PLEASE ANSWER THESE QUESTIONS NOT THE ONES IN THE CASE

Application of concepts and tools. Assuming that the student is a member of the TQM team at that company chosen in Part 1 (case study), it is expected to:

1. propose two pertinent quality tools studied in class that can help to complete or develop quality improvement. Explain the reason of this proposal (1/5 Analysis)
2. implement those tools based on available data from the case study or from companys web site or similar companies from Internet, in this order (4/5 Practice).

PLEASE ANSWER THESE QUESTIONS NOT THE ONES IN THE CASE

Case study 10 Establishing a capability for continuous quality improvement in the NHS BACKGROUND AND HISTORY depth knowledge about the DRIVER improvement InMarch2009CountyDurhamandDarlingtonCommunityHealthServices(CDDCHS)formu-latedastrategytoimprovepatientoutcomes,safetyandserviceefficiencybydevelopingandimplementingalarge-scalequalityimprovementprogrammeacrosstheorganization.CDDCHSwastheprimarycareproviderforalarge,semi-ruralmethodology-aprovenapproachtocontinuousimprovement(FigureC10.3).Partofthistrainingakeyprojectintoringtheparticipantsastheytackledlearnfromexperienceandstarttoquicklyreapthebenefitsofthetraining.Thiscreatedacommunityofpeoplewhocouldshareexperiencesandbestpracticesandactivelycoachothers. area around Durham and Darlington, serving a practices and actively coach others. diverse community of around 600,000 people third level managers across all directorates to approximately 3,000 staff and had an annual provide them with quality tools and techniques budget of 1.1 billion to spend on services. They and a robust approach to implementing continuprovided over 50 services, such as community were also provided with CQI toolkits to enable nursing, speech and language therapy, podiatry, them to introduce the methods to their teams and county Durham and Darlington operational developed the criteria and process for selecting region. The programme and its supporting priority areas to reengineer and designed staninfrastructure would also play a key role in helping dardized materials and guidelines to ensure a CDDCHS with their journey towards a culture of continuousqualityimprovement.theorganizationinlinewiththelocalPrimaryCareTrustsexistingpoliciesandframeworks.Theyalso identified and delivered breakthrough wins in service that improved patient pathways and created APPROACHCDDCHSdevelopedasimpleandpragmaticexemplarsfortheapproach.servicethatimprovedpatient approach to the improvement programme, based Quality Infrastructure - the approach was on the 'quality journey' that organizations typically underpinned by the deployment of a culture assessprogress on (Figure C10.1). The approach was ment to evaluate the extent to which the culture of highly customised to meet their service needs the organization supported a continuous improve(Figure C10.2) which involved the following. ment orientation, development and deployment Executive Engagement - they developed a of an integrated communications programme to clear vision for quality, created executive buy-in engage the wider PCT community, the establishthrough two-way interviews and workshops and ment of a measurement system to monitor progress developed guidelines to clarify the role of leader- and the development of a governance process to ship in driving the programme. The Executive ensure that the programme continued to maintain team also received training to ensure that they were well versed in the concepts and methodologies associated with the improvement programme. PROGRAMME DELIVERABLES Quality Improvement Training - representa- The Executive team in CDDCHS identified a tives from each of their directorates were trained as The Executive team in CDDCHS identified a 'improvement leaders', providing them with in- common view of the 'vision' for quality Figure C10.1 Organizations progress on a 'quality journey' Figure C10.2 Addressing four areas helps create a sustained culture of continuous improvement Case 10 Capability for continuous quality improvement in the NHS 517 Figure C10.3 DRIVER structured approach for improvement Figure C10.4 DRIVER in Primary Care Figure C10.5 Typical profile for Rol Case 10 Capability for continuous quality improvement in the NHS 519 courses as perceived by participants. Outcome ACKNOWLEDGMENT measures were focused on the proportion of The author would like to thank the team from improvement projects and proportions by CDDCHS for their agreement to publish this case directorate (Figure C10.5). Breakthrough Wins in Service - activity measures included the number of breakthroughs, DISCUSSION QUESTIONS the value of the improvement as perceived by the leadership team and satisfaction with the 1. Discuss different possible approaches to support provided by Oakland Consulting on the establishing a CQI capability in an organization. breakthrough.OutcomemeasureswereconcernedwiththebenefitsrealizedbythebreakthroughsinInyouropinion,whichpartsoftheCDDCHSapproachhadthegreatestimpactonsustainable terms of efficiency gains and patient experience. improvement and why? Quality Infrastructure - measures on the 2. Review the measures CDDCHS used to evaluculture assessment related to timeliness and ate their programme. Why is it important to response rates and measures on the commu- have both activity a quality of the communications. 3. Discuss how the approach to CQI might need to vary between a service based organiza- tion such as CDDCHS and a manufacturing tion such as organization