OBJECTIVES: This study aims to evaluate the effectiveness of the Lean Six Sigma approach in improving procedure for (TAT) of reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 testing at The Medical City. Specific objectives of the study are to determine the following: 1) baseline sigma and average TAT (in hours); 2) post-implementation sigma and average TAT (in hours) 3) compare if there is a significant improvement between baseline and post-implementation sigma and average TAT (in hours) 4) effect on workflow efficiency. METHODOLOGY: Lean Six Sigma method for quality improvement was applied using DMAIC: Define, Measure, Improve, and Control. The root causes identified were lack of manpower, equipment, space, and manual and complex processes. Then, process wastes were identified, and corresponding proposed solutions were sustained in the control phase, such as standardization and the use of automation. Measurement of turn-around time and six sigma of the process were performed for evaluation. RESULTS: Results showed a significant improvement in the TAT in RT-PCR results, with most results released within 24 hours. The pre-Lean Six Sigma data on TAT were as ollows: 24.88% released within 24 hours; 65.14% released within 24-48 hours; 3.56% released within 48-72 hours, and 6.42% released in more than 72 hours. The post Lean Six Sigma TAT were as ollows: 95.32% released within 24 hours; 4.29% released within 24 to 48 hours; 0.13% released within 48-72 hours, and 0.12% released more than 72 hours. The computed sigma post-implementation was increased from 3.56 to 4.82. The p-value was calculated using the chi-square test, and the computed chi-square statistic is 1894.1021. The p-value is <0.00001 and the result is significant at p<.05. Although there is a significant decrease in the volume of samples post implementation due to the changing COVID-19 situation, real time TAT was improved. It also resulted to increased workflow efficiency with the use of lesser manpower with more appropriate utilization. CONCLUSION Applying the Lean Six Sigma method to improve quality processes in the laboratory is shown to be practical, cost-effective, and straightforward.
Lean Six Sigma ; SARS-CoV-2

The Ho Chi Minh Center for hematology and blood transfusion has been completing the quality management network on the blood bank to assure that the blood products meet the requirement of the ISO9002 including quality management of blood donors (standard making, training on the blood collection; clinical tests and quality management in the preservation, storage, transport, distribution of blood and its components.
Blood transfusion ; Total Quality Management

BACKGROUND: Proficiency testing is part of a total quality management program that provides objective evidence of clinical laboratory testing competence for customers, accrediting bodies, and regulatory agencies. Performing alternative assessment procedures for clinical tests, without proficiency testing, is recommended by Clinical and Laboratory Standards Institute (CLSI) guideline. In our study, an alternative assessment procedure was performed for blood bank tests that do not have an external proficiency program. METHODS: The laboratory for development and an evaluation center, supervised the program. Proficiency testing by seven institutions was performed 3 times at 6 month intervals by evaluating isoagglutinin and anti-D titers, and Weak D, Rh C and E typing, using ID-Internal Quality Control (Bio-Rad Laboratories) kits. RESULTS: Isoagglutinin and anti-D titer results were within one fold dilution range for all seven participating institutions, and Weak D, Rh C and E typing results all demonstrated identical antigenic reference patterns. CONCLUSION: An alternative assessment procedure was successfully performed without a proficiency testing program. Commercially manufactured reference materials could be an alternative method to support commutable, external, proficiency testing program.
Blood Banks ; Isoantibodies ; Mental Competency ; Quality Control ; Total Quality Management

Cell Line ; Humans ; Quality Control ; Research ; standards ; Total Quality Management

The Continuing Professional Development (CPD) program of Korean medical doctors had problems that did not resolve for many years. The primary concern of this study is to examine the problems of the CPD program of Korean medical doctors and to suggest practical guidelines to resolve such barriers. The findings show that the major barrier for improving CPD program is the lack of total quality management. Such lack came from insufficient manpower to plan, execute, and evaluate the CPD programs. The insufficient financial support aggravated the situation. In order to enhance the CPD program, various problems in planning, executing, evaluation stage must be dealt. Specific plans and resolutions in each stage have been suggested.
Financial Support ; Porphyrins ; Program Development ; Total Quality Management

The strategies and methods of the total quality management (TQM) need to applied in quality management of radiation therapy. We should improve the level of quality control and quality assurance in radiation therapy. By establishing quality control system in radiation therapy, standardization of radiation therapy workflow, strengthening quality control of devices and physical technique and paying attention to safety protection and staff training.
Quality Assurance, Health Care ; organization & administration ; Quality Control ; Radiotherapy ; Total Quality Management

