Juran Trilogy

Problem Defined: Patients have to wait for long hours in emergency ward. Usual Corrective Measure: increase the emergency ward, increase the number of doctors and present doctors duty hour to serve more patients as they can.

Quality planning
Identify the customers: Which are actually in critical/severe condition & need more health care. Determine the customer needs: Patients want to wait as minimum as possible. Develop product feature: Emergency services of the hospital should match to the customer expectations and need. Develop adequate processes: Establish weekly survey programs which actually help to know the customers incoming lot and the nature of the patients and their type of diseases. Prove the process: Made quality circles which actually help to improve the quality of services or we can say made specialized coaching team and toolkit to help hospital and its management to quickly identify the ways they can improve the operation of their emergency waiting.

Quality Control

Define control: are weekly survey program made to know the customers incoming lot and the nature of the patients and their type of diseases? Measurement: How much customers came weekly? What type of diseases came frequently? Current doctors are quite enough to serve the incoming lot of patients per week? How much time it takes to serve a patient?

Standard: Serve 95% of patients, decrease the waiting time in emergency ward and minimize number of death per week. Measure actual operating performance Hospital is serving 92% patients per week. Numbers of deaths are varying (5%) per week. Some time patients have to wait more than they expect. Number of wards is less as compare to the incoming of lot of customers per week. Act on difference Inform management that Still 3% difference is present in patients serving per week. Numbers of deaths are varying while we make a commitment to minimize number of deaths. Hospital needs more wards for patients. Patient waiting in emergency ward is creating disloyalty and dissatisfaction.

Quality Improvement
Spend more money on planning part which basically decreases the chronic waste. Make flowcharts. Need more employee commitment. Isolation of departments is necessary. Made specialized coaching team and toolkit to help hospital and its management to quickly identify the ways they can improve the operation of their emergency waiting. New technologies using rapid tests to evaluate patients have helped reduce waiting times. Some are using sophisticated computer systems to give complete, up-to-the minute status reports on every patient in every emergency bed.1 Hospital needs more wards for patients and for this hospital need financial support so hospital has to ask for Government support. Regression analysis revealed that service quality dimensions of trust, responsiveness, and staff service were significant predictors of patient satisfaction so hospital has to more focus on the patient satisfaction.2

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http://www.acep.org/content.aspx?id=25908 http://www.ncbi.nlm.nih.gov/pubmed/10127062