Application of new TQM framework to Healthcare Kazuhiro ESAKI Japanease Registerd Enginnear Assistant Professeor Doctor HOSEI University Faculty of science and engineering Kees959@hotmail.com

Contents ■Background ■Frame work of ISO/IEC25000 ( SQuaRE ) ■Basic Concept of Quality Control ■System Quality Model ■Three Dimensional Unification Value Model ■Quality Management Structure ■TQM Matrix ■Construction of framework of New TQM ■Application of new TQM to Healthcare ■Conclusion

Back ground ■ We have been working on developing the ISO/IEC25000 (SQuaRE) series so long time. ⇒Suporting technology for the method of quantitative quality requirement definitions and evaluation of system. ■ Definition of system ⇒a combination of interacting elements organized to achieve one or more stated purposes defined in ISO/IEC15288:2008 -System life cycle processes ■ Organization or Person is considered as a kind of system ⇒Evaluation frame work of ISO/IEC25000 for Information System can be applied to Healthcare.

Back ground ■ In recent years, TQM is widely recognized. ⇒However, contents of assessment criteria are various, and it is very difficult to define the whole scope of TQM. ■ In the previous study, we suggested the framework of new TQM based on the original developed concept of TQM matrix, the Three Dimensional Unification Value Models and framework of ISO/IEC 25000 for evaluating management quality of company. ■ We found that “Risk and Investment management” were short in an criteria of the conventional TQM. ■ We would like to propose the Application of new TQM for Healthcare Management.

Frame work of ISO/IEC25000 (SQuaRE) Constraints Schedule, Budget, Technology Outcome Input Quality Requirement process Quality Requirement specification Quality Evaluation process Customer needs Evaluation report Development Target Product Intermediate or Final ISO/IEC25030 ISO/IEC25040 ISO/IEC25041 　Resource (Infrastructure) ISO/IEC9126 (25010) System Quality model

Basic Concept of Quality Control （CPD Cycle） Process Plan Purpose Strategy Target Specification Issue Input Product Product Process Process Check Do Target Result Evaluation Assessment Target Method Activity Result Product Outcome

System Product Quality Model-ISO/IEC9126

Three Dimensional Unification Value Model for Syatem ■ Supplied Value ⇒Functionality ⇒Usability Value axis Total Quality ■Capability of corresponding environment change ⇒Portability ⇒Maintainability Performance axis ■ Capability of System ⇒Reliability ⇒Efficiency　 Adaptability axis 8

Structure of Quality Management Evaluation Prediction E f e c t Advantage Good Value Improvement Investment Issue Issue L o s Correction Risk Management Problem Damage Present Future 9

Concept of TQM Matrix E f e c t L o s Big Resolution Cancellation Execution Quality Improvement Dynamic Risk management Medium Small L o s Small Possession Reduction Medium Correct Problem Move Quality Assurance Static Risk management Big Evasion （ Join Insurance） High Medium Low Low Medium High Outbreak frequency Outbreak probability 10 present Future 10

Construction of new TQM ISO/IEC25000 SQuaRE Quality Evaluation Framework New TQM for Healthcare System Quality Model Basic Concept of Quality Control （CPD Cycle） Three Dimensional Unification Value Model　for Product & Process New TQM Framework Concept of Quality Management Structure Common Management Process TQM Matrix 11

Constrain （Environment） Resource （Infrastructure） Framework of New TQM Constrain （Environment） Needs law Technology Time Budget Human resource Outcomes Input Process Quality Improvement Dynamic Risk Management Improve -ment Resource Leadership of Top management Product service Quality Assurance Static Risk Management Profit Resource （Infrastructure） Human resource Technology Facility IT system Asset 12 12

Three Dimensional Unification Value Model for Healthcare ■Supplied Value ■Characteristics ⇒Healthy, Safety, Comfortable, Stability, Satisfaction, Convenient Value axis ■Capability of Organization ■Characteristics ⇒Confidence, Efficiency, Productivity Profitability, Maturity, Continuity　 Outcomes Quality ■Capability of corresponding environment change ■Characteristics ⇒Flexibility, Expandability, Conformance Performance axis Adaptability axis 13

Application of Product Quality Management ■Top Management ⇒Ethic, Fairness, Decision making, Good sense of responsibility, Leadership, Strategy, Control. ■Input Value ⇒Safe food, Intelligence, Superior medical equipment, Medicine, Sickbed, Facility Performance ⇒Human Resource ( Doctor, Nurse) , Education, Facility ■Outcomes of Product, Service & Improvement Value ⇒Safety, Happiness, Health body, mind, skill Performance ⇒ Good Service, Health worker, Facility, Equipment, Technology Adaptability ⇒Satisfaction of Patient, Health Worker

Application of Product Quality Management ■Constrain (Environment) Value ⇒Law necessary for healthy social maintenance Performance ⇒Limitation of medical expenses, technology, medical support system, ability of healthcare worker Adaptability ⇒Technology, Medical support system, Education ■Resources (Infrastructure ) Performance ⇒Human resource, Budget, Supporting technology, Medicine, Sickbed, Superior medical equipment, medical facilities Adaptability ⇒Technology, Medical support system 15

Application of Process Quality Management ■Quality Assurance & Improvement Value ⇒Guarantee of quality of health care service Performance ⇒Healthcare worker, medical equipment, education, medical institution, medical system, Safe food, Pharmaceutical guarantee of quality

Application of Process Quality Management ■Static Risk management (Conventional Risk) Value ⇒Measures for New disease, New variety of bacteria, Virus Performance ⇒Lack of resources ( personnel, fund ) ⇒Preventive measures against medical accidents ⇒Measures to a medical error ■Dynamic Risk Management (Investment ) Value ⇒Health care service reinforcement ⇒Research and development new health care service Performance ⇒Research and development new medical technology ⇒New pharmaceutical development 17

TQM Matrix of Healthcare Big Healthy increase Cancellation　　　　　　　　　 R&D of new Service technology of healthcare Quality Improvement Dynamic Risk management Medium Small Target Scope of conventional of Oriental medicine medical Target Scope of conventional Western medicine L o s Small Possession Reduction Prevention Foresight Medium Rehabilitation Emergency care Move Quality Assurance Static Risk management Big Evasion （ Join Insurance） High Medium Low Low Medium High Outbreak frequency Outbreak probability 18 present Future 18

Verification ■New TQM is effective to support Healthcare. ⇒Not only Assessment Product Domain of Outcomes but also Product Domains such as the Inputs, Constrain and Resources are necessary. ⇒Assessment of Process Domains such as Static Risk Management and Dynamic Risk Management from long term prospects are important for Healthcare. ⇒Assessment Criteria for Target Entities of Product and Process from the view point of Three Dimensional Unification Value Models is useful. 19

　　 Conclusion ■Static & Dynamic risk management is effective for a stage of foresight non-illness. ■Preventive maintenance regularly and development of new medical technology for health care service may cause ⇒Reduce disease and medical cost. ⇒Increase health care service investment and reward. ⇒ Satisfaction of Patient ⇒ Satisfaction of healthcare worker ■Should circulate effective CPD cycle !!! 20

Conclusion ■Healthcare should be supported by Government. Also, government should be support by common sense of polite people who understand the importance of Healthcare. In order to achieve good Healthcare Management, Human society should be realized based on the concept of framework of new TQM. ■”Quality of Person” synonyms ⇒Health ⇒ Body, Mind, Skill ■”Quality of Earth” synonyms ⇒Environment. 21

END Our dreams come true.