Quality Definitions: The totality of features and characteristics of a product or service that bear upon its ability to satisfy a given need. When the experience of the customer matches their expectation. When the product or service conforms to its specification. What is quality? Number of definitions – my preference Often confusion between quality and grade E.G. supermarkets ‘budget’ brand and ‘top-of-the-range’ products Top-of-the-range products perceived to be of higher quality In fact they are of a higher grade Budget products will meet their quality standards Your experience of the product purchased will meet your expectations

Total Quality Management TQM is an effective system for integrating the quality development, quality maintenance, and quality improvement efforts of the various groups in an organisation so as to enable production and service at the most economical levels which allow for customer satisfaction.

The Characteristics of TQM Meeting the needs and expectations of customers All parts of the organisation and supply chain are included Culture of empowerment There is 'no blame' Right first time and Zero Defects Quality assurance increased, quality control decreased. Quality systems with clear specifications, rules and procedures Continuous improvement - Kaizen An organisation that adopts TQM would exhibit these characteristics: Needs & expectations Embracing all internal & external customers, internal & external suppliers, all staff Enabling all staff to identify and resolve problems. No ‘blame’ – problems identified are resolved. Core aim Higher level of QA than QC (more in a couple of slides) These are regularly reviewed and developed. Kaizen – next slide

Continuous Improvement - Kaizen Definition: Gradual and orderly, continuous improvement Philosophy: discard conventional fixed ideas 'how it can be done' rather than 'why it can't be done‘ question current practice seek improvements initially, not perfection correct mistakes immediately don't spend money on quality, use your wisdom. Wisdom is brought out when faced with hardship ask 'why' often and seek the root causes of problems ten heads are better than one Kaizen ideas are infinite Definition: So, consistent, small, incremental improvements Philosophy: New staff question established practice gradual evolution, chip away Certainly true in my experience! Enquiring minds! Particularly with Ascribe! If you’ve got ten heads! We can always do better

Quality Traditional approach v TQM approach Prevention Checking Fire fighting Prevention Checking Fire fighting Diagram illustrates the effect on processes as quality control decreases and quality assurance increases PREVENTION PREVENTION Little prevention Focus to reduce problems early – zero defects CHECKING CHECKING To identify problems Sampling to ensure prevention achieved FIRE FIGHTING FIRE FIGHTING Resolving problems Minimal as a result of the above Use picking as an example

Consider the adoption of TQM within your organisation and supply chain. Which aspects would be easily implemented, which would be more difficult? Understanding customer needs and expectations. Who are they? What do they want? Patient receiving? Nurse administering? Doctor prescribing? Trust providing? PCT commissioning? Would all of these ‘customers’ want the same thing? Will it change? DIFFICULT – customers, blame culture, KPI’s Achievable performance measures needed – if you can’t measure it, you can’t control it (more from Kevan later) UNSURE – empowerment EASY – RFT 0D (Pharmacy culture), Kaizen

The Quality Guru’s Deming PDCA cycle – plan, do, check, act 14 points for quality Juran Quality trilogy Feigenbaum Staff participation Ishikawa Quality circles Taguchi Design quality Crosby Zero defects & right first time Cost difference between QA & QC Peters 12 Traits of a Quality Revolution I’m not going through these in detail, pick out more pertinent points (I want you to come back from lunch!) – all in hand outs / on website

Other Quality Issues ISO9000 series MHRA / EMEA Specifications ISO9000 series accreditation Can be considered as a minimum standard requirement Concerned with quality systems employed by organisations and ensuring they’re applied Does not ensure quality of goods or services provided No guarantee the buyer’s needs will be met. Licensing Authorities We are fortunate to have licensing standards imposed on suppliers and their products. Product and manufacturing licenses guarantee certain quality standards. The reason specials & U/L meds carry risk. Involvement of regional QA in PaSA contracting also of great benefit.

Performance and conformance specifications Clear & specific Restrict supplier innovation Buyer must be expert Performance Clear indication of purpose & performance Facilitate supplier innovation Conformance Clear & unambiguous requirements for product or service that must be met by supplier Can be restrictive of innovation buyer expertise essential Performance Supplier has opportunity to use expertise to meet buyer’s needs Requirements in specification are clear indication of: Purpose Function Application Of required goods or services

For each situation decide which specification would be most appropriate.