external audit side in quality assurance other than their other audits. I am curious to understand CQC role because speaking from the implementation of QMS, there is the internal audit side where the organisation really audits its QMS along an audit schedule. There is a management review process that aligns with that. Marrying CQC performing that level of assurance in alignment with ISO 7101:2023 for Trusts I think would be ideal.
Tom I would love to get your perspective on what we have done
I’d love to have a look at what you have done. Is it published anywhere or could you send a link to your set of standards. My email is t.rose.1@bham.ac.uk
I’ve emailed you Tom