Quality Control

UNDERSTANDING QUALITY CONTROL ? Quality Control is a process by which entities review the quality of all factors involved in production. This approach places emphasis on three aspects: o Elements such as controls, job management, defined and well managed processes, performance and integrity criteria, and identification of records o Competence, such as knowledge, skills, experience, and qualifications o Soft elements, such as personnel integrity, confidence, organizational culture, motivation, team spirit, and quality relationships The quality of the outputs is at risk if any of these three aspects is deficient in any way. Quality control is a major component of total quality management; and the quality-control cycle consists of four steps: quality planning, data collection, data analysis, and implementation. o Quality planning consists of defining measurable quality objectives. Quality objectives are specific to the product or service and to the phase in their life cycle, and they should reflect the customer’s requirements o The collection of data about product characteristics that are relevant to the quality objectives is a key element of quality control. These data include quantitative measurements (measurement by variables), as well as determination of compliance with given standards, specifications, and required product features (measurement by attributes). Measurements may be objective, that is, of physical characteristics, which are often used in the control of the quality of services.

Since quality control was originally developed for mass manufacturing, which relied on division of labor, measurements were often done by a separate department. However, in the culture of Total Quality Management, inspection is often done by the same individual or team producing the item. The data are analyzed in order to identify situations that may have an adverse effect on quality and may require corrective or preventive action. The implementation of those actions as indicated by the analysis of the data is undertaken, including modifications of the product design or the production process, to achieve continuous and sustainable improvement in the product and in customer satisfaction Data Analysis: The methods and techniques for data analysis in quality control are generic and can be applied to a variety of situations. The techniques are divided into three main categories: diagnostic techniques; process control, which includes process capability assessment and control charts; and acceptance sampling. Diagnostic techniques serve to identify and pinpoint problems or potential problems that affect the quality of processes and products, and include the use of flowcharts, cause-and-effect diagrams, histograms, Pareto diagrams, location diagrams, scatter plots, and boxplots Process-control methods are applicable to systems that produce a stream of product units, either goods or services. They serve to control the processes that affect those product characteristics that are relevant to quality as defined in the quality objectives.

For example, in a system that produces metal parts, some of the processes that might need to be controlled are cutting, machining, deburring, bending, and coating. The relevant product characteristics are typically spelled out in the specifications in terms of physical dimensions, position of features, surface smoothness, material hardness, paint thickness, and so on. In a system that produces a service, such as a telephone help line, the relevant processes could be answering the call, identifying the problem, and solving the problem.

The characteristics that are relevant to quality as perceived by the customer might include response time, number of referrals, frequency of repeat calls for the same problem, and elapsed time to closure. Process control focuses on keeping the process operating at a level that can meet quality objectives, while accounting for random variations over which there is no control. There are two main aspects to process control: control charts and capability analysis. Control charts are designed to ascertain the statistical stability of the process and to detect changes in its level or variability that are due to assignable causes and can be corrected. Capability analysis considers the ability of the process to meet quality objectives as implied by the product specifications.

Acceptance sampling refers to the procedures used to decide whether or not to accept product lots or batches based on the results of the inspection of samples drawn from the lots. Acceptance sampling techniques were originally developed for use by customers of manufactured products while inspecting lots delivered by their suppliers. These techniques are particularly well suited to situations where a decision on the quality level of product lots and their subsequent disposition needs to be made but it is not economic or feasible to inspect the entire production output. ? The ISO definition states that quality control is the operational techniques and activities that are used to fulfill requirements for quality. This definition could imply that any activity whether serving the improvement, control, management or assurance of quality could be a quality control activity. What the definition fails to tell us is that controls regulate performance. They prevent change and when applied to quality regulate quality performance and prevent undesirable changes in the quality standards. Quality control is a process for maintaining standards and not for creating them.

