Caso Qmh

HKU131
08/15/01

Continuous Quality Improvement Initiatives at Queen Mary Hospital
Drastic cuts in government funding coupled with rising healthcare costs in 1995 forced the adoption of new management techniques in the healthcare industry in Hong Kong. A management technique that had gained prominence in the United States from 1995 to 2000 in the healthcare industry was continuous qualityimprovement, or CQI. Also in 1995, hospitals in Hong Kong adopted CQI as a strategy for change and for improving quality while containing costs. Queen Mary Hospital (QMH), in particular, established a CQI Unit that focused entirely on improving the quality of its services to its patients. The CQI model that the unit adopted followed the four steps of Focus, Analyse, Develop and Execute (FADE). Thismodel helped QMH to achieve the CQI objectives in its project “Pre-Operative Skin Preparation: Shaving and Pre-Operative Baths”. The CQI Unit’s intention was to administer the same CQI model in other areas, one of which was the “Food Wastage Minimisation” project. Would the same FADE model, the methodology, the approach and the success factors in the implementation be applicable to this new CQIundertaking? What were the critical CQI characteristics that would contribute to a significant outcome in minimising food wastage at QMH? A critical factor was how the CQI Unit should implement other changes using CQI. How should the CQI Unit respond to organisational resistance and managing professionals through change? The Unit also had to reckon with where and how to collect data in determiningareas for CQI application. What were the key elements that had to be considered to achieve co-operation and support of everyone at QMH, particularly the medical professionals, who were recognised as critical decision-makers?

The Global Perspective of CQI and the Concept of Quality in the Healthcare Sector
CQI in healthcare was pioneered in the US, where, in 1996, there were as many as 80,000deaths every year due to medical errors and negligence.1 This prompted the US government to initiate discussions on creating a Federal Agency of Patient Safety. The healthcare profession around the world was beset with challenges and difficulties concerning patient care and had to hold up under extreme pressure to change. The scrutiny from the outside
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Brashier, L. W., et al., “Implementation ofTQM/CQI in the Healthcare Industry,” Benchmarking for Quality Management & Technology, 1 April, 1996.

Marissa McCauley prepared this case under the supervision of Dr. Simon S. K. Lam for class discussion. This case is not intended to show effective or ineffective handling of decision or business processes. This case is part of a project funded by a teaching development grant from theUniversity Grants Committee (UGC) of Hong Kong. Copyright 2001 The University of Hong Kong. No part of this publication may be reproduced or transmitted in any form or by any means - electronic, mechanical, photocopying, recording, or otherwise (including the Internet) - without the permission of The University of Hong Kong. Ref. 00/76C 15 August, 2001

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Purchased by Michael Rojas(michael.e.rojas@gmail.com) on June 29, 2012

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Continuous Quality Improvement Initiatives at Queen Mary Hospital

environment focused on protracted and more frequent hospitalisation due to misdiagnoses, substandard surgery, improper drug therapies and hospital-acquired infections. Other factors that contributed to the decline in hospital care included the rising employee turnover rates, the delegatingof patient care to under-qualified and inexperienced staff, the increasing number of lawsuits resulting from poor medical outcomes and other internal weaknesses driven by the need to reduce hospital operating and administration costs due to decreasing annual budgets. Quality management, some doctors believed, would have a significant role in minimising the many problems associated with the...