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SECTION 0700
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January 2014
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Welcome to the January Edition of the ASQ-LA Newsletter.
Looking forward to see you at our January 15th Member Meeting which will be at Mattel in El Segundo. If you plan to attend the meeting, YOU MUST RSVP to Chen Low 310-334-7044, pager 310-353-8293 or e-mail ChenLow_88@hotmail.com, no-later-than Noon on Monday, January 13th, so he can get the list of attendees to Mattel Security.
Harold Martinez
Newsletter Chair
ASQLA
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 | | Fred Ung |
ASQLA MEMBER MEETING - January 15, 2014
"Quality Management of Clinical Laboratories in a Highly Integrated Health Care System, A matter of Culture"
Please join the ASQLA Section 0700 for its monthly member meeting on Wednesday, January 15th. The meeting will be at Mattel in El Segundo. This meeting is an opportunity to network with other Quality professionals and to learn about current techniques & technologies. Our guest speakers this month is Fred Ung speaking on "Quality Management of Clinical Laboratories in a Highly Integrated Health Care System, A matter of Culture."
The presentation will discuss differences of managing a Quality Management System in a clinical laboratory associated with a highly integrated health system versus what is typically found in a single independent clinical laboratory. A brief history of Kaiser Permanente, the current status of clinical laboratory quality, the challenges presented by being an integral member of the health care team and the future of quality management within the Kaiser system.
Fred has practiced clinical laboratory science for Kaiser Permanente for more than 37 years. Initially he practiced the science of Chemistry and Toxicology as a bench technologist rising to the position of Supervisor in the Esoteric and Toxicology Department at Kaiser's Regional Reference Laboratory. Fred transitioned as Quality Systems leader in 1999 overseeing the quality management system, accreditation and laboratory regulations. Since 2004 he has held the position of Director of Clinical Laboratory Quality and Compliance for Southern California and manages the Quality and Compliance concerns for all Kaiser Permanente Clinical Laboratories. Fred has served as a member of the Clinical Laboratory Technology Advisory Committee for the State of California for the past 5 years.
The program will be held at 2nd Floor Main Conference Room at Mattel 333 Continental Boulevard El Segundo, CA 90245-5012. This meeting is an opportunity to network with other Quality Professionals, learn about quality related topics and earn 0.3 Recertification Units. Registration and networking starts at 5:30 PM. The meeting runs from 6:00 to 7:30 PM. Crackers, Cookies, Coffee & Water will be provided at no charge.
You MUST RSVP to Chen Low 310-334-7044, pager 310-353-8293 or e-mail ChenLow_88@hotmail.com, no-later-than Noon on Monday, January 13th, so he can get the list of attendees to Mattel Security.
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Message from the Chair - Catherine Martin
Thank you for giving me the opportunity to serve as your Chair this year and to work closely with ASQ Los Angeles Officers and Leadership Team. I see a lot of wisdom and talent on the Board, and together we pledge our continuing efforts to ensure that ASQLA remains strong and effective.
Celebrate! Yes, 2014 is a special year for ASQLA as we continue our ASQ Certification Program. This is applauded as the next step forward in our efforts to advance the practice and profession of quality. As we expand our mission, we will need to recruit new volunteers who can serve on the Leadership Team (LT) and represent the LT on appropriate committees and help with other strategic initiatives. To this end, I will ask our LT to join me in creating a searchable database of members with expertise/interest in specific quality areas to serve as volunteers. Stay tuned for details as this project unfolds.
One of the highlights of our monthly general meetings is to provide outstanding speakers to the membership. This year we will continue to spotlight quality and other noteworthy topics. Visit our website for details. If you are unfamiliar with our website, go to http://www.asqla.org and be sure to add the monthly meetings to your calendar.
Your Leadership Team continues to look into new areas of activities and to reassess long-standing practices. We are developing strategic initiatives designed to increase the visibility of our profession. Increasing our membership and adding member value remain a focus of the ASQLA Leadership Team effort and attention. Again, stay tuned for details.
Have you visited the ASQ website? To get you started, here is the website: http://www.asq.org. The website is a global community of people passionate about quality, who use the tools, their ideas and expertise to make our world better. Did you know that if your company is a Corporate Sponsor of ASQ your local ASQLA membership dues are only $20.00? If you do not know how to sign up for local ASQLA membership, please contact any member of the ASQLA Leadership Team.
