Running head: QUALITY CONTROL CIRCLES IN HEALTH CARE
The Use of Quality Control Circles in Health
Care
Mace Ross
Northcentral University
Professor Earl Greenia
November 4, 2014
Quality control
circles are a total quality management (TQM) tool that serve to improve quality
and productivity, increase efficiency, and reduce costs by eliminating wasteful
practices (Savane, 2012). Additionally
quality control circles help to solve work related problems affecting
productivity as well as increase teamwork and communication within the work
place. This document will serve to
further define quality control circles and explore three examples of how
quality control circles have been implemented in health organization to
increase the quality of the products and services they provide. The specific examples being discussed will
include; the application of quality control circles in Taiwanese hospitals to implement
a culture of quality control, the use of quality control circles to decrease
the rate of hospital-acquired infection, and the impact of quality control
circles on the prescription patterns of physicians in a primary medical care
setting.
Quality Control Circles
The
concept of quality control circles within an organization is to establish a
team of individuals who share the same work-related responsibilities and
empower them to actively create a work environment that is harmonious and conducive
to quality and teamwork. The direction
of quality control circles can be provided by upper management or determined by
the group itself. Several key features that further define quality control
circles include; group size, group dynamics, and frequency of meeting.
Quality
control circles typically consist of eight to ten members who share a common
work-area and perform the same work-related responsibilities, this is not to
say that all individuals involved in the quality control circle must have the
same job title but they must be engaged in achieving common work-related goals
(Savane, 2012). Participation in a
quality control circle should be encouraged but must be completely voluntary. Meeting should occur once a week for roughly
an hour to allow all member to actively express their thoughts and concerns on
work-related issues (Savane, 2012).
The
focus of quality control circles will be to identify, analyze and resolve
work-related issues. Savane explains
that individual who are performing the tasks that create the products and
services for an organization are the same individuals who are best able to recognize
issues that inhibit the attainment of quality (2012). Quality control circles can approach problems
related to quality itself, cost reduction, or safety issues (Savane,
2012). The end goal of quality control
circles is to empower employees to take a role is proactive management and
allow them to enrich their work-life atmosphere (Savane, 2012).
Quality Control Circles and Organizational
Learning in Taiwan
A
study published in the journal of Human
Resource Development International evaluated the development of the Taiwanese
health care system between 1995 and 2007 to review their application of quality
management, quality control circles, and organizational learning techniques
(Chen & Kuo, 2011). To understand
the link between the organizational learning techniques and the quality control
circles that were applied in the Taiwanese health care systems the authors of
the study recognized a pattern of what they termed the 4Is; intuiting, interpreting, integrating and institutionalizing
(Chen & Kuo, 2011). Additionally the
authors noted that most of the quality control circle activates that took place
addressed issues regarding; process management, cost management, and clinical
and medical problem solution (Chen & Kuo, 2011).
The
first stage in addressing work-related issues within a quality control circle
is the intuiting stage. The intuiting
stage is where the quality control circle defines its direction. For the majority of the quality control
circles reviewed in the study determining the focus of the group based on team
members’ past personal experiences or involved prominent work-related problems
(Chen & Kuo, 2011). It was also
mentioned by the authors of the study that some of tasks taken on by the
quality control circles were assigned by upper management (2011).
The
interpreting stage of quality control circles works as a brainstorming activity
between all members of the group, to essentially interpret the perceptive that different group members take on a
given problem. Chen and & Kuo note that
when quality control circles were attempting to interpret an issue involving
clinical issues, it was common for group member reference literature or medical
record reviews in order to address the problem systematically (2011). Group discussions are an important part of
the interpreting stage because all members have come across different observations
and patient experiences.
The
integrating phase of quality control circles involves the application of
quality improvement tools such as; Pareto diagrams, cause-effect analyses, and
the Plan-Do-Check-Act cycle all of which supply a monitoring system for
progress and feedback toward the desired goal (Chen & Kuo, 2011). It was shown that this stage inspired quality
control circle members because it allowed for a measurement of their progress
to success on particular issues.
Additionally the application of the quality improvement tools allowed
for the opportunity for individual and group learning in relation to relevant
issues (Chen & Kuo, 2011).
The
final stage of quality control circles influence on work-related problems is
termed institutionalizing. Which essentially
means that quality control activities are conformed into departmental or organizational
standards (Chen & Kuo, 2011). Many
of the quality control circles reviewed in the research study applied training
courses in the form of employee orientation programs to successfully implement institutionalization
(Chen & Kuo, 2011).