Standards are maintained through a process of selection, measurement and correction of work, so that only those products or services which emerge from the process meet the standards. In simple terms quality control prevents undesirable changes being present in the quality of the product or service being supplied. The simplest form of quality control is illustrated in the Figure below. Quality control can be applied to particular products, to processes which produce the products or to the output of the whole organization by measuring the overall quality performance of the organization. [pic] Quality control is often regarded as a post event activity. i. e. means of detecting whether quality has been achieved and taking action to correct any deficiencies. However, one can control results by installing sensors before, during or after the results are created. It all depends on where you install the sensor, what you measure and the consequences of failure.

Some failures cannot be allowed to occur and so must be prevented from happening through rigorous planning and design. Other failures are not so critical but must be corrected immediately using automatic controls or fool proofing. Where the consequences are less severe or where other types of sensor are not practical or possible, human inspection and test can be used as a means of detecting failure. Where failure cannot be measured without observing trends over longer periods, one can use information controls. They do not stop immediate operations but may well be used to stop further operations when limits are exceeded. If you have no controls then quality products are produced by chance and not design. The more controls you install the more certain you are of producing products of consistent quality but there is balance to be achieved. Beware of the law of diminishing returns. It is often deemed that quality assurance serves prevention and quality control detection, but a control installed to detect failure before it occurs serves prevention such as reducing the tolerance band to well within the specification limits. So quality control can prevent failure.

Assurance is the result of an examination whereas control produces the result. Quality Assurance does not change the product, Quality Control does.

Quality Control is also a term used as a name of a department. In most cases Quality Control Departments perform inspection and test activities and the name derives from the authority that such departments have been given. They sort good products from bad products and authorize the release of the good products. It is also common to find that Quality Control Departments perform supplier control activities which are called Supplier Quality Assurance or Vendor Control. In this respect they are authorized to release products from suppliers into the organization either from the supplier’s premises or on receipt in the organization. Since to control anything requires the ability to effect change, the title Quality Control Department is in fact a misuse of the term since such departments do not in fact control quality. They do act as a regulator if given the authority to stop release of product, but this is control of supply and not of quality. Authority to change product usually remains in the hands of the producing departments. It is interesting to note that similar activities within a Design Department are not called quality control but Design Assurance or some similar term. Quality Control has for decades been a term applied primarily in the manufacturing areas of an organization and hence it is difficult to change people’s perceptions after so many years of the terms incorrect use. In recent times the inspection and test activities have been transferred into the production departments of organizations, sometimes retaining the labels and sometimes reverting to the inspection and test labels.