I want to end my first message by noting that the chairs & members of our vital committees, the officers & members of the Board, are all making amazingly significant contributions to our Section. Thank you for your loyal service. See you in January!
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Robust Quality Improvement Programs:
Providing a Competitive Edge for Healthcare Organizations
Susan Hapner
California State University - Dominguez Hills
QAS 511
Professor William Trappen
March 26, 2013
Thesis Statement: Healthcare organizations that focus on quality improvement are better positioned to achieve payer reimbursement incentives and increase market share.
Pay for performance incentive programs in healthcare have mushroomed since the Institute of Medicine (IOM) exposed the incidence of medical error and harm in the United States and called for massive improvement in the book, To Err is Human: Building a Safer Health System (IOM, 2000). Insurers and consumers reacted with calls for transparency in reporting patient outcomes and implementation of incentives to reward hospitals and providers for achievement of high quality, safe patient outcomes. Aaronson et al. (2013) reported, "Public reporting of hospital performance has become a common strategy for monitoring and improving the quality of healthcare" (p. 15). Healthcare organizations wishing to preserve their reputations and market share as well as take advantage of payment incentives have had to take a hard look at their quality results and have designed performance improvement processes to correct the gaps and inconsistencies.
In addition to the IOM report, other reports highlighted disparities in the care provided and results achieved by region in the United States as well as overall gaps in the quality of care provided nationwide (Agency for Healthcare Research and Quality [AHRQ], 2011). One study revealed that participants received only fifty-five percent of recommended care. Further, 46% of participants did not receive recommended care and 11% received non-recommended care that was potentially harmful. McGlynn et al., (2003) concluded that Americans only receive about half of evidence-based recommended care.
The nation's largest payer, the Center for Medicare and Medicaid Services (CMS), led the public reporting charge, requiring hospitals to measure and publicly report outcomes and the use of quality process measures in order to receive full annual market basket payment updates (CMS, 2005). The initial required reporting included outcomes and process measures for three high-volume diagnoses: Acute MI, Pneumonia, and Heart Failure. Additional measures for Surgical Care, Behavioral Health, and Emergency Department Care later joined the list of requirements, as well as measures for patient safety and the patient experience of care. The Healthcare Incentives Improvement Institute (HIII) reported that thirty-nine pay-for-performance programs existed in 2003, growing to one hundred sixty pay-for-performance programs in November, 2007 (HIII, 2011). These programs ranged from the federal payer incentive programs run by CMS as previously described, to state-specific incentive programs such as the Arkansas Medicaid Inpatient Quality Incentive program, to private insurer incentive programs. CMS has since expanded their program to the recently implemented Value-Based Purchasing program, a true pay-for-performance program for hospitals.
Outcomes data, seeking to measure the end results of healthcare interventions, is reported as mortality and morbidity rates and is considered by Lansky to be what most consumers are interested in when making healthcare choices (as cited in Aaronson et al. 2013, p. 15). Process measures reflect the percent of usage of evidence-based practices that lead to improved patient outcomes, and structural measures are directed at collecting data on the customer experience or level of satisfaction, as well as the use of electronic health records for recording and collecting process measures data. The Medicare Modernization Act of 2003 promoted and provided incentives for the increased use of technology to develop electronic healthcare records. In addition, "CMS was mandated by the Deficit Reduction Act of 2005 to maintain a consumer-targeted website publicly reporting hospital performance on quality of care which CMS has stated will empower consumer choice" (Aaronson et al., 2013, p. 15).
As hospitals struggled to hire and train medical record data abstractors to accurately collect the required data from largely paper medical records, they also struggled with getting processes hardwired to prevent the evidence-based process measures from being overlooked by busy caregivers and providers. State-based Quality Improvement Organizations were contracted by CMS, and provided education and training to hospitals on best practices tips, shared best practice tools, and served as a liaison between the hospitals and CMS. Hospitals collaborated with the Institute for Healthcare Improvement and The Joint Commission Center for Transforming Healthcare, trained staff in Lean and Six Sigma methodologies, and accomplished rapid process improvement (American Hospital Association, 2012).
