Health Care Quality Initiatives Make the News Pages

paperboy Several quality initiatives in the health care sector have made the news in recent weeks.

Accelerating Change Today (ACT), a program sponsored by the Institute for Healthcare Improvement and the National Coalition on Health Care, recently issued its publication Reducing Medical Errors and Improving Patient Safety. It reports actions taken by several organizations and institutions to reduce medical errors and improve patient safety.

At a recent conference, representatives from these organizations described actions that could be adopted or adapted to substantially reduce the number of medical errors. These numbers were the basis for late 1999 reports in mainstream media that medical errors cause up to 100,000 deaths a year in the United States.

In addition, the U.S. Agency for Healthcare Research and Quality (AHRQ) announced in April that 1997 data files from 13 states participating in its Healthcare Cost and Utilization Project State Inpatient Databases partnership are centrally available.

The 13 states are Arizona, California, Colorado, Florida, Iowa, Maryland, Massachusetts, New Jersey, New York, Oregon, South Carolina, Washington and Wisconsin.

Each database file contains information on every hospitalization in the state and can be used to address a wide range of research questions, including access, quality and cost issues.

AHRQ also issued a new fact sheet with tips to help people protect themselves from health care errors. Called 20 Tips To Help Prevent Medical Errors, the information includes research based recommendations on preventing errors related to medicines, hospital stays and surgery.

Finally, the California HealthCare Foundation announced its funding of a $2.4 million program to evaluate the quality of the state's nursing homes and distribute the findings to the public.

Called the California Nursing Home Consumer Information System, the program will be conducted over the next two years by a coalition of the University of California-San Francisco, the University of Wisconsin-Madison, the RAND Corp., the UCLA/Borun Center for Gerontological Research and the California Advocates for Nursing Home Reform.

Two sets of measures will be used, based on characteristics of the facilities themselves and on the quality of care provided.

For information on the ACT initiative, visit 

For additional information on the state inpatient database files, contact Bob Isquith at 301-594-6394 or Bisquith@ahrq.gov, or Louise Arnheim at 301-594-6350 or Larnheim@ahrq.gov.

To order the fact sheet on medical errors, visit www.ahrq.gov/consumer/20tips.htm or call 800-358-9295 and ask for AHRQ publication number 00-P038.

For information on the California study of nursing homes, call Stephen Robitaille of the California HealthCare Foundation at 510-587-3150 or srobitaille@chcf.org.

IAAR Elects President, Board; Announces AS9000 Program

The Independent Association of Accredited Registrars (IAAR) elected a new president and board members and announced the official launch of its third party registration for AS9000, the aerospace standard, at its spring meeting in Cleveland.

The election of Greg Swan of BVQI as president was necessitated by the resignation of Bob Levine from the position. Also elected to the board were Thomas Arnold of TRA Certification, Pierre Salle of KEMA Registered Quality Inc., Malcolm Phipps of Quality Management Institute, John Sedlak of Smithers Quality Assessments Inc. and Bill Vosburg of Entela Inc. They joined continuing board members Mark Alpert of TUV America and Julie Press of Quality Certification Bureau Inc.

The AS9000 third party registration program was officially launched on March 1. To date, nine registrars have been accredited, and 50 auditors have been qualified. IAAR representatives, as well as the American National Standards Institute and the Registrar Accreditation Board, worked with the American Aerospace Quality Group to develop this program in a relatively short period of time.

IAAR's next meeting will be on August 22 and 23 in Milwaukee. For additional information on IAAR, contact Mark Alpert at 978-739-7022 or malpert@tuvam.com or visit the IAAR Web site at www.iaar.org

North Central Assn. Introduces New Higher Ed. Accreditation Model

The North Central Association (NCA) introduced a new, alternative model of accreditation at its annual meeting on April 3. The model was developed by its Academic Quality Improvement Project (AQIP) and partially funded by a grant from the Pew Charitable Trust.