Control of quality, or anything else for that matter, can be accomplished by the following steps: 1. Determine what parameter is to be controlled. 2. Establish its criticality and whether you need to control before, during or after results are produced. 3. Establish a specification for the parameter to be controlled which provides limits of acceptability and units of measure. 4. Produce plans for control which specify the means by which the characteristics will be achieved and variation detected and removed. 5. Organize resources to implement the plans for quality control. 6. Install a sensor at an appropriate point in the process to sense variance from specification. 7. Collect and transmit data to a place for analysis. 8. Verify the results and diagnose the cause of variance. . Propose remedies and decide on the action needed to restore the status quo. 10. Take the agreed action and check that the variance has been corrected. We may wonder QC is the same as QA? Let’s discuss…… Quality Control & Quality Assurance F I R S T . . . . Quality control emphasizes testing of products to uncover defects, and reporting to management who make the decision to allow or deny the release, whereas Quality assurance attempts to improve and stabilize production, and associated processes, to avoid, or at least minimize, issues that led to the defects in the first place. Quality assurance, or QA for short, refers to a program for the systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure that standards of quality are being met. Quality assurance includes regulation of the quality of raw materials, assemblies, products and components; services related to production; and management, production and inspection processes. It is important to realize also that quality is determined by the intended users, clients or customers, not by society in general: it is not the same as ‘expensive’ or ‘high quality’. Even goods with low prices can be considered quality items if they meet a market need. QA is more than just testing the quality of aspects of a product, service or facility, it analyzes the quality to make sure it conforms to specific requirements and comply with established plans. S E C O N D . . . . Quality control means checking a finished product against the specification and rejecting anything that does not meet the specifications. Checks can be on every item or on a sample. Quality assurance means checking the inputs to a manufacturing process, things like raw materials, measuring devices that are used and machine settings. If QA is done correctly, you should make little or no product out of specification. | | |TOTAL QUALITY MANAGEMENT | |In recent years, National Kidney and Transplant Institute has assumed a trailblazing role in renal healthcare and | |organ transplantation in the Philippines and Asia and the Institute has constantly walked the path of service | |quality. | | |The Institute’s Total Quality Management advocacy was formally launched on March 28, 2001, a defining milestone in | |our delivery of quality healthcare. As supported by the Institute’s Quality Policy and Quality Objectives, we | |maintain service quality in all areas of the hospital. Quality Management is seen in all aspects of our daily | |operations: from the Medical, Para-Medical, Patient Safety, Infection Control and to the Nursing Services, quality | |permeates all activities. Incorporating the five pillars of Total Quality Management – 5S, Suggestion Scheme, | |Quality Circles, ISO – to our Institute has allowed us to be more responsive to the needs of our patients and their| |families, visitors, and express genuine concern for their utmost comfort, welfare and self-esteem. | | |We acquired our ISO 9001 : 2000 Certification (Comprehensive Specialty Healthcare Services) in April 25, 2002, and | |up until now remain the only Philippine Tertiary Government Hospital who has attained the ISO global seal of | |quality standard. As a result, we have embraced and actualized the concept of Continual Quality Improvement in our | |services; and we acknowledge that it is through a competent workforce with selfless teamwork, dedication, and sense| |of accountability that quality improvement and service quality can be achieved. | | |For the past two years, as part of our service quality, we are implementing an efficient Hospital Information | |System that ensures smooth and prompt processing of your transactions – from Admission until Discharge, requests | |for diagnostic procedures and release of results, requests for medical supplies and pharmaceuticals, etc. | | | |At NKTI, we make sure that your expectations from us are met; and our commitment to Quality also guarantees that we| |will exceed your expectations. |[pic] | | | | | | | |  | |Quality Policy | |  | |To fulfill the Vision-Mission of National Kidney and Transplant Institute, we shall provide the most appropriate, | |comprehensive, effective health care services to exceed our customers’ expectations. | | | |Our success will be achieved through full participation of our employees at all levels of the organization guided | |by our Quality Objectives. | | |National Kidney and Transplant Institute shall commit to ensure compliance to all regulatory, statutory, | |environmental, and health / safety requirements of the government and other recognized world organizations like the| |WHO, etc. | | | |The Quality Policy shall be communicated to and made understood by all employees through orientations, meetings, | |circulars, posters and other related means. | | | |This Quality Policy shall be reviewed annually or as necessary by management to adapt to current developments / | |requirements through continual improvement. |  | |Quality Objectives | |  | |T he objectives of the Quality Assurance Program of National Kidney and Transplant Institute is the preservation | |and enhancement of the high quality patient-centered care by ensuring that : | |  | |HUMAN RESOURCES have optimum skills and competencies. | |TECHNOLOGY and FACILITIES are state-of-the-art and properly maintained. | |SERVICES are delivered in the safest and most efficient manner. | |SYSTEMS are effective, well-defined and continually improved to meet customer requirements. | |AFFORDABILITY shall not compromise the cost of QUALITY. | |REQUIREMENTS OF INTERESTED PARTIES shall be observed with maximum compliance at all times. |  | |Above-mentioned Quality Objectives are inspired by the following CORE VALUES of TOTAL QUALITY MANAGEMENT : | |  | |“Customer-First” Attitude | |Commitment and | |Competence Development | |Long-Term Perspective | |Process and Results | |Orientation | |Prevention | |Continuous Improvement | |Learning from Others | |Fast Response | |Management by Fact | Nursing services department Vision | |  | |Imbued with compassion, professionalism and excellence, we shall be the role model in the entire nursing profession| |and its allied health care services, globally recognized in the delivery of effective and efficient quality care to| |everyone we serve. | |  | |Mission | |  | |We are dedicated to serve and share our expertise to everyone with integrity and with partiality to none. |  | |Quality Objectives | |  | |PATIENT CARE | | | |Provide individualized quality patient care using the nursing process to meet patient care needs from admission to | |home management. | | | |EDUCATION | | | |Establish a continual program in quality training and education to provide the staff with the cutting edge | |knowledge, skills and values to effectively and efficiently care and interact with the patients. | | | |CONTINUOUS QUALITY IMPROVEMENT | | | |Review, evaluate and revise processes and practices, to achieve best outcomes. | | |RESEARCH | | | |Develop and implement research-based strategies on identified patient care needs and job performance needs. | | | |LEADERSHIP | | | |To provide competent, responsible, and accountable leadership aimed at developing and sustaining a creative and | |positive culture and milieu for professional nurses and support staff. |Core Values | |  | |Competence & Compassion | |Timeliness | |Accountability | |Empowerment | |Respect & Integrity | |Innovation | |Qualification |Graduate of Bachelor of Science in Nursing | |Standards / Eligibility: |B. Licensed to practice nursing in the Philippines | |Position: NURSE I (SG 11) |C. Member, Philippine Nurses Association | | |D. Licensed Basic Life Support (BLS) Provider | | |E. Licensed Intravenous Therapy (IVT) Practitioner | | |F. 4-months Basic Skills Training mandatory for non-practicing nursing graduates of | | |more than 5 years ago or 6 months hospital experience of no less than 100 bed | | |capacity | | |G. Computer Literate | |Qualification |Completion of two years studies in college relevant to the job or have undergone a | |Standards / Eligibility: |relevant post secondary or required training course: ELIGIBILITY: MC 12 Medical | |MST 1 SG 6 |Equipment/Services Technician | |Qualification |- Bachelor’s degree relevant to the job; | |Standards / Eligibility: |- 2 years of relevant experience; | |Statistician III SG 18 |- 8 hours of relevant training | | |- Career Service ( Professional ) | | |- 2nd level Eligibility | |Qualification |Bachelor’s Degree in Radiologic Technology | |Standards / Eligibility: |2 years relevant experience | |Radiologic Technologist II SG 13 |8 hours relevant training | | |ELIGIBILITY: R. A. 080 | |Qualification |Bachelor’s degree | |Standards / Eligibility: |3 years supervisory experience | |Department Manager III SG 26 |ELIGIBILITY: CES | |Qualification |Bachelor’ s degree relevant to the job | |Standards / Eligibility: |2 yrs.