Significant push-back from medical staff occurred, questioning the validity of certain measures and highlighting the "cons" of a pay-for- performance system. Unintended consequences of some of the measures were a frequently-cited "con." Some noted that the requirement for antibiotics to be given within six hours of arrival to patients with pneumonia resulted in unnecessary prescribing of antibiotics. Busy, backlogged emergency department physicians were giving antibiotics to patients when they hadn't fully determined if the patient was suffering from pneumonia or from heart failure. Another "con" was the potential mismatch of the incentive to the activities required. The cost of exceeding certain targets to healthcare organizations and providers was in some cases greater than the reimbursement offered, and would likely result in no change in patient care processes (AHRQ, 2006). Hospitals cited the dilution of efforts as a result of healthcare providers trying to meet varying performance metrics for CMS, Joint Commission, and private insurers. Often the topic being measured was the same, but the measurement numerator and denominator and timeframes were different, increasing workload demands on hospital data abstractors.
The push for consensus measures resulted in the 2008 alignment with quality measures that were endorsed by the National Quality Forum (AHA, 2012). The National Quality Forum reviewed the strength of the research behind each measure and only endorsed measures with the highest level of strength. CMS and Joint Commission also began the alignment of their required measures.
The next hurdle for hospitals has been to bridge the gaps in the care provided that resulted from poor communication between providers, lack of the needed tools to get the job done efficiently, and other process defects that allowed cases to fall through the cracks. Not having vaccines available on patient care units for nurses to give when determining that a patient met criteria for vaccination was one example. Robust quality improvement programs were clearly indicated. Through the concentrated education efforts of the state QIO's and state quality organizations, progress in care for cardiovascular disease was realized. AHRQ reported that several measures were retired from the mandatory reports when performance exceeded 95%. The majority of the retired measures related to the management of cardiovascular risk factors or disease. The remaining cardiovascular disease quality of care measures all showed improvement (AHRQ, 2011).
The ability to deploy process improvement teams with leaders trained in rapid cycle improvement enabled some hospitals to achieve targets much more quickly in other non-cardiac measures than the overall slow improvement that has been seen nationally. As a result of lagging patient safety improvement, a Federal initiative called The Partnership for Patients, was established in 2011. This initiative has targeted reduction of preventable hospital-acquired conditions by 40% by December, 2013. Funding was provided to bring national resources together for use by hospitals at no charge, and leadership for the initiatives was provided by CMS to coordinate implementation of best practices in smaller groups of hospitals known as Hospital Engagement Networks (AHRQ, 2011).
Implementation of the Hospital Engagement Network (HEN) program has served to provide training and use of process improvement tools based in LEAN and Six Sigma methodology that hospitals' staff charged with performance improvement may not previously have had the expertise to use. Facilitators trained in these methodologies were brought into struggling hospitals and facilitated concentrated work out sessions to improve key safety measures. The tools included organization safety assessment tools, tracer assessments, swim lane diagrams, process maps, and others. Action plans and timeframes for addressing gaps were presented to and approved by hospital Senior Leaders at the conclusion of the HEN facilitator's visit. Physician champions were encouraged for each targeted safety measure and included in webinar training sessions offered by national physician experts. The addition of these tools and resources to hospital quality department personnel toolkits served to narrow the gap in their performance improvement process abilities compared to facilities with more robust performance improvement departments (AHA, 2012). Participation in the HEN initiative has been voluntary, with metrics being collected to evaluate the effectiveness of this approach.
Some hospitals have additionally embraced use of Malcolm Baldrige criteria for self-assessment. The rigorous criteria have highlighted gaps in leadership, strategic planning, process development and deployment, data management, workforce training, and customer focus. The criteria have served to accelerate improvement efforts, learning from feedback, and have created clarity in organizational mission, vision, and values (Fletcher, 1999).
Robust performance improvement processes such as building workforce skills and training in Lean, Six Sigma, and rapid cycle improvement processes, as well as self-assessment against Malcolm Baldrige criteria helped accelerate hospitals' improvement efforts and patient outcomes of evidence-based safe, quality care. Many healthcare leaders have pushed for achievement of top decile performance in quality and safety measures and have added these targets to leadership and middle manager annual performance evaluations and bonus criteria. With increased public reporting in the past decade, consumers are able to access outcomes, as well as quality, safety and patient experience results as they select hospitals and surgeons for elective surgical procedures and make other medical care selections. Opportunities exist for healthcare providers to differentiate themselves from competitors based on achievement of top outcomes of mortality and morbidity and top performance ratings in quality, safety, and customer experience. This differentiation brings financial rewards to hospitals as well as serves as one key to increased market share.