PURPOSE: We created an 'AAPM TG18 Evaluation Tool' and we determined its usefulness for the quality control of a diagnostic monitor. MATERIALS AND METHODS: We created an evaluation tool (the AAPM TG18) for conducting quality control of a diagnostic monitor, and we evaluated the measurement items of the AAPM TG18 evaluation tool. The measurement items were geometric distortion, fixed quantity assessment and visual assessment of the veiling glare, and we carried out adjustment for the luminance meter 0% calibration, which was used to revise the diagnostic monitor DICOM LUT. RESULTS: With the AAPM TG18 Evaluation Tool, we measured the 2-dimensional length when evaluating the quantitative geometric distortions in the TG18-QC test pattern, and we measured the veiling-glare ring response function, which provided information regarding the spatial extent of the luminance spread, and this measurement of the can be performed using the TG18-GV pattern. Additionally, the AAPM TG18 Evaluation Tool can be used for sensor calibration to standardize the basic rate of 0% luminance when performing periodic calibration. CONCLUSION: The evaluation tool is a very useful for easily evaluating many of the examination items of the AAPM TG18 for performing quality control of a diagnostic monitor.
Calibration ; Computer Terminals ; Glare ; Organothiophosphorus Compounds ; Quality Control ; Radiology Information Systems ; Total Quality Management

The purpose of this study was to measure patients satisfaction and expectation with hospital foodservices, and thereby identify areas for improvement and provide basic data for the introduction of total quality management with hospital foodservices. This survey was carried out on 383 hospitalized patients of 7 hospitals in Deagu, Busan, Changwon with 350 beds to determine the quality satisfaction with foodservices. The subjects were 50.5% male and 49.5% female. 62.6% of the subjects were over 40 age, 31.4% were only educated to middle school or below, 28.3% were hospitalized for 7 - 14 days. The mean score for taste of diet was 2.79, temperature 3.23, appearances 2.96. Most subjects agreed with following foodservice characteristics that meals of movement (4.03 ), dress of employees (3.84 ), kindness of employees and meals arrived exactly the same time every day (3.47 )and cleanliness of foods (3.34 )and dishes (3.33 ). The unsatisfied quality attributies were information provide (2.82 ), variety of the meals (2.91 ), mixing of meals (2.95 ), the opportunity to meet with a dietitian (2.97 )and prompt dealings with meal complaints (3.01 ). Most subjects expectation that the decrease the multiple of menus, increase provide of fruits in hospital meals and selective menus in hospital foodservices operations. In conclusion, it would seem to be desirable that hospital foodservices departments introduce selective menus, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.
Busan ; Daegu ; Diet ; Female ; Food Quality ; Fruit ; Gyeongsangnam-do ; Humans ; Male ; Meals ; Nutritionists ; Total Quality Management

ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.
Hospital Administration/legislation & jurisprudence ; Hospital Administration/*standards ; Hospitals, Public/legislation & jurisprudence ; Hospitals, Public/*standards ; Management Audit/*standards ; Quality Assurance, Health Care/*organization & administration ; Quality Control ; Total Quality Management/methods ; Total Quality Management/*standards

The purpose of the study was to identify the relationships Total Quality Management (TQM) performance, job satisfaction, and organizational commitment among dietitians in business and industry foodservice. A total of 300 dietitians working in business and industry foodservices in Seoul and Gyeonggi province were surveyed using a self-administrated questionnaire and 203 responses were obtained. The data were analyzed using SPSS Windows (Ver. 12.0) for descriptive analysis and reliability analysis, and AMOS (Ver. 5.0) for structural equation modeling. The respondents were all female, 56.7% single, and 71.4% under regular employment. By foodservice management type, 52.7% of the foodservice operations were self-operated. The majority of the operations provided meals more than twice a day (73.9%), and 70.4% offered a non-selective menu. The dietitians of the contracted foodservices tended to have higher TQM performance scores than those of the self-operated foodservices (P<0.01). There were no significant differences in job satisfaction and organizational commitment scores by the type of the foodservice management. TQM performance was found to have a positive effect on job satisfaction, and job satisfaction affected organizational commitment for both the self-operated and contracted foodservices. A relationship between TQM performance level and organizational commitment of self-operated foodservices was not found. On the other hand, TQM performance level was the principal significant factor for increasing the organizational commitment of contracted foodservices. This research suggests that business and industry foodservices need to improve TQM performance to enhance job satisfaction and organizational commitment of foodservice dietitians and to develop specified TQM strategies that can be applied to each type of foodservice management.
Commerce ; Contracts ; Surveys and Questionnaires ; Employment ; Female ; Hand ; Humans ; Job Satisfaction ; Meals ; Total Quality Management