The model provides quality assurance through support and review of systematic institutional initiatives to improve performance results. Differing from traditional accreditation in both content and process, the model demands that institutions examine and measure the effectiveness of their processes. Similar to the Malcolm Baldrige National Quality Award criteria and state quality award programs, it stresses systems thinking, process analysis and measurement. Institutions are expected to strive continuously to better understand and address the needs of students and other stakeholders.

NCA says the AQIP model demands that an institution measure the contributions its systems and processes make in achieving its own mission. A primary goal of the model is to help an institution learn new ways to measure effectiveness and drive improvements.

While the new accreditation model will cost more than the traditional model, NCA says, "That cost, when balanced against the need for investment in an institution's health and vitality in an increasingly competitive educational marketplace, is reasonable. Institutions already engaged in systematic quality improvement initiatives should find the AQIP model cost effective and less intrusive than traditional accreditation."

For additional information, call Stephen D. Spangehl, AQIP director, at 800-621-7440, ext. 106.

Aerospace Quality Group Agrees To International Alignment

The International Aerospace Quality Group (IAQG) agreed to align the existing requirements of the international aerospace quality management system standard (AS 9100, prEN 9100, SJAC 9100) to the year 2000 revision of ISO 9001 while retaining the existing version of the 9100 standard until November 2003.

The 9100 standard, released as identical documents in the United States, Europe and Japan, includes the aerospace sector specific additions to ISO 9001. It was developed by representatives of the aerospace community from Europe, Asia, North America and South America.

The ISO 9001 revisions allow users up to three years to comply. IAQG established an international team to align the specific industry requirements contained within 9100 to the ISO 9001 revisions. The team expects to complete its work by this summer, according to Gary Baker from the Boeing Commercial Air-plane Group. Baker is the IAQG chair.

Boeing Stresses Quality Management, Engineering Accountability to Suppliers

On April 12, Boeing reported that its leaders met with 150 suppliers to discuss the results of the Boeing Mission Assurance Review and its findings in terms of supplier expectations. A quality review board had studied the company's expendable launch vehicle program and made recommendations to improve mission success.

Recommendations included that quality must be the highest priority; there is a need for increased emphasis on horizontal integration across vehicle subsystems and organizational elements; internal procedures should be modified to require closure between design engineering and manufacturing; a formal procedure should evaluate the need for requalification of flight critical elements after design changes; there is a need to require suppliers of flight critical hardware to implement management and control disciplines that Boeing uses; there is a need for increased emphasis on failure risk management and independent reviews; and there is a need for clarification of responsibility and accountability within program organizations, including certification of component and system responsible engineers.

From these recommendations, Boeing established a mandatory certification program for all suppliers of flight critical launch vehicle hardware requiring training and quality improvements. The certification process must be completed by this Dec. 31.

First South American University Registered to ISO 9001 Standard

Universidad Norbert Wiener (Norbert Wiener University) of Lima, Peru, became South America's first ISO 9001 registered university on March 17.

The idea for registration began with Wilfred Jackson, a Peru native and U.S. businessman committed to ISO 9000's quality management system. Jackson, former CEO of Citibank (Nevada) and current principal at Heidrick and Struggles, a Miami executive search firm, also provided assistance in overcoming the language barrier caused by the fact that most university staff members were unfamiliar with the vocabulary used in the American business and technical world.

The ISO 9001 registration effort was lead by Alcibiades Horna, founder and president of Universidad Norbert Wiener. The university offers degree programs in administration, nursing, obstetrics, industrial engineering and pharmacy. It has about 1,400 students and 200 faculty members and administrators and is part of a larger group of universities with a total of about 10,000 students.

Working with consultant Ashok Thakkar of ITTI LLC in Roswell, GA, the university also decided to apply the concept of design control to the development of courses and curricula. Juan Medina was lead assessor for Lloyd's Register Quality Assurance, the registrar.

Fewer than 10 universities in the world, most in the United Kingdom, are registered to ISO 9000. For additional information, contact Thakkar at 770-998-6379 or ashok@ittillc.com.