References
Aaronson, D., Bardach, N., Lin, G., Chattopadhyay, A., Goldman, E., & Dudley, R. (2013). Prediction of hospital acute myocardial infarction and heart failure 30-day mortality rates using publicly reported performance measures. Journal for Healthcare Quality, 35, 15-23.
Agency for Healthcare Research and Quality. (2006). Pay for performance: A decision guide for purchasers. Retrieved from www.ahrq.gov/professionals/quality-patient.../p4p/p4pguide.pdf
Agency for Healthcare Research and Quality. (2011). National healthcare disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf
American Hospital Association. (2012). Hospitals demonstrate commitment to quality improvement. Retrieved from http://www.aha.org/research/reports/tw/12oct-tw-quality.pdf
Center for Medicare and Medicaid Services. (2005). Pay-for-performance/quality incentives. Retrieved from http://www.cms.gov/Regulations-and-Guidance/Guidance/.../tab_H.pdf
Fletcher, A. (1999). Building world-class performance with the Baldrige criteria. Retrieved from http://
www.qualitydigest.com/aug99/html/baldrige.html
Healthcare Improvement Initiatives Institute. (N.D.) Pay-for-performance models. Retrieved from http://www.hci3.org/content/pay-performance-models
Institute of Medicine. (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.
McGlynn, E., Asch, S., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., & Kerr, E. (2003). The quality of healthcare delivered to adults in the United States. New England Journal of Medicine, 348, 2635-2645.
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ASQ-Los Angeles
Section 0700
New and Renewal Members
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| SALUTATION | FULL NAME | JOB TITLE | COMPANY | |
Ian Scott Nicholson
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QA Director
| Pelican Products | | Edwin Mehdikhan | Quality Assurance Engineer | Triumph Aerostructures, Vought Aircraft | | MR | Yuen Yang | Sr Supplier Quality | | | MRS | Estela Solano-Gomez | QA Compliance Manager | Grifols Biologicals Inc. | | MRS | Lora Turovsky | Laboratory Mgr | California Cryobank | | MR | Yijun Zheng | | | | MS | Linda Laim | | N/A | | MR | Ashutosh Battish | Quality Associate II | Amgen | | Roberto Lopez | Consumer Safety Officer | NOAA - Seafood Inspection Program | | Raul Munguia | | | | MS | Prachi N. Dalal | | | | MR | Juan C. Mireles | Sr Systems Consultant | Permanente Medical Group | | MRS | Ellise Taylor-Brebes |
| Kaiser Permanente | | DR | Dakshine Shanmugarajah | | | | Maricris R. Niles |
| Hathaway-Sycamores | | MR | Mujeebur Rahmansaher | Project Manager | Deluxe Entertainment Services Group | | MS | Estela Niazi | Quality Engineer | | | MRS | Pamela Karno | | | | Jay M. Fried |
Quality Engineer
| Ducommun Technologies | | Rene Dominguez | Quality Department Lead | | | MISS | Pranjali P. Shinde | | University of So California | | Leilani Fajota Reddy | CEO-Risk and Quality | Lelancr Health & Treasure |
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BSQA - 2014 SPRING Session II
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First Day
of Class
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Last Day To Register
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Last Day of Class
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Mar. 3
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Feb. 28
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Apr. 27
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Course
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Title
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Instructor
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QAS 220.45
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Fundamentals of Measurement (3 units)
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Emil Hazarian (ehazarian@csudh.edu)
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QAS 332.45
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Electrical Metrology (3 units)
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Emil Hazarian (ehazarian@csudh.edu)
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QAS 355.45
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Safety and Reliability (3 units)
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Dan Dunahay (ddunahay@csudh.edu)
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QAS 360.45
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Lean Manufacturing (3 units)
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Gerald VerDuft (gverduft@csudh.edu)
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Prerequisites may be waived at the discretion of Dr. Milton Krivokuca, academic advisor and program coordinator
To reach the Extended Education Registration office please call (310) 243-3741, fax (310) 516-3971, or by email at eereg@csudh.edu.
