Implementing a Quality Management System Approach Catholic Health Australia National Conference 20 August 2012 Marise Goddard-Jones GGJ Consultants WWW.GGJ.COM.AU

Community care context ... Australia’s population is living longer and there are more frail aged people needing care in the community. The Intergenerational Report 2010 Presently there are over 3 million Australians aged 65 years or older (15.3% of the population). This is projected to rise to around 7.5 million (26% of the population) by 2055. Australian Bureau of Statistics 2012 / Living Longer Living Better Report 2012 91% of Australians want to remain as independent as possible as they grow older and remain in their own homes, with the support of professional services. Australian Housing and Urban Research Institute May 2010

Community care context There is clearly a need to ensure quality services are delivered to community care clients Quality standards are a key strategy: they are an indicator that service providers are delivering quality services They provide a framework and impetus for service providers to continuously improve services

Do Standards make a difference to client outcomes? Not on their own! An integrated quality management system (QMS) approach is required to ensure that the Standards and organisation processes are implemented effectively.

What is a QMS approach? The International Organisation for Standardization (ISO) Quality Management Systems Requirements ISO 9001:2008 describes organisations applying a QMS approach can: Demonstrate the ability to consistently provide product/service that meets customer and applicable regulatory requirements, and The QMS aims to enhance customer satisfaction through the effective application of the system, including processes for continual improvement of the system and the assurance of conformity to customer and applicable regulatory requirements.

What does a QMS look like? Systematic, integrated and structured Demonstrates an understanding of regulatory, legislative and customer requirements Documentation and records are maintained Processes and risks are measured and monitored Competence, training, skills, and experience of staff are demonstrated Services are linked to customer needs Equipment and materials are suitable Continual improvement is demonstrated A QMS approach is a health tonic for your business – it makes everything work better. You may notice some similarities between these elements and the CCCS – in developing the Standards we ensured alliance with the QMS requirements of the International Standard.

What else is required? Involved leadership An understanding of quality, the business and continuous improvement Commitment and enthusiasm Knowledge and skills to implement systems, measurement and monitoring Creativity to engage others and The drive to seek out relevant standards and other resources A leadership team that does not display and interest in the systems, processes and outcomes of them will not reach its potential. Leadership needs to be displayed by executive management and management that sets the example, is involved and involves and enthuses others. An understanding of what quality means for the organisation, the requirements of Standards, the businesses’ systems and processes and continuous improvement. Commitment and enthusiasm to improve and apply the quality systems. Knowledge and skills to improve through the involvement of all stakeholders and to implement systems to monitor and measure the quality system and its outcomes, such as the implementation of a robust internal audit program. Creativity: often people say that a quality management system approach limits innovation and creativity. That is not my experience; once systems and processes are in place, including monitoring processes, they then have the freedom to trial and implement improvements. You need creativity to engage with people both within and outside of your organisation to get them on board. Application of other relevant standards an other resources: the health sector more broadly has been implementing standards and quality management systems for years – we can learn from the resources developed by these other health sectors.

Sector concerns Standards stifle innovation Standards and ‘quality’ stop us doing our real work – delivering services and support to clients Standards are all about paperwork and nothing about giving better services to clients It is all about processes and not outcomes Staff and volunteers will leave We don’t have enough time to do all this We don’t have the expertise…..

Be prepared for change… “It is not the strongest of the species that survive, nor the most intelligent, but the ones most responsive to change.” Darwin Implementing a quality management system approach necessitates change: New ways of doing things Processes and structures to promote consistency Insistence on documentation, monitoring, internal audit Go slow!

Critical elements to make your QMS work Policy and procedures matched to practice Efficient work processes Staff knowledge and competence Records – eg client, training, incidents, staff, reports eg KPIs Collect data/conduct surveys/research Seek ongoing customer feedback Review of environment/products

EG: Complaints and feedback P & P: description of how feedback and complaints are handled with timeframes Processes for collection: forms, surveys, forums, collecting ‘hidden’ feedback, trending feedback Staff: all staff trained in complaints/feedback management Records: evidence of timely, appropriate action and improvements based on feedback Evaluation: internal audit of policy, procedures and practices; is there customer satisfaction with the outcome?; are the processes efficient?

Standards and other resources Be informed and seek info: Community Care Common Standards Information from funders and peak agencies ISO 9001:2008 Quality management system requirements Specific Australian Standards Australian Commission on Safety and Quality in Health Evidence based practices Technology

It’s too hard….. Measure your progress on other health sector performance: 1st 3 years – formative (systems implemented) 2nd 3 years – consolidation (status quo and testing/monitoring) Next 3 years – streamlining (an integrated system that demonstrates improvements easily)

What are the outcomes of a QMS approach? Sustainable business that can provide ongoing high quality services Implementation of client ideas and preferences leading to services more in tune with client needs Enthusiastic and committed workforce Potential for growth and diversity in service provision And more…

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