Teradyne Engineers Win Engineering Quality Award

An engineering team at Teradyne Inc. was corporate recipient of Design News' annual Engineering Quality Award. According to an announcement by the magazine, the award is given annually to a company best demonstrating that engineering design leads to major gains in product quality.

"Teradyne's 10-year commitment to its total quality management philosophy and its new revolutionizing product development process were key elements in the M9 project's success," said Eric Truebenbach, who accepted the award.

The M9 Series Digital Test Instrument is used in automatic test systems to measure and diagnose circuit board and subsystem performance. It is most widely used by the military to service electronic modules in avionics and weapons systems.

Quality Press Releases Three Health Care Books

Three new books on quality in the health care sector have been released by ASQ Quality Press.

* Healthcare Performance Measurement: Systems Design and Evaluation addresses the need for a systematic review and understanding of performance measurement systems. Authored by Vahé A. Kazandjian and Terry R. Lied, the book provides step-by-step instruction on the design of these systems. Epidemiology and psychometrics, the two most important disciplines for designing and evaluating performance systems, are discussed at length.

* Insights to Performance Excellence in Health Care 2000: An Inside Look at the 2000 Baldrige Award Criteria for Health Care presents criteria and scoring guidelines for any organization, whether or not it intends to apply for the Malcolm Baldrige National Quality Award. The criteria and guidelines can be used as assessment tools to help identify organizational strengths and areas in need of improvement, to set priorities and to design action plans. The authors are Mark L. Blazey, Paul L. Grizzell, Linda M. Janczak and Joel H. Ettinger. Blazey wrote the Insights to Performance Excellence series.

* How To Use Control Charts for Healthcare by D. Lynn Kelley is one of the few books on statistical process control written specifically for health care professionals. The author draws on her experience with the clinical faculty of the Joint Commission on Accreditation for Healthcare Organizations to provide a link between accreditation standards and the quality tools needed to meet these standards. The simple step-by-step guide to control charting allows users to determine common and special cause variation for key processes and determine if the processes are stable.

The books can be ordered by calling 800-248-1946 or 414-272-8575 or online at http://qualitypress.asq.org


GE, Motorola and AlliedSignal aren't the only companies stressing Six Sigma. DuPont's 1999 annual report highlights Six Sigma on the cover, and an inside letter to stockholders from chairman and CEO Chad Holliday cites the bottom-line impact of the methodology. At the giant corporation, each Six Sigma project is designed to deliver business benefits in excess of $175,000. Specific success stories of annual savings ranging up to $380,000 in one business system were shared.


KPMG Consulting has issued its Knowledge Management (KM) Re-search Report 2000, a follow-up to the first report on the subject in 1998. The report suggests that while organizations across all sectors recognize the critical role that effective KM will play in future success, few have tackled implementation as effectively as they could or should. To view the complete report, visit www.kpmg.co.uk/kpmg/uk/index.cfm


The National Institute of Standards and Technology's (NIST) Manufacturing Extension Partnership (MEP) has joined with Productivity Inc. to provide business and technical assistance in the area of lean manufacturing to smaller U.S. manufacturers. Manufacturing specialists at NIST's MEP centers around the country will receive training in Productivity's 5-S Visual Systems, a lean manufacturing course. The trained MEP personnel will be licensed to use customized Productivity materials to train their clients. For information, call 800-637-4634 or visit www.mep.nist.gov.


Global SafeBuy Inc. says it reviews online merchants and certifies those who meet or exceed standards for privacy, security and reliability. The site is said to include extensive measures to prevent loss, misuse and alteration of information. For information, visit www.globalsafebuy.com.


The National Institute of Standards and Technology (NIST) says companies that sell software based products could save a lot of money by following well-known software quality practices. NIST obtained data related to failures in medical devices and says about 6% of the problems were related to software. NIST computer scientists analyzed the data and concluded that in many cases manufacturers could have prevented system failures through improved testing and other quality assurance techniques. NIST believes failures with similar origins occur in other industries.


Joseph A. DeFeo is the new president of the Juran Institute. Formerly executive vice president, he will continue as CEO for strategic business operations and overseer of global business development.

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