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APPLYING THE ISO 9001 PROCESS APPROACH AND SERVICE BLUEPRINT TO HOSPITAL MANAGEMENT SYSTEMS
ISO 9001:2008 QUALITY MANAGEMENT SYSTEM REQUIREMENTS
ISO 9001:2008 promotes the adoption of a “process approach” when developing, implementing, and improving the effectiveness of a quality management system in order to enhance customer satisfaction by meeting customer requirements. The quality management system can be divided into three processes, including customer-oriented processes (COPs), support processes (SPs), and management processes (MPs).
ISO 9001 : 2008 CLAUSES
THREE PROCESSES QUALITY MANAGEMENT SYSTEM
SIX MAJOR FACTORS THAT AFFECT PATIENTS PERCEPTION OF MEDICAL TREATMENT Medical Personel Specialty The relationship between patient and hospital Convenience Experience of payment Capability of staff Ease of use of equipment
FIVE-PLANE LINE BLUEPRINT
(1) Line of interaction: based on the customer perspective, separate service providers, and customer activities. (2)Line of visibility: lies .between staff’s service supply and logistics support service preparation. (3) Line of internal interaction: lies in the interactions between logistics support, client services, and technicians. (4) Line of penetration: the action required by clients’ decisions to apply for the ordering production (or service supply) strategy organisation’s inner value chain relates to value-added activities. (5) Line of implementation: the logistics staff’s technical service and management checks.
CASE RESEARCH METHOD ..... (1)
The case study hospital was established in 1966. It is located in southern Taiwan and is one of the area hospitals granted by the Department of Health in 2002. In the past, the hospital’s primary clientele were demobilised soldiers and veterans who sought medical treatment and care in over 500 wards from several departments, including internal medicine, surgery, nephrology, urology, psychiatry, dentistry, ophthalmology, ENT, orthopaedics, nursing, and medical affairs. In 2008, some departments obtained the certificate of ISO9001:2008, the quality management systems certificate, including the following departments: outpatient services, department of X-ray, department of nursing, department of pharmacy, medical records office, registration office, social work office, medical management office, and the secretariat office. The hospital has 32 doctors, 162 nurses, 66 technicians, 46 general technicians such as mechanics, manual workers, and drivers, and 63 administration staff members including social workers, salesmen, and general staff.
CASE RESEARCH METHOD ..... (2)
Top management includes the department directors of internal medicine, surgery, anatomy, reinstate, urology, gynaecology, family medicine, psychiatry, ophthalmology, dentistry, etc. According to the case hospital organisational chart, the hospital superintendent appoints a vice superintendent as management representative to ensure that quality systems are established, implemented, and maintained. The objectives of the case hospital are to construct and provide a “community health” service network for the physical and mental well-being of the region’s population. A case study of this area hospital was undertaken. In-depth interviews of relevant patients and hospital employees were conducted. These were done based on the quality manual, procedures, work instructions, Institute of Medicine (IOM), and the healthcare quality bid which was revised in 2001, as well
THE PROPOSED APPROACH BASED ON CASE
(1) Step 1: task assignment: - Process: blueprint the hospital services by using the process approach. - Product: set up the management review committee. (2) Step 2: relationships involved: - Process: an in-depth interview method was chosen for this study. It is an open-ended, discoveryoriented method for describing both programme processes and performances from the perspective of the superintendents, management representatives, committee members, patients, and others. - Product: records of in-depth interviews.
