scholarly journals El papel de la Estadística en la metodología Seis Sigma: una propuesta de actuación en servicios sanitarios = The key role of statistical methods in Six-Sigma: a proposal of implementation in health care services

2012 ◽  
pp. 111
Author(s):  
Carmen Huerga Castro ◽  
Julio Ignacio Abad González ◽  
Pilar Blanco Alonso
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Six Sigma ◽  
Health Care Services ◽  
Industrial Sector ◽  
Rational Approach ◽  
Statistical Tools ◽  
Care Services ◽  
Continuous Quality ◽  
Wide Range

<p>La metodología seis sigma es un programa de mejora continua de la calidad que, en base a hechos y datos, persigue reducir errores y avanzar hacia altos objetivos de calidad. Ofrece un enfoque estructurado, analítico y racional para el establecimiento de proyectos de mejora acordes con los objetivos planteados. Si bien la popularidad del seis sigma se deriva de su aplicación en los procesos productivos del sector industrial, cada vez está más extendida su aplicación en el sector servicios y, por ende, en los servicios sanitarios donde la “satisfacción del cliente” adquiere una relevancia vital.<br />La aplicación de seis sigma requiere el uso de un amplio abanico de herramientas estadísticas, de hecho, el término sigma representa la desviación típica de una distribución y es el factor clave para conocer la variabilidad de la misma. Por ello, en este trabajo señalamos las herramientas más apropiadas en cada etapa o fase de implementación del seis sigma (definir, medir, analizar, mejorar y controlar) y presentamos una propuesta de aplicación en un servicio sanitario.</p><p>Six-Sigma is a strategy for continuous quality improvement based on facts and data that attempts to reach higher quality standards and lower number of defects. Six-Sigma provides a structured, analytic and rational approach that allows the implementation of quality improvement projects according to the planned objectives. Although its current popularity is mainly due to its widespread implementation in the industrial sector, it is also being increasingly used in the services sector, such as in health care services, where the customer’s satisfaction has an even more crucial relevance.<br />Six-Sigma involves the use of a wide range of statistical tools; in fact, the term <em>sigma</em> means standard deviation, which is a key measure of the distribution’s variability. In this paper the statistical tools more suitable for each phase of Six-Sigma’s adoption are presented as well a proposal of its adoption in health care services</p>

scholarly journals El papel de la Estadística en la metodología Seis Sigma: una propuesta de actuación en servicios sanitarios = The key role of statistical methods in Six-Sigma: a proposal of implementation in health care services

2012 ◽  
pp. 111
Author(s):  
Carmen Huerga Castro ◽  
Julio Ignacio Abad González ◽  
Pilar Blanco Alonso
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Six Sigma ◽  
Health Care Services ◽  
Industrial Sector ◽  
Rational Approach ◽  
Statistical Tools ◽  
Care Services ◽  
Continuous Quality ◽  
Wide Range

<p>La metodología seis sigma es un programa de mejora continua de la calidad que, en base a hechos y datos, persigue reducir errores y avanzar hacia altos objetivos de calidad. Ofrece un enfoque estructurado, analítico y racional para el establecimiento de proyectos de mejora acordes con los objetivos planteados. Si bien la popularidad del seis sigma se deriva de su aplicación en los procesos productivos del sector industrial, cada vez está más extendida su aplicación en el sector servicios y, por ende, en los servicios sanitarios donde la “satisfacción del cliente” adquiere una relevancia vital.<br />La aplicación de seis sigma requiere el uso de un amplio abanico de herramientas estadísticas, de hecho, el término sigma representa la desviación típica de una distribución y es el factor clave para conocer la variabilidad de la misma. Por ello, en este trabajo señalamos las herramientas más apropiadas en cada etapa o fase de implementación del seis sigma (definir, medir, analizar, mejorar y controlar) y presentamos una propuesta de aplicación en un servicio sanitario.</p><p>Six-Sigma is a strategy for continuous quality improvement based on facts and data that attempts to reach higher quality standards and lower number of defects. Six-Sigma provides a structured, analytic and rational approach that allows the implementation of quality improvement projects according to the planned objectives. Although its current popularity is mainly due to its widespread implementation in the industrial sector, it is also being increasingly used in the services sector, such as in health care services, where the customer’s satisfaction has an even more crucial relevance.<br />Six-Sigma involves the use of a wide range of statistical tools; in fact, the term <em>sigma</em> means standard deviation, which is a key measure of the distribution’s variability. In this paper the statistical tools more suitable for each phase of Six-Sigma’s adoption are presented as well a proposal of its adoption in health care services</p>

Quality improvement in Indigenous primary health care: History, current initiatives and future directors