QAS course fees for spring 2014 are $266.00 per unit or $798.00 per three unit course.
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ASQ Certification Exams
Application Deadline
April 18, 2014
Late Application
Fee ($50) Deadline
April 23, 2014
June 7, 2014
Certifications
Quality Engineer(CQE)
Quality Auditor(CQA)
Six Sigma Green Belt (SSGB)
Software Quality Eng. (CSQE)
Quality Improvement Assoc (CQIA)
Calibration Technician(CCT)
Quality Process Analyst (CQPA)
Application Deadline
January 10, 2014
Late Application
Fee ($50) Deadline
January 15, 2014
Exam Date
March 1, 2014
Certifications
Six Sigma Black Belt(SSBB)
Mgr of Qual/Org Excel (CMQ/OE)
Quality Inspector(CQI)
Quality Technician(CQT)
Biomedical Auditor(CBD)
Reliability Engineer(CRE)
HACCP Auditor(CHA)
CALL ASQ HEADQUARTERS:
800-248-1946
or
www.asq.org
for more information.
Cal State Dominguez Hills BSQA & MSQA Programs
sponsor certification preparation courses, See certification
Did you know that Joe DeSimone is our section's Certification and Recertification expert and Chair? Joe is available for your tough questions at jrdesimone@msn.com else you can find answers to your general questions at www.asq.org/certification This page is very helpful. Check out the Certification Handbook: 21 pages of detailed certification facts! RECERTIFICATION NEWS The easiest way to recertify is to scan your completed application with credit card information and supporting documents and Email to our Recertification Chair: jrdesimone@msn.com.
You can also mail your package to P.O. Box 1291, San Pedro, CA 90731.
NOTE: You must send a check. Joe is too busy to chase you and will not review you package without payment. In fact Joe could use help with Recertification!
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ASQ LA LEADERSHIP TEAM
MEETING SCHEDULE
Time: 5:30 - 6:00 Networking & Dinner
6:00 - 8:00 Meeting
Location:
CSUDH Extended Education Bldg
1000 Victoria St., Carson, CA 90745
Contact: Catherine Martin, Chair
(310) 616-0936
Catherine_Martin@raytheon.com
Dates: 1st Wednesday of the Month(not in July and December)
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2013
Officers & Committee Chairs of ASQ Los Angeles Section 700
www.asqla.org
CHAIR: Catherine Martin - 310-616-0936 Catherine_Martin@raytheon.com
CHAIR-Elect: Alan Wang - 310-383-2393 - awang@spectrumchemical.com
SECRETARY: Lane Parrott (310) 489-9018 lanep@phenomenex.com
TREASURER: Jim Morrison - 310-541-1417 - jamamorr@aol.com
PAST CHAIR/Executive Advisory: Lane Parrott (310) 489-9018 lanep@phenomenex.com
Arrangements: Chen Low - 310-334-7044 - chenlow_88@hotmail.com
Job Listing: Armen Yeghoian - 818-912-9272 - Armen2049@yahoo.com
Website Chair: Alan Wang - 310-383-2393 - awang@spectrumchemical.com
Membership: Lisa Uhrig - 310-283-1197 - lisa@uhrigconsulting.com
Education: Bill Trappen - 760-723-7718 - tankerwht@aol.com
CSUDH Liaison: Milt Krivokuca - 949-892-7994 - Milt619@cox.net
Certification: Joe DeSimone - 424-772-6371 - jrdesimone@msn.com
Re-certification: Joe DeSimone - 424-772-6371 - jrdesimone@msn.com
Newsletter: Harold Martinez - 310-214-1606 - martinez2004@verizon.net
Awards and Recognition: Imre Fischer - 949-493-3914 - imrefische@aol.com
Quality Management Process (QMP): Peter Crosson - 310-819-0944 - peter_crosson@hotmail.com
Financial Audit: Michael Schaffer - 310-895-0802 - michaels@psychemedics.com
-Simon Collier Quality Award: Imre Fischer - 949-493-3914 - ImreFische@aol.com
Publicity & Advertising Chair: : Alan Wang - 310-383-2393 - awang@spectrumchemical.com
Voice of the Customer: Open
Communications Chair: Rhonda Y. Hayes - 310-334-0381 - ryhayes@raytheon.com
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