(3) Step 3: pre-processing interview data: - Process: classify the in-depth interview results into several customer-oriented classifications. - Product: summarise the in-depth interview data. (4) Step 4: review and evaluate: - Process: review and evaluate again by the management review committee members to determine if appropriate to meet patiet requirements. - Product: determination of management review committee. (5) Step 5: confirm the blueprint service: - Process: integrate customer-oriented items into the front-office and back-office dimensions of the blueprint service. - Product: confirm and publish the blueprint of the
A HOSPITAL SERVICE BLUEPRINT UNDER THE ISO 9001:2008 REQUIREMENTS TO SATISFY PATIENT REQUIREMENTS : STEP 1 TASK ASSIGNMENT Process: a task assignment is designated by the hospital superintendent to blueprint the hospital services by using the process approach to ensure that the task is appropriate to the objectives of the hospital. The superintendent is the head of the hospital, the vice superintendent is in charge of the management representative, outpatient services, department of X-ray, department of nursing, department of pharmacy, medical records office, registration office, social work office, medical management office, secretariat office, etc., and every director is in charge of top management members to establish, implement, improve, and maintain the quality management system. Product: the management review committee is
A HOSPITAL SERVICE BLUEPRINT UNDER THE ISO 9001:2008 REQUIREMENTS TO SATISFY PATIENT REQUIREMENTS : STEP 2 RELATIONSHIPS INVOLVED
Process: in order to satisfy patients’ needs, having a professional relationship with th patients can help the hospital staff understand the requirements ofpatients. The relevant personnel interviewed in this study included the management representative, medical administrative director, pharmacy, surgery, psychiatry, nursing department representative, and consultants. Product: semi-structured, in-depth interviews were conducted with an open framework for focused, twoway communication. This was done so that interviewees were free to answer in a flexible way. Interviews were tape recorded and later transcribed.
A HOSPITAL SERVICE BLUEPRINT UNDER THE ISO 9001:2008 REQUIREMENTS TO SATISFY PATIENT REQUIREMENTS : STEP 3 PRE PROCESSING IN-DEPTH INTERVIEW DATA
Process: in this step, embed in-depth interview data into front-office and back-office categories, and the contents of the five-plane lines will be reviewed and confirmed in the next step. Product: summary of in-depth interview data.
A HOSPITAL SERVICE BLUEPRINT UNDER THE ISO 9001:2008 REQUIREMENTS TO SATISFY PATIENT REQUIREMENTS : STEP 4 REVIEW AND EVALUATE
Process: after the summary of the in-depth interview data is completed, it will be taken to a management review committee for review and evaluation to determine if it is appropriate to meet patients’ needs and other requirements. The input to the management review shall include information on: – results of in-depth interviews; – process performance and service conformity; – status of preventive and corrective actions; – follow-up actions from previous management reviews; – changes that could affect the quality management system – third-party requests. Product: a draft of the service blueprint is established in this step
A HOSPITAL SERVICE BLUEPRINT UNDER THE ISO 9001:2008 REQUIREMENTS TO SATISFY PATIENT REQUIREMENTS : STEP 5 CONFIRM THE SERVICE BLUEPRINT
Process: the confirmation of the service blueprint from the management review committee shall include any decisions and actions related to: – improvement of the effectiveness of the quality management system and its processes. – improvement of services related to patient requirements. – resource needs and allocations. – the purpose of the hospital foundation. Product: a service blueprint based on the ISO 9001:2008 patient-oriented process approach
CONCLUSIONS ... (1)
A healthcare service strategy is built from the ISO 9001:2008 requirements and blueprint perspective by using the process approach. The contribution of this study is to illustrate the visualisation and organisation with a practical case in a hospital and to describe process activities. The advantage of the process approach of the ISO 9001:2008 quality management system is that it has an ongoing control that provides a linkage between individual processes within the healthcare service system and blueprints. In the healthcare industry, the issue of human resources has played a key role in the patient-oriented service strategy, both on behaviours of employeeswithin the organisation and on patients.
CONCLUSIONS ... (2)
The ISO 9001:2008 process approach and service blueprint are not merely a technological application for medical caring services, but rather a fully patient-driven, technologically integrated, and diligently implemented one. A service blueprint includes the front office and back office, and the in-depth interviews done in this study were summarised and categorised into lines of interaction, visibility, internal interactions, penetration, an implementation.
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