Keys for successful implementation of total quality management in hospitals
Abstract
This article reports the findings of an analysis of the implementation of continuous quality improvement (CQI) or total quality management (TQM) programs in 10 hospitals. This analysis is the result of a 2-year study designed to identify and assess the ingredients that lead to the successful implementation of CQI programs in acute care hospitals.
Total quality management (TQM) in a hospital library: identifying service benchmarks
Hospitals are turning to total quality management (TQM) to lower costs of providing care. A hospital library in a TQM environment needs to embrace corporate goals while maintaining its accountability as a contributor to quality patient care. Alliant Health System (AHS) Library at Norton Hospital and Kosair Children's Hospital in Louisville, Kentucky, conducted a study to establish TQM benchmarks and to examine the significance of its role in clinical care. Using a methodology designed to allow both library user and nonuser to respond, 2,091 surveys were distributed to physicians and nursing and allied health personnel. Areas surveyed included frequency of library use, impact of information received on clinical judgments, cognitive value of the information, and satisfaction with library products and services. Results confirm that the library has a substantial clinical role. Eighty-eight percent of reporting physicians agreed that information from the library contributed to higher quality care. Nursing and allied health were less convinced of the importance of the library's clinical role. Sixty-nine percent of nursing personnel and 58% of allied health personnel agreed that the library contributed to higher quality care. Nursing and allied health personnel also used the library less frequently than physicians. With these results as benchmarks, improving the clinical role of the library will take commitment to the TQM process and a willingness to change.
Using scientific evidence to improve information practice
Abstract
The recent policy statement of the Medical Library Association (MLA) takes the position that scientific evidence is the basis for improving the quality of library and information sciences now and in the future. Research activity is seen as the foundation of an evolving knowledge base for the profession--a knowledge base that will set health sciences librarians apart from others in an increasingly competitive world of information service providers. The statement represents the culmination of many years of activity by association members, during which the role of research in health information practice has been debated. Over a similar time period, the quality movement, with its increasing demand for the collection and use of data, has been growing. Developments such as total quality management (TQM) and continuous quality improvement (CQI) reinforce the centrality of research with its increasing demand for the collection and use of data, has been growing. Developments such as total quality management (TQM) and continuous quality improvement (CQI) reinforce the centrality of research and its relationship to efficient and effective information practice as envisioned in the MLA policy statement
Evaluating clinical librarian services: a systematic review
Abstract
BACKGROUND: Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.
OBJECTIVES: To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.
METHODS: Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.
RESULTS: There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.
CONCLUSIONS:
This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians.
APPLICATION OF TOTAL QUALITY MANAGEMENT TO LIBRARY AND
INFORMATION SERVICES IN INDIAN OPEN UNIVERSITIES
The Indian Higher Education System comprises 210 conventional universities and a single mode open universities. The conventional universities have more than a hundred years of tradition and many have international recognition as centres of excellence in specific disciplines. In this competitive educational environment, open universities in India are thriving to establish reputation by way of imparting quality education to the distance learners. The DEC, the apex body in open and distance education in India has initiated several projects to ensure quality in higher education through distance mode. It is in this context that the study of Total Quality Management (TQM) of library and information systems and services becomes crucial.
This paper intends to study the application of TQM to the provision of library and information services.
OBJECTIVES
The specific objectives of the study are to :
*Understand the concepts of Quality; Quality Control; Quality Assurance: Total Quality Management;
*Review the Quality Assurance System in Distance Education;
*Examine the application of TQM to Library & Information Science (LIS) Sector, with particular reference to Distance Education Libraries;
*Discuss the experiences of Dr. B. R .Ambedkar Open University in providing quality information services;
*Discuss the criterion for Quality assurance in providing Quality Information Services .
UNDERSTANDING THE CONCEPTS
In order to critically analyse and examine the applications of TQM to Library and Information Services, it is essential in the first place to understand the various related concepts.
The educational role of health sciences librarians
The educational role of health sciences librarians in both academic centers and in hospitals is expanding due to influences of new educational models and growing use of technology. Innovative health sciences curricula are being applied in undergraduate and continuing educationcontinuing education:see adult education.
continuing education
or adult education
Any form of learning provided for adults. In the U.S. the University of Wisconsin was the first academic institution to offer such programs (1904).
..... Click the link for more information. and often incorporate new technologies. The health sciences librarians' educational responsibilities include teaching access to the literature and other information resources(1) The data and information assets of an organization, department or unit. See data administration.
(2) Another name for the Information Systems (IS) or Information Technology (IT) department. See IT.
..... Click the link for more information., teaching use of technology as a means to access and manage information, and teaching skills in information organization and critical appraisal Noun 1. critical appraisal - an appraisal based on careful analytical evaluation
critical analysis
appraisal, assessment - the classification of someone or something with respect to its worth . Integration of teaching activities into the health sciences curriculum is a promising trend. The many changes in the health sciences environment present numerous teaching opportunities but also require flexibility, adaptation, and creative solutions on the part of practicing librarians.
Value of hospital libraries: the Fuld Campus study
Objective: The paper demonstrates the value of the Health Sciences Library/Fuld Campus to the organization and shows how responses from patrons aligned themselves with the categories of the taxonomy of contributions of library and information services (LIS) to hospital and academic health centers devised by Abels et al.
Methods: Over a period of thirty-two months during 2001 to 2003, patrons' literature searches and interlibrary loans were followed up on by sending patrons letters, which included a question asking for feedback as to how the information was used. The comments from users were analyzed according to Abels et al.'s taxonomy of LIS contributions in hospital and academic health centers.
Results: Results of this study substantiated previous research showing that health sciences LIS contributes to patient health care. Feedback also demonstrated other areas where LIS contributes to the mission and goals of the organization and how these align themselves with Abels et al.'s taxonomy.
A TQM Approach to the Improvement of Information Quality
Abstract
There is a consistent gap between users expectations regarding Information Quality (IQ) and the perceived quality of the information they are using. An explicit approach to IQ is required, meaning that all stakeholders should specify in detail the IQ requirements, design them into the information solutions and track their fulfillment.
A Total Quality Management (TQM) based framework for the IQ improvement process is proposed. The framework employs six TQM concepts, namely Customer Focus, Leadership, Teamwork, Continuous Improvement, Measurement and Benchmarking. A case study about an initiative to improve information on Project Status is discussed.
IQ dimensions are at the centre of this framework. They are organized in a three level hierarchy. User satisfaction is decomposed into "Customer Needs" which are translated into "IQ metrics" These dimensions are treated as objects. The paper lists the set of operations that should be performed on these objects including selection, scaling and prioritization.
InfoQual, a methodology designed to facilitate the manipulation of IQ dimensions in the improvement process, is described. This methodology is based on the TQM framework and uses three specific tools:
• QFD (Quality Function Deployment) to translate Customer Needs into metrics.
• IQ dimensions and metrics database to preserve and reuse experience gained during the improvement process
• IQ metrics graphical representation to communicate metrics information.
The value and impact of information provided through library services for patient care: a systematic review
Abstract
1. Top of page
2. Abstract
3. Introduction
4. Methods
5. Results
6. Discussion
7. Acknowledgements
8. Appendix
9. References
10. Key Messages
11. Supporting Information
Objective: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals.
Methods: A comprehensive systematic search was undertaken of the published literature to September 2003 in eric, lisa, medline, premedline, embase, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or ‘time saved’ outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis.
Results: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37–97% on general patient care, 10–31% on diagnosis, 20–51% on choice of tests, 27–45% on choice of therapy and 10–19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards.
Conclusions: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.