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

2. 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

3. 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.

4. 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 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.

5. 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

6. 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

7. System Product Quality Model-ISO/IEC9126

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 　　 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

21. 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

22. END
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