بكارگيري روش FOCUS-PDCA در بهبود عملكرد مراقبت هاي اوليه بهداشتي - مطالعه موردي مركز بهداشت استان آذربايجان شرقي

The Use of FOCUS-PDCA in Primary Health Care Performance Improvement: Case Study of East Azerbaijan Health Centers

Introduction: Quality management improves longstanding satisfaction of the customers. FOCUS-PDCA is one of the methods of quality management and process improvement which was designed by American hospital association in 1989. This case study explores the implementation and evaluation of continuous quality improvement (CQI) in primary health care system of East Azerbaijan Province. Methods: CQI was implemented with institution of steering committees, creation of learning networks, cascade education of employee, and improvement of key processes. 260 improved processes in health houses, health centers and district health centers in 2001- 2002 were evaluated by a specific checklist, assessing process type, improvement team, tools that were used, community participation, amount of improvement, measurement indicator and improvement strategy. Results: Assessment of the processes five years after implementation of quality management showed that organization culture was in concordance and alignment with quality. The biggest change was seen in staff participation, effective communication, team work, acceptance of criticism, attention to the voice of customers and process standardization. CQI changed traditional literature of managers and employees and expanded the use of quality, and customer and process based management to the service delivery point. The average number of the people participated in each teams was 5.8. In 43% of the projects, the improvement teams used control charts. Conclusion: For establishing CQI culture in any organizations, it is necessary to educate the service providers about it. FOCUS-PDCA is a simple method for performance improvement which can be easily taught to managers and staff.