Quality is a way to describe a product or service according
to set standards, specifications or expectations. The notion of “high quality”
has been associated with terms such as excellence, superiority, high caliber,
value and worth. Quality is a complex and multidimensional concept and
therefore has been defined in many ways, using different terms, labels, and
models; the choice of which definition depends on intended use. Quality is also
subjective, meaning that it is opinion-based and therefore means different
things to different people.
QI Approaches
Several approaches and models of quality improvement have
been adopted in delivery of health services. Some of these approaches are:
5S: A management
tool used as a systematic approach for productivity, quality and safety
improvement in all types of organizations.
Improvement
collaborative: An organized network of sites (e.g. districts, facilities or
communities) that work together for a limited period of time to rapidly achieve
significant improvements in a focused topic area through a red learning and
intentional spread methods
Stepwise
certification towards accreditation (SCTA): A process of validation in
which facilities are evaluated through standard which are set by a responsible
board hence upgraded to a specific level such as 2 star, up to 5 star.
Standard based
management and recognition (SBMR): is the approach utilizes the performance
improvement cycle of measuring actual performance using standards, identifying
gaps, determining the root causes of the gaps, and identifying and implementing
interventions to address the gaps.
Results based
financing (RBF): is an approach that links financing to pre-determined
results. Payment is made only upon the verification of the agreed results which
have actually been delivered.
Strengthening
laboratory management towards accreditation (SMLTA): a structural quality
improvement program, teaches laboratory managers how to implement practical
quality management systems in resource limited settings using available
resources.
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| Respublika Narodnaya, original work by Nikita Klyuchko, CC BY-SA 4.0, via Wikimedia Commons |
The 5S Approach
Five-S (5-S) as an entry point for overall health system
quality improvement. Five-S is a philosophy and a way of organizing and
managing the work place and work flow with the intent to improve efficiency of
work by eliminating waste, improving flow, improving safety and minimizing time
wasting, often occurring secondary to disorganized environment.
5-S principles are reliable instruments which help to make a
break-though in your work environment and staff attending various service
provisions in an institution. This is not only a concept but also a set of
actions, which has to be conducted systemically with the full participation of
staff serving the institution.
5-S activities are practiced in a real participatory
movement to improve the quality of both the work environment and service
contents, which are delivered to your clients using the improved environment.
It is used as a basic, fundamental, systemic approach for productivity, quality
and safety improvement in all types’ organizations.
Targets of 5-S
principles are:
- Zero changeovers leading to product/service
diversification - Zero defects leading to higher quality
- Zero waste leading to lower cost
- Zero delays leading to on-time delivery
- Zero injuries thus promoting safety
- Zero breakdowns bringing better maintenance
- Zero customer complaints, i.e., customer
satisfaction - Zero red ink, i.e., betterment of organization’s
image.
Furthermore, introduction of 5-S is expected to instill team
culture, increase morale and motivation and improve job satisfaction. They are
simple but effective methods to organize the workplace (Hirano and Talbot,
1995). In the long-run implementation of the 5-S principles also helps in
creating positive altitude to the workforce.
What is 5-S?
Five-S approach is based on the abbreviation for the five
terms presented below
1. Sort
Remove unused stuff from your
working place by:
·
Categorizing and colour coding the items
·
Developing inventory list for all categorized
items
·
Removing all unnecessary items for discarding
·
Storing (keeping) “may be needed” items
·
Regular sorting of unused items
·
Developing a culture of returning items to where
they belong
2. Set
It is to organize all necessary
items in proper order for easy services provision:
·
Organize cabinets with labeling/numbering
·
Keep items at their respective areas and label
them accordingly
·
Post directional arrows leading to service areas
·
Label all service rooms
·
Update stock/equipment inventories
The rules and regulations must be written and well known to
all staff.
3. Shine
To ‘shine’ is to maintain high
standards of cleanness. This involves:
·
Routine
cleaning and mass cleaning campaigns
·
Clean not only
the place that comes into your view but also behind/under furniture or
equipment
Clean and attractive environments will be appreciated by
internal & external clients
4. Standardize
To ‘standardize’ is to set up the Sort, Set and Shine as
norms in every section of health facility. This involves creating:
·
Work instructions
·
Standard Operating Procedures (SOPs)
·
Standard and regulations for both administrative
and technical staff
5. Sustain
To ‘sustain’ is to ensure that all of the other S’s are
taking place on an ongoing basis. This involves training and maintaining the
discipline of the health workers engaged. This can be done by:
·
Applying regular self assessment
·
Conducting a quarterly 5-S audit and
implementation of improvement activities.
Importance of 5-S
Approach
- ·
The workplace gets cleaned and better organized - ·
Hospital and office operations become easier and
safer - ·
Results are visible to everyone, including
insiders and outsiders - ·
Visible results enhance the generation of more
and new ideas - ·
People will be proud about their clean and
organized workplace - ·
As a result, a health facility’s good image
generates more business