Within
this research study the content of quality control circles that evaluated
problems related to process management addressed the specific issues of;
reducing patient waiting times, simplifying the health care delivery process,
and improving the medical record review system (Chen & Kuo, 2011). For issues involving clinical processes the
content of quality control circles addressed; health promotion activities, reduced
nosocomial infection rates, and the reduction of medical errors(Chen & Kuo,
2011). All of the above work-related
issues were resolved by quality control circles implementing the 4Is; intuiting,
interpreting, integrating, and institutionalizing.
Hospital-Acquired Infection
In
2000 the Journal of Hospital Infection
published a continuous quality improvement study that looked at how to improve
the prevention of hospital acquired infections in surgical departments and
intensive care units through the application of quality control circles
(Forster, et al., 2000). Interestingly
within this study there was one deviation from the typical setting of a quality
control circle. While the hospitals
selected for the study met on a regular basis and ran their own quality control
circles, there were two interventional periods scheduled, each 10 months apart,
in where four external physicians with training in hospital epidemiology and
infection control ran the quality control circle (Forster, et al., 2000). It was as if the hospital had created quality
control circles with special guests to discuss the topic of interest.
The
authors of this study concluded that the application of quality control circles
served to greatly benefit the prevention of hospital acquired infections. Traditional methods of attempting to prevent
hospital acquire infections involved following infection control guidelines that
were established from an external agency or organization (Forster, et al.,
2000). The use of quality control
circles integrated health care workers into the mix and allow them to actively participate
in resolving the issue. The authors note
that the power of quality control circles comes from taking established guidelines
and bringing them into brainstorming secessions of the circle to figure out the
best way to implement and improve upon current circumstances (Forster, et al.,
2000).
Prescription Patterns in Primary Medical
Care
A
study published in the Journal of Evaluation
in Clinical Practice looked at the effectiveness of a large scale program
of quality control circles on quality and costs of prescribing patterns (Wensing,
Broge, Kaufmann-Kolle, Andres, & Szecsenyl, 2004). Typical quality control circles were established
of a several small groups of physician who meet on a regular basis to discuss
prescribing patterns. The main purpose
of the study was to assess the proportion of patients who received a
prescription, what the average cost of a prescription was per patient, and what
proportion of the prescriptions were of a generic brand.
The
quality control circle proved to be effective.
The results of the study show that physicians who participated in the
quality control circle over the course of two years decreased the total number
of prescription, the cost of prescription per patient and increased the proportion
of generic drugs prescribed (Wensing, et al., 2004). Overall this study indicates that physicians
who participated in quality control circles decreased the use of prescription drug
in turn also decreasing the cost of health care.
Cost and Management
Two
important shifts occurs when employees participate in quality control circles. “First
employees are exposed to new ideas, and second, by participating in quality
control circles, employees may think differently about the nature of their work”
(Chen & Kuo, 2011). This shift in
the mentality of employees not only encourages and motivates employees to
strive for excellence in the work place, it allows employees to see achieving
excellence as their personal responsibility.
When this
mentality is established in a workplace employees increase the cohesiveness of
their teams within their departments and come together to self-manage success within
the organization. A common side effect
of creating quality practices and implementing efficient tactics within the
workplace is a decrease in the cost of operations. In all the previously mention examples of
quality control circle implementation, group member self-managed their
departments through tough quality improvement issues that resulted in a more
cost efficient practice for the health care system.
References
Chen, I., &
Kuo, M. C. (2011). Quality improvement: perspectives on organizational learning
from hospital-based quality control circles in Taiwan. Human Resource Development International, 1491), 91-101. Doi:10.1080/13678868.2011.542901
Forster, D. H.,
Krause, G., Gastmeier, P., Ebner, W., Rath, A., Wischnewski, N., & …
Daschner, F. D. (2000). Can quality circles improve hospital-acquired infection
control?. The Journal of Hospital
Infection, 45(4), 302-310.
Savane, A. (2012, April 6). Final quality
circle. Retrieved from: http://www.slideshare.net/AshwiniSavane/final-quality-circle-4
Wensing, M.,
Broge, B., Kaufmann-Kolle, P., Andres, E., & Szecsenyl, J. (2004). Quality
circles to improve prescribing patterns in primary medical care: what is their
actual impact?. Journal of Evaluation in
Clinical Practice, 10(3), 457-466.
