Google Analystics

Thursday, 31 July 2014

When is it a good idea to pursue ISO 9001 certification?

It' always a good idea to be ISO 9001 compliant, but when is it a good idea to take the next step and become certified?

  • Are you sometimes excluded from submitting RFPs or RFQs because you are not an ISO 9001 company?
  • Have you lost business to another company or service provider that is ISO 9001 certified?
  • Are you subject to repeated or burdensome site visits by clients or their representatives in order to be qualified or re-qualified as a supplier?
  • Have you lost business because you failed to qualify as a supplier?
  • Does your company have the self-discipline to maintain and improve its Quality Management System effectively and beneficially without the external oversight that ISO 9001 requires?

The more yes answers you provide, the stronger your case for getting certification.

Monday, 14 July 2014

Cost of Quality or Return on Investment (ROI)?

Is there a cost to establishing and maintaining a Quality Management System?

In answering this question many people will readily recognize that we have to spend money on preventing 'bad' things from happening, such as defective parts in manufacturing or an avoidable critical incident in a nursing home. We also have to lay out money in what are known as 'appraisal costs' such as quality control on the production line or double-checking that the correct medication was given to the correct patient/resident at the correct time or covering the costs of auditors or accreditation surveyors.

But to be fair and accurate, whenever we have to calculate and report the cost of quality we should also identify and add in the Cost Of Poor Quality (COPQ) also called PONC - Price of Non-Compliance or Non-Conformance.

For example: time spent 'fixing' problems, retooling, speaking to unhappy family members in a Long-Term Care Home, covering staff absences because of stress and demotivation and, of course, time spent with inspectors for reported complaints or critical incidents should all be seen as “waste” and added to the cost of poor quality.

Of course, there is also the cost of lost reputation when our failures become public knowledge, which also adds to staff stress and demotivation. Inspection reports are really dirty laundry hanging on a very public clothes line.

To the extent that our preventive and appraisal efforts are reducing the incidence of poor quality and non-conformance and the associated costs, we are receiving a return on investment in our Quality Management System.

 There is a tax benefit to reporting money spent on quality as a cost of doing business, but in our minds and hearts we would do better to see that money as a capital investment that produces a return. Then we are more inclined to ask, How can we get the best ROI, Return On Investment? This question is not limited to for-profit organizations.

An efficient and effective QMS is really an asset, not a cost:

  • Ask: How can we get a return on investment? (Note. This question applies equally to NFPs as For-Profits)
  • It’s a shame and a waste to use accreditation or certification mainly for ‘window dressing’
  • Time and resource spent on preventable complaints and inspections for reportable events should be cost out as ‘waste’ (COPQ, PONC). Any reduction is ROI.
  • Other ROI: reduced staff turnover; reduced absenteeism; prevention of recurring non-compliance or defects; fewer follow-up and other inspections
  • Intangible ROI includes: fewer preventable critical incidents and reportable events; increased satisfaction both for residents or patients and their families; happier Government regulators; Improved, reality based, public recognition and reputation

Wednesday, 9 July 2014

Long-Term Care Homes, Complaints and Critical Incidents

All Long-Term Care Homes have got the on-going challenges of heading off resident complaints at the pass and preventing avoidable critical incidents. Many have got these pain points satisfactorily under control. Many others are struggling with this challenge and finding that they are triggering unwanted inspections from the Ontario Ministry of Health and Long-Term Care.

The video is best viewed full-screen.

Monday, 7 July 2014

Concerned about the number of inspections for Critical Incidents and Complaints at your LTC Home?

As an Executive Director, or as Chairman of the Board, or Coordinator for Continuous Quality Improvement, or a member of the Quality Committee, or just a staff member with the good of our residents at heart - am I concerned with the number of Ministry of Health and Long-Term Care (MOHLTC ) inspections for complaintsand critical incidents? If this is an area for concern then one or more of three things is probably not happening as well as they should:

Firstly: Are we measuring all the right things? Of course, we are measuring for CIHI and HQO and our own Board meetings, but have we got the metrics in place to red flag the likelihood of an avoidable critical incident occurring, to red flag the future likelihood of one or more resident complaints that could trigger an inspection? In the field of quality management we call this type of metric KPIs, Key Performance Indicators. KPIs are the organization’s "vital signs", the vital few metrics that report on the health of the organization in living out its mandate from and to society. KPIs should not be confused with the kind of quality indicators that are reported to HQO such as falls, wounds and restraints, although KPIs might well incorporate some of those metrics.

Secondly: Are we monitoring effectively? Assuming that we actually do measure those KPIs, are we reporting them in an accountable manner to the right people who are best positioned to effect change – change in our processes and change in our culture? Managers and others in positions of responsibility who are not being fed the information they need to do their job need to report this as a concern up the management chain. Without KPIs you are flying blind.

Thirdly: Are we managing efficiently and effectively? Assuming that we are reliably measuring and monitoring KPIs, are the process owners and managers sufficiently trained, mandated, empowered, resourced and accountable to take the actions necessary to enhance the Quality Management System (QMS) and foster a culture of quality to prevent the bad stuff happening? If not, that is fodder for a KPI in itself and needs to be reported as a resourcing issue to senior management. Managers and others in positions of responsibility who feel they need training need to do whatever it takes to get it; if your department is at risk for non-compliance because you are lacking resources then that needs to be reported, repeatedly if necessary.

What do you think? Let's have a discussion.