Quality

The term ‘management’ can be defined as referring to ‘making’ or ‘acting’. So quality management means: "The doing" or rather "The accomplishing" of quality.

Quality management in hospitals is nothing new, however. As early as 1845, Ignaz Semmelweiss in Vienna was engaged in an interdisciplinary effort to improve the quality of outcomes in obstetrics, and in London Florence Nightingale laid the foundations of quality assurance by establishing systematic hospital statistics from 1860 onwards. There are other historical references of this kind to the existence of quality management.  

What is new in today's view of quality management, in addition to the legal obligation, is that the process of service provision and its structural prerequisites are systematically recorded and assessed in a patient- and problem-oriented manner.  

This requires a quality management system. Such a system comprises the totality of the structural and procedural organisation of a facility. All quality-related activities in the company are taken into account here with uniform, targeted planning and control.

The introduction of an internal quality management system at Johanniter-Krankenhaus Gronau was the first step towards implementation. The tool used for implementing our mission statement, for defining the quality policy, and for achieving the set quality goals is this quality management system.  

This system is documented in an organisation manual. The quality management system is based on the approach of "Total Quality Management (TQM) - Comprehensive Quality Management".  

Quality management is understood here as a continuous improvement process. It encompasses all areas of the hospital and is therefore necessarily a management task.

Quality Management (QM) Representative

The quality management representative is not an expert on the individual areas of a hospital. It is rather the case that every QM system and every employee who deals with the system is dependent on the experts and specialists of their respective areas. This becomes particularly clear in QM concepts that place a high emphasis on self-assessment and require the establishment of QM teams. The quality of hospital services can thus only be guaranteed and improved through the constant commitment of all employees. All upstream and downstream areas, as well as those directly involved in the service creation process, are included and involved

The quality objectives of Johanniter-Krankenhaus Gronau

Within the framework of the introduction of a quality management system and the preparation for certification according to DIN ISO 9001:2015, the following topics, which can be found in the guidelines, are considered particularly important for Johanniter-Krankenhaus Gronau:  

• A) Interaction with each other
• B) Cooperation and coordination of work processes
• C) Patient-oriented behaviour
• D) Information and communication
• E) Safeguarding the future
• F) Transparency

• We positively influence the working atmosphere and enjoyment of our work through friendliness and politeness. We cultivate human manners, even in stressful situations.
• In the event of problems, we seek direct dialogue with the people concerned. We find solutions and do not assign blame.
• We do not express differences of opinion in front of third parties, especially not in front of patients and visitors.
• We express criticism appropriately and politely. We thoroughly familiarise new staff members with their area of work.
• We listen to suggestions for improvement first, try to understand them before we evaluate and judge them.

We must be able to answer the following questions positively for all agreements made between persons, departments, and areas to coordinate work between:  

• Does this arrangement serve the welfare of the patient?
• Have the interests of the staff and areas concerned been adequately taken into account?
• Does the agreed measure objectively increase the effectiveness of the work of all those involved?

For us, this goal means that we will maintain and further develop a high level of medical and nursing competence. At the same time, we will enable individual care.  

• We give patients sufficient information about their illness and their planned therapy.
• We enable the patient to reduce their fears and to find confidence and security.
• We respond to the patient's wishes as far as possible.

In detail, this means:

• We welcome the patient already in admission and advise them competently.
• We admit the patient to the ward through the nursing service and the doctor. We inform the patient about the required therapeutic and nursing measures.
• We avoid subjecting the patient to unnecessarily long waiting times. We obtain the patient's consent for measures concerning them.
• We do not sideline the patient. We involve the patient in discussions at the bedside.
• We show willingness to talk to the patient and their relatives.
• We develop a patient guide for the hospital as a whole and for the ward routine.
• We are constantly developing the expertise of our staff.
• We know how important nutrition is for the patient.
• We offer them a range of choices and dietary advice.
• We provide pastoral, psychological, and social support to our patients.
• We care for the patient even after discharge, by organising home care.
• We support volunteers in caring for our patients.

Information must be passed on to the employees concerned in a timely and comprehensible manner. A good flow of information increases the transparency of decisions and supports the efficiency and motivation of staff. Optimal information flow requires open, trusting communication between all employees and the areas of the hospital.

• We improve our written communication.
• We improve our direct oral communication.
• We share necessary information during regular departmental meetings.
• We give the opportunity to discuss upcoming issues.
• We log our meetings and make this information available to all staff at the meeting with regard to the agreements reached.
• We clarify at the end of each meeting who will inform whom about what content of the meeting and what information must remain confidential for the time being.
• We inform all employees throughout the hospital management, and employee representatives, of information meetings held about important developments at the hospital.

Future development means establishing and expanding comprehensive quality management.  

• We will thereby enable cost awareness and optimal use of resources.
• We will promote flexibility in work processes and structures.
• We will develop the medical, nursing, and care sectors in a future-orientated manner. The hospital's management will formulate corporate goals and a strategy for their implementation.
• We will regularly review our range of services and work processes, as well as our departmental structures to see whether they meet the requirements of optimal patient care. We hope that all staff members of the hospital will be willing to undergo continuous training and further education.
• We are further expanding an efficient IT system to support these processes.

Initiative Quality Medicine – We are for transparency

In the Initiative Quality Medicine