Quality Improvement

Improving systems & processes

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Implementing VQM in Auckland Regional Dental Service

Implementing VQM in Auckland Regional Dental Service

What is Visual Quality Management (VQM)?

Visual Quality Management is a 6 step methodology for achieving a consistently tidy, efficient and effective work environment.


Step 1: Safety

Step 1: Safety

  • When undertaking quality improvement the safety of our patients, their family/whanau and our staff is our number one priority.
Step 2: Sort

Step 2: Sorting

  • Separating the things you need from those you don't need.
  • Sorting through items in the work area and removing what is not essential.
  • Removing clutter.
Step 3: Simplify

Step 3: Setting In Order, Straightening, Simplifying

  • Organising the workplace in such a way that things are EASY to see, EASY to get and EASY to return.
  • A motto often used is "a place for everything and everything in its place".
Step 4: Shine

Step 4:  Sweeping, Shining, Systematic Cleaning

  • As the name says, it means to wash, dust, sweep, and clean everything.
Step 5: Standardise

Step 5: Standardising

  • Putting standards in place to make sure that everything is kept where its supposed to.
Step 6: Sustain

Step 6: Sustaining

  • No matter how well you do on the previous steps, if you don't sustain the gain, you move slowly back to square one.  It is important to put a plan in place to make sure that doesn't happen.

Auckland Regional Dental Service

The Auckland Regional Dental Service (ARDS) is responsible for providing free dental care for all children up to the age of 18 that live in the Auckland region from Wellsford to Waiuku. The service covers over 270,000 children and has:

  • 365 staff
  • 41 permanent community clinics mostly located in schools
  • 21 transportable dental units (TDUs) which move from school to school
  • an additional 18 mobile vans that go to schools that don’t have a permanent clinic or are unable to accommodate a TDU

Transportable dental unit
Transportable dental unit

Community dental clinic
 Permanent community dental clinic

Mobile dental van
Mobile dental van


What are we trying to achieve?

Value: Better, Best, BrilliantAlthough our dental clinics are standardised in design they are organised differently and have clutter, waste and inappropriate stock levels. This leads to unsafe work environment for patients and staff.

The aim of this project is to:

  • reduce waste
  • optimise productivity through maintaining an orderly workplace
  • use visual cues to achieve more consistent appealing results
  • create a clean, organised, standardised and visual workplace

What did we find?

Waste of:

  • time searching for items, equipment and supplies
  • time moving items, equipment and supplies to where they are needed

E.g. ARDS clinic storeroom

What we found - before
Before

What we found - after
After

Waste of:

  • inventory from overstocking of items, equipment and supplies
  • space for storage of unnecessary items, supplies and equipment

Excess stock in TDU

Excess stock in TDU

E.g. Excess stock from a two chair TDU


What have we done?

  • We trained all staff members (365) on VQM methodology.
  • All permanent community clinics and TDUs undertook VQM, i.e. we sorted, simplified, shined, standardised and this is being sustained through an ongoing audit process.
  • We managed the movement and circulation of overstocked items.
  • We disposed of extra, unwanted and outdated items , e.g.  expired supplies, old forms and broken equipment.

What we did - before
Before

What we did - after
After


Did we make a difference?

Deliverable / Outcome 1

  • $267,000 cost reduction of clinical supplies from July 2012 – June 2013 compared to the previous 12 months.

ARDS Clinical Supplies Spend


Deliverable / Outcome 2

  • Positive feedback from all concerned:
VQM ARDS Feedback 1
VQM ARDS Feedback 2
VQM ARDS Feedback 3
VQM ARDS Feedback 4
VQM ARDS Feedback 5