Warning: I know that other quality management professionals may say that there is a lot more to QMS’s than what I describe here. But I am all about simplicity, so this post does use simple, and I hope, accessible language to try and explain something that can be complex.
Let’s say you have to, or you choose to, comply to a set of standards. You read through the standards and then create a policy to address each indicator / clause / expected outcome, then procedures too, based on whatever process the management team thinks everyone follows. You put all of those into your network or
intranet, call it your quality management system, and you’re done! Right?! Ready for your external audit?
You’ve probably guessed that I’m already going to say an emphatic ‘no’.
Summing up what a quality management system is in a really simplistic way is difficult, but I’ll give it a go. It’s basically: the resources and the things you do to ensure that your (the organisation’s) objectives are met and that you continually improve what you’re doing. An extra for human services organisation: that you (the
organisation) deliver what you’re actually meant to deliver.
So as you can see from the above definition, a QMS is really not just about a set of documents. It’s about how everything is coordinated to produce a service. This is especially important for human services organisations to understand, because it’s about your human resources, your suppliers / contracted services,
equipment, how you work with your clients—all coming together to deliver a service that your clients will deem to be “quality”.
In order to coordinate all of those humans and tasks, it really helps to define what your processes are, and then to document them. Do you see how in the second paragraph the documentation came first? In reality, the documentation should be the product of management assessing risks and putting in place measures—most commonly done in the way of policies, procedures and forms—to ensure those risks are controlled. The organisation then has something to assess themselves against, and to help them improve.
The most popular “management systems certification” standards are the ISO 9001:2008. They’re about how your organisation organises everything in order to produce whatever it is you produce (including services). Standards like the Human Services Quality Framework are what is called “product certification” standards—basically they’re about how organisation deliver their services, and they are based on a continual improvement framework. While the HSQF and other standards like it don't specifically ask organisations to create a Quality Management System, a system is helpful in order to control, monitor and improve your activities.
If you need to set up a QMS and don't know where to start, don't despair. Start small by defining your core processes. A self-assessment may also help; there are usually self-assessment tools connected with the various human services quality standards in Australia, but if you need further help, please don't hesitate to send me an email.
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I hope everyone has had a happy Easter / public holiday break. Personally, I've been taking it a little easy and trying to catch up on some sleep!
However, I still always have time for Quality. Last week I came across this great infographic that I had to share. Created by Rick Torben and from from his website, this is a handy list of the Top 40+ questions to ask before embarking on any change. If you are about to start a project or even just have an idea for improvement, I'd be printing this off and using it as a guide to kickstart your process.
I don't think you need to ask every question for every change—after all, sometimes we are only tweaking a process, other times we are conducting major systems change. For smaller changes, or if you're just starting out in quality management or change processes, just going through #2 of the list would be a great start. But always, always must we ask this question from #1: "What will tell us that we've been successful?" and all of #6 - review!! Without doing this, you'll never know if the change you made is actually an improvement. And if you don't know that you might as well have done nothing at all.
I've realised after I've embedded this that it doesn't quite fit onto my page. My apologies, I've tried several ways to do this but no luck. So please view this as a taste and click to view the full infographic in Rick Torben's website.
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I was in my late 20s when I started working in Quality Management, and moved into a management role fairly quickly after that. In quality years, I believe this was pretty young, although these days I think a
lot of people are starting to get into it younger as training opportunities and the profession’s profile increase. But, back then, I was pretty much the youngest person at conferences, it seemed.
While I worked very hard to reach a management role, I admit that in some ways I was pretty green and learned a lot on the job. As I’ve moved from small to big organisations, from private to government to NGOs, these are the lessons that have stayed with me:
1. You will be a confidante to many, so confidentiality should be your number one priority—because quality staff are (and should be) objective and not usually involved in the services, many people will start to open up and tell you about issues / office politics / their personal lives. So it is very, very important not to break their trust (legislative / duty of care reasons aside, of course). Never engage in office gossip. That’s not to say you can’t make friends at work, but take care.
2. Don’t do all the changes at once—it is great to be proactive, and it is so tempting to get out there and show people all the wonderful improvements you’ll make to change their lives…but in reality, that will just cause stress if there’s too many changes going on. It is far better to plan changes progressively, as this will let you see where there might be linkages or conflicts in changes across the board. Prioritise and start small. Show people what difference the change has made and this will make them excited for the next change.
3. Consult wisely—this is especially important in bigger organisations. Basically, when you’re reviewing something, you could consult forever, as there will always be another opinion, a new staff member, a tweak here and there. But change that takes too long disengages staff. Pull together a list of critical partners, and then backups in case those people aren’t available. Set deadlines from the start. Even better, get them into a room for an hour—you’ll get more done in that hour than you would sending out a document for review by email, which can take weeks.
4. Be nice to people—I hear a lot these days about how it’s not about being liked, it’s about getting people to do what you need them to do. Well, you can do that and still be nice. And I mean really nice, genuinely interested in them and invested in your organisation. Smile, say hello when someone passes you in the hall, be down to earth. Always remember, in quality management, YOU work for the other staff in the organisation. You are THEIR support service. If you don’t like people or prefer working alone, you need to think about whether quality is for you. Plus being friendly makes you feel good!
Do you have any tips or lessons from your early days in Quality Management that you’d like to share? Please feel free to email me or comment.
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At some point in the life of your quality management system you will need to document how something is done (I say 'document' but these principles will apply to whatever format you use—written, video, voice or picture). Developing a procedure requires a delicate balancing act—too little information and you may not be controlling risk effectively, or your procedure may be plain wrong. Too much information, though, and staff will just tune it out. Here are a few tips on how to write one that works:
1. Start with a scope, criteria and objective, or, the who, what and why—who does the procedure relate to? What does it connect with (link with standards, legislation, guidelines)? And why does it exist? For example:
Procedure: Client Review and Re-assessment
Scope: Services providing Home Care Packages.
Criteria: Home Care Guidelines (August 2013).
Objective: To ensure that all clients are reviewed / re-assessed in a timely and cost-effective manner according to their need.
2. I've talked before about using flowcharts to document procedures—specifically, I think swim lane flowcharts are good because they show who is responsible for particular tasks (Visio is best for creating these types of flowcharts). If you're not into flowcharts, however, lists can also work well if you need your procedure to be in written form.
One thing to remember when creating a procedure is to ensure that you have carefully considered everything that goes in, and will come out, of the process you are documenting. This is not a new formula by any means, but one that I find simple and helpful:
Inputs - Actions - Outputs - (Outcomes - optional).
Inputs are transformed by actions into outputs. So for a referral procedure, you might have an intake form (the input), which, after it's been completed, becomes the output (a completed intake form filed in the new client's file, for example. Specifying inputs and outputs is useful as it ensures that your staff are clear on what they need to use, and what should be the result of their actions.
3. Ensure that you make connections to other relevant procedures and forms, the purpose being that if you make a change to one you will know what other documents need changing. If you have the time or inclination, documenting these in a documents register or similar makes for quick referencing when documents are changed.
4. I cannot stress this enough—document control! Put a version number and date on everything. Remember, you are controlling risk by documenting your processes. You are also ensuring that your processes meet legislation, standards, guidelines, etc. You need to be sure that your staff are using the right documents and doing the right thing.
Helping organisations set up or review their processes and documents is part of the service that The Quality Nerd provides, so if you do need help, please contact me—I know it can feel overwhelming. But you can achieve much by keeping it simple.
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The Quality Nerd loves all things Quality Management and Internal Audit...too much is never enough!