What are the benefits of QMS for a fertility centre and how do we measure them
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Transcript of What are the benefits of QMS for a fertility centre and how do we measure them
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IMPROVING THE PATIENT’S LIFE THROUGH
MEDICAL EDUCATION
What are the benefits of QMS for a fertility centre and how do we measure them
S. EstevesBrazil
23-24 January 2015 - Hamburg, Germany
Learning objectives
At the completion of this presentation, participants should be able to:
• Understand how an organization could benefit from establishing an effective QMS
• Learn how to measure quality as per QMS perspective
• Learn what we achieved at Androfert after having implemented ISO 9001
Know your customers and define the processes to meet their expectations
Define goals and objectives, so that processes and procedures help you achieve them
Offer resources and infrastructure to fulfill objectives
Systematically correct and prevent non-conformities
Measure your performance and your customers’ satisfaction periodically
Make changes, adjustments, and improvements based on measured results and not on assumptions
Essentials of a successful QMS
Customers are not only our patients…
• Doctors who use our services
• Our employees
• Suppliers
• People in our community
• Regulatory authorities
Adoption of QMS is a strategic decision of a fertility center
Influenced by:
Regulatory directives
Concerns about quality of services
Effectiveness & efficiency
Safety
Customer requirements/satisfaction
Worldwide tendency is IVF guidelines including QMS become mandatory
Australia Code of practice for assisted reproductive technology units, Reproductive Technology Accreditation Committee (RTAC)
Brazil RDC 33 and 23, National Agency of Sanitary Surveillance (ANVISA)
European Union
EU directive 2004/23/EG, 2006/17/EG, 2006/86/EG
South Africa National Health Act 61/2003; Human Tissue Act
USA CLIA for Andrology laboratories; FDA for cryobiology
What regulatory bodies ask for
Document control system
Personnel training
Periodic audits
Procedures for detection, registration, correction and prevention of errors and non-conformities
Compliance with biosafety regulations
System to evaluate and control materials and equipment
Concerns about quality of services
Dancet et al.
Hum Reprod 2013
0% 50% 100%
Doctors &embryologists
Nurses
PatientsSafety
Effectiveness
Patient-centeredness
How stakeholders value the top 3 quality dimensions of infertility care
QM focuses on customer requirementsand satisfaction
Lack of psychological support and poor quality of service ~60% treatment discontinuation
22 studies sampling 21,453 patients from 8 countries
A QMS will ensure that two important requirements are met…
1. Customer’s requirementsConfidence in the ability of the center to deliver the desired service consistently meeting their needs and expectations
2. Fertility center’s requirementsBoth internally and externally, and at an optimum cost with the efficient use of the available resources (materials, human, technology and information)
Key points (1)
The benefits are…
1. Enables fertility center to provide consistency in terms of methods, materials, equipment, etc.
Safety and effectiveness
2. Ensures that services conform with customers' needs and requirements
Customer-centeredness
3. Allows an increase in efficiency Profitability
How to get information
Internal and external audits
Registration of quality actionsNon-conformities, preventive actions, improvement actions, complaints
Satisfaction surveys/questionnaires QC and QA reports
Key performance indicators
Mai
n T
oo
ls
How to measure & analyze
Pareto diagram
Diagram of cause and effect
Control chart
Histogram
Flowchart
Qu
alit
y To
ols
PDCA
Balanced score card (BSC)
Six sigmaQu
alit
y M
eth
od
s
0
2
4
6
8
10
12
Q12010
Q22010
Q32010
Q42010
Q12011
Q22011
Q32011
Q42011
Q12012
Q22012
Q32012
Q42012
Number of non-conformities
HistogramDistribute data and shows how a given
process varies
How to measure & analyze
Pareto diagram
Diagram of cause and effect
Control chart
Histogram
Flowchart
Qu
alit
y To
ols
PDCA
Balanced score card (BSC)
Six sigmaQu
alit
y M
eth
od
s
Category Metric Target Status
Customer satisfaction
Repeat customer % IVF drop-out <50% 50%
Service % IVF cycles w/complaints
<5% 2%
Financial
No. IVF cycles % Annual growth >5% 8%
No. tests Andrology lab % Annual growth +/- 10% 8%
Payment rate sperm/embryo bank
% clients in debt<35% 40%
Employee satisfaction
Turnover 2-yr. period <5% 9%
Absenteeism Days year/employee 4 2
QualityISO recertification approval
Non-conformities No. year reduction -10%
Balanced Score Card Provide a hierarchized view of the organization’s
performance management system
Key points (2)
Measurement is carried out by…
Getting information Audits, registration of quality actions, data collection of (key performance indicators)
Applying quality tools Pareto diagram, diagram of cause/effect, histogram, flow chart
Integrating quality tools with quality methodsPDCA, BSC & 6 Sigma
1996 – Androfert
Foundation
2000 – IVF Program
started
2006 – Started QMS implementation
2010 – ISO Certification
2013 – Recertification
What we achieved…
Main reasons we implemented QMS
Core reasonsConcerns about quality of servicesRegulatory directive
Beyond the coreImage and reputationCustomer satisfactionMarket share (customer
retention/acquisition)Profitability
Core Reasons Achieved
•Quality of servicesCertified and recertified with “zero” non-conformities during external auditing
First in Brazil to obtain ISO 9001 certification
•Full compliance with regulatory authorities
Image and Reputation
Recognized as “Model” fertility center by national government agency
• Germinative cell and tissue division; ANVISA
• Training center for ANVISA inspectors (Brazilian GerminativeTissue Directive)
0
2
4
6
8
10
12
14
16
18
20
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Pe
rce
nt
gro
wth
pe
r ye
ar
Year
IVF Program
Profitability
And more…
Set direction & met customers’ expectations
Improved process control & reduced wastage
Created a proper documentation system
Facilitated training
Involved staff & raised morale
Improved communication & feed-back with all team members