2008 ◽  
Vol 14 (2) ◽  
pp. 53 ◽  
Author(s):  
Ross Bailie ◽  
Beverly Sibthorpe ◽  
Karen Gardner ◽  
Damin Si
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Performance Measurement ◽  
Health Care Services ◽  
Clinical Care ◽  
Care Services ◽  
Continuous Quality ◽  
Primary Health ◽  
Primary Health Care Services

This paper addresses the question: "What is the current situation for Aboriginal primary health care services in relation to continuous quality improvement (CQI) in clinical care and what is needed for sustainable practice to be achievable five years from now?" The paper describes a number of recent CQI initiatives that evolved within an accountability framework, the origins of which are based on a top-down government approach to performance measurement. Over the last decade there has been a shift to a more negotiated approach and most recently to an emerging agenda that focuses more on systems to support CQI at the primary care coalface. Further development should aim to capitalise on the synergies between different CQI-related initiatives and effectively align quality improvement with performance measurement. Principles of CQI and key challenges for the future are identified.

scholarly journals Access and participation: What factors influence the provision and utilisation of health care services by children with learning disabilities?

2017 ◽  
Vol 41 (S1) ◽  
pp. S452-S452
Author(s):  
A. Rebowska
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Young People ◽  
Intellectual Disabilities ◽  
Health Care Services ◽  
Healthcare Services ◽  
Children And Young People ◽  
Care Services ◽  
Healthcare Needs ◽  
Wide Range

AimsThe aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.BackgroundChildren with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.MethodsComprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.ResultsBarriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.ConclusionThe factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals What Are the Potential Advantages and Disadvantages of Merging Health Insurance Funds? A Qualitative Policy Analysis from Iran

2020 ◽  
Author(s):  
Mohammad Bazyar ◽  
Vahid Yazdi-Feyzabadi ◽  
Nouroddin Rahimi ◽  
Arash Rashidian
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Health Care Expenditures ◽  
Advantages And Disadvantages ◽  
Care Services ◽  
Wide Range ◽  
Insurance Funds ◽  
Rich Data ◽  
Health Insurance Funds

Abstract Background:In countries with health insurance systems, the number and size of insurance funds along with the amount of risk distribution among them are a major concern. One possible solution to overcome problems resulting from fragmentation is to combine risk pools to create a single pool. This study aimed to investigate the potential advantages and disadvantages of merging health insurance funds in Iran. Methods:In this qualitative study, a purposeful sampling with maximum variation was used to obtain representativeness and rich data. To this end, sixty-seven face-to-face interviews were conducted. Moreover, a documentary review was used as a supplementary source of data collection. Content analysis using the 'framework method' was used to analyze the data. Four trustworthiness criteria, including credibility, transferability, dependability, and confirmability, were used to assure the quality of results. Results:The potential consequences were grouped into seven categories, including stewardship, financing, population, benefit package, structure, operational procedures, and interaction with providers. According to the interviewees, controlling total health care expenditures; improving strategic purchasing; removing duplication in population coverage; centralizing the profile of providers in a single database; controlling the volume of provided health care services; making hospitals interact with single insurance with a single set of instructions for contracting, claiming review, and reimbursement; and reducing administrative costs were among the main benefits of merging health insurance funds. The interviewees enumerated the following drawbacks as well: the social security organization’s unwillingness to collect insurance premiums from private workers actively as before; increased dissatisfaction among population groups enjoying a generous basic benefits package; risk of financial fraud and corruption due to gathering all premiums in a single bank; and risk of putting more financial pressure on providers in case of delay in reimbursement with a single-payer system. Conclusion:Merging health insurance schemes in Iran is influenced by a wide range of potential merits and drawbacks. Thus, to facilitate the process and lessen opponents’ objection, policy makers should act as brokers by taking into account contextual factors and adopting tailored policies to respectively maximize and minimize the potential benefits and drawbacks of consolidation in Iran.

Impacts of continuous quality improvement in Aboriginal and Torres Strait islander primary health care in Australia

2018 ◽  
Vol 32 (4) ◽  
pp. 545-571 ◽  
Author(s):  
Beverly Sibthorpe ◽  
Karen Gardner ◽  
Mier Chan ◽  
Michelle Dowden ◽  
Ginny Sargent ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Service Systems ◽  
Client Outcomes ◽  
Content Type ◽  
Care Services ◽  
Continuous Quality ◽  
Primary Health ◽  
Primary Health Care Services