Experience in cadaver organ retrieval |Transplant Coordinator I |16 hours of relevant training/administrative, proficiency, kills development | |SG 16 |Career Service Professional or relevant Eligibility for 2nd level position | |Qualification |Licensed Engineer | |Standards / Eligibility: |1 year relevant experience | |Engineer II SG 16 |8 hours relevant training | PRESIDENTIAL DECREE No. 807 October 6, 1975 PROVIDING FOR THE ORGANIZATION OF THE CIVIL SERVICE COMMISSION IN ACCORDANCE WITH PROVISIONS OF THE CONSTITUTION, PRESCRIBING ITS POWERS AND FUNCTIONS AND FOR OTHER PURPOSES ARTICLE VIII PERSONNEL POLICIES AND STANDARDS Section 20. Qualification Standards. (a) A qualification standard expresses the minimum requirements for a class of positions in terms of education, training and experience, civil service eligibility, physical fitness, and other qualities required for successful performance. The degree of qualifications of an officer or employee shall be determined by the appointing authority on the basis of the qualifications standard for the particular position. Qualification standards shall be used as basis for civil service examinations for positions in the career service, as guides in appointment and other personnel actions, in the adjudication of protested appointments, in determining training needs, and as aid in the inspection and audit of the agencies personnel work programs. It shall be administered in such manner as to continually provide incentives to officers and employees towards professional growth and foster the career system in the government service. (b) The establishment, administration and maintenance of qualification standards shall be the responsibility of the department or agency, with the assistance and approval of the Civil Service Commission and in consultation with the Wage and Position Classification Office. [pic][pic][pic]

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