Rattan Quality Matters

1. Auflage 2019
ISBN: 978-1-85097-331-7
Verlag: Quintessenz Verlag
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, Band 31, 176 Seiten

Reihe: QuintEssentials of Dental Practice

This unique book considers the concept of quality as it relates to the provision of dental care. For the author's purposes, quality is defined in relation to the process of care, the service given, the people delivering the care, and the environment in which the care is provided. In each of these various facets of dental care, the author considers the process of measuring, assessing, improving, and monitoring quality and its impact on the way we work and live.

Autoren/Hrsg.

Rattan, Raj

Leseproben

Chapter 2
The Meaning of Quality
Aims
This chapter aims to explore the various definitions of quality and to define commonly used words and phrases. It also aims to summarise the valuable contributions made by some of the leading gurus of the quality movement. Outcome
The reader should be familiar with a number of approaches to quality and the impact of some of the leading proponents in this field and how their views relate to general dental practice. Introduction
Society has always been concerned about the quality of goods and services provided. Over the ages quality has developed as a discipline; the earliest paradigm of quality relying on the principle of caveat emptor (let the buyer beware) – an approach that placed the responsibility of appraising goods and services firmly with the user. The principles of quality control and total quality management came later with the industrial age, although there is evidence of conformance and control in ancient Rome. However, it was the post-industrial age that saw the development of the modern paradigm which impacts on the world as we see it today. The American Society for Quality (ASQ) suggests that the term “quality” should not be used as a single term to express a degree of excellence in a comparative sense, nor should it be used in a quantitative sense for technical evaluations. These meanings, it suggests, should be communicated by a qualifying adjective. A review of the literature suggests that there are numerous definitions of quality – almost as many as there are quality consultants. Hoyer and Hoyer (2001) surmised that these expert definitions of quality fall into two broad categories: Level one quality is a simple matter of producing products or delivering services, the measurable characteristics of which satisfy a fixed set of specifications that are usually numerically defined. Independent of any of their measurable characteristics, level two quality products and services are simply those that satisfy customer expectations for their use or consumption. This approach is well suited to general dental practice where success is dependent on the delivery of quality care at both these levels. The meaning and interpretation of quality is contextual; it depends on the nature of the service or product on offer and domain within which it is available. Some examples are listed in Table 2-1 and have certain themes in common, which are: Cost Time Customer experience Defect-free.   Table 2-1 The contextualisation of quality Domain The consumer view on quality indicators Airlines Safety, on-time, comfort, low-cost, good on-board food and drink Healthcare Correct diagnosis, minimum waiting time, safety, security, low cost Restaurant food Good food, fast delivery, comfortable environment, good atmosphere, polite service Postal services Fast delivery, reliable, low cost Consumer products Well made, fit for purpose, defect-free, good value Mobile phone communication Clear, fast, good coverage, low cost, design Cars Reliable, defect-free, faster, inclusion of extras, image and reputation of brand   Definitions
According to the American Institute of Medicine, quality is constituted by: “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” It suggests that: Quality performance and outcomes occur on a continuum, theoretically ranging from unacceptable to excellent. The scope of inquiry is limited to the structure, process, and outcomes of care provided by the healthcare delivery system. Quality may be assessed at multiple different levels. The link between process and outcomes should be established. Research evidence must be used to identify the services that improve health outcomes and in the absence of scientific evidence regarding effectiveness, professional consensus can be used to develop criteria. In the UK, Donaldson and Muir Gray defined quality in healthcare as: “Doing the right thing, for the right person at the right time and getting it right first time.” It is a definition that suits the practice of dentistry because it emphasises that there is more to quality than the quality of the technical outcome. For example, the quality of the outcome of root canal therapy on an upper molar may be undisputed, but if the root canal therapy has been the result of an incorrect or delayed diagnosis, then the patient has not received the “right thing at the right time”. The root canal therapy may be excellent, but the quality of care may be less than satisfactory. Another, more generally stated definition (European Committee for Standardization, 1994) holds that: “Quality is the totality of characteristics of an entity that bears on its ability to satisfy stated or implied needs.” This allows both provider and patient expectations to be taken into account. Øvretveit (1992) prefers a broader view, arguing that the scope of the above definition is limited by the fact that it considers the satisfaction of only those who receive the service and ignores those who do not. He defines quality as: “Fully meeting the needs of those who need the service most, at the lowest cost to the organisation, within limits and directives set by higher authorities and purchasers.” Another interpretation introduces variance into the definition. Robert A. Broh observed that: “Quality is the degree of excellence at an acceptable price and the control of variability at an acceptable cost.” During December 1999, readers of Quality Digest magazine were invited to submit their definitions of quality. Some of those definitions, which reflect the earlier discussions in this chapter, are shown in Table 2-2.   Table 2-2 Some thoughts on the meaning of quality The meaning of quality The meaning of quality Quality is the ongoing process of building and sustaining relationships by assessing, anticipating, and fulfilling stated and implied needs Quality is meeting the customer’s needs in a way that exceeds the customer’s expectations Quality is performance excellence as viewed by all stakeholders Quality is the customer’s perception of the value of the supplier’s work output Quality is the extent to which products, services, processes and relationships are free from defects, constraints and items that do not add value for customers Quality is when the customer returns and the product doesn’t. Karl Albrecht of Karl Albrecht International defines quality in two ways: Objective quality is the degree of compliance of a process or its outcome with a predetermined set of criteria that are presumed essential to the ultimate value it provides. Example: the proper formulation of medicine. ...