PurposeContinuous quality improvement (CQI) programmes have been taken up widely by indigenous primary health care services in Australia, but as yet there has not been a systematic assessment of their focus and achievements. A scoping review of the literature from studies of CQI in indigenous primary health care services was undertaken to explore impacts on service systems, care and client outcomes with the aim of providing guidance on future evaluation efforts. The paper aims to discuss these issues,Design/methodology/approachSearches were conducted in MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews to December 2016 and handsearching of key websites and publications. Studies of CQI programs or activities in Indigenous primary health care services which demonstrated some combination of CQI characteristics, as described by Rubenstein (2013) were included. A two-stage approach to analysis was undertaken. Stage 1 identified the range and scope of literature, and Stage 2 investigated impacts to service systems, care and client outcomes. The Framework for Performance Assessment in Primary Health Care was used to frame the Stage 2 analysis.FindingsThe majority of Aboriginal community controlled health services have been involved in CQI but there are gaps in knowledge about uptake in general practice and government clinics. There are as many baseline studies as studies on impacts over time. Of the 14 studies included for further analysis, 6 reported on impacts on service systems; all 14 reported on impacts on care and 6 on client outcomes. Changes to services systems are variable and studies of impacts on care and client outcomes show promising though uneven improvements. There are no economic studies or studies addressing community engagement in CQI activities.Research limitations/implicationsTo supplement existing limited knowledge about which service system change strategies are effective and sustainable for which problems in which settings, there needs to be investment in research and development. Research needs to be grounded in the realities of service delivery and contribute to the development of CQI capacity at the service level. Knowledge translation needs to be built into implementation to ensure maximum benefit to those endeavouring on a daily basis to constantly reflect on and improve the quality of the care they deliver to clients, and to the stewardship structures supporting services at regional, state/territory and national levels.Practical implicationsImproved approaches, methods, data capture and reporting arrangements are needed to enhance existing activity and to ensure maximum benefit to services endeavouring to reflect on and improve quality of care and to the stewardship structure supporting services at regional, state/territory and national levels.Originality/valueAlthough there is a growing body of research evidence about CQI both nationally and internationally, and considerable investment by the federal government in Australia to support CQI as part of routine practice, there has not been a systematic assessment of the achievements of CQI in Indigenous primary health care services. Many unanswered questions remain about the extent of uptake, implementation and impacts. This is a barrier to future investment and regional and local programme design, monitoring and evaluation. The authors conducted a scoping review to address these questions. From this, the authors draw conclusions about the state of knowledge in Australia with a view to informing how future CQI research and evaluation might be intensified.

Business Process Reengineering: A Remedy for Health Care

1994 ◽  
Vol 7 (4) ◽  
pp. 44-50 ◽  
Author(s):  
B. Donald Carmichael
Keyword(s):  
Health Care ◽  
Business Process ◽  
Health Care Services ◽  
Business Process Reengineering ◽  
Health Care Organizations ◽  
Process Reengineering ◽  
Care Providers ◽  
Productivity Improvement ◽  
Care Services ◽  
Continuous Quality

Health care organizations are facing significant economic constraints that threaten to dismantle core services. The perceived need for reform is great. Business process reengineering may be the strong medicine required to achieve dramatic productivity improvement without jeopardizing the quality and scope of core health care services. Reengineering challenges health care organizations to eliminate functions that do not contribute to a flattened organization structure in which fewer care providers deliver a wider range of health care services. Information technology is used to displace manual checks and controls. Reengineering may facilitate the implementation of contemporary management models, such as patient-focused care, case management and product or program management. The product of reengineering can be enhanced over time by Continuous Quality Improvement.

scholarly journals Conscience absolutism via legislative amendment

2021 ◽  
pp. 147775092110635
Author(s):  
Peter G. N. West-Oram ◽  
Jordanna A. A. Nunes
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Conscientious Objection ◽  
Care Providers ◽  
Object A ◽  
Care Services ◽  
Wide Range ◽  
Significant Harm

On 30 June 2021, Ohio state Governor, Mike DeWine, signed a Bill which would enact the state's budget for the next two years. In addition to its core funding imperatives, the Bill also contained an amendment significantly expanding entitlements of health care providers to conscientiously object to professional duties to provide controversial health care services. This amendment has been heavily criticised as providing the means to allow health care providers to discriminate against a wide range of persons by denying them access to often contested services such as abortion and contraception. In this paper, we examine the implications of this amendment and situate it in relation to other legislative actions intended to guarantee absolute rights to conscientious objection. In doing so, we argue that the entitlements extended to health care providers by these Bills are overly broad and ignore their potential to allow significant harm to be caused to clients. We then argue that if health care providers should have rights to conscientiously object (a question we do not try an answer here), then any legislation intended to protect such rights should be limited, specific, and parsimonious. Where it is not, the ideological liberty of HCPs treads dangerously on the physical freedom of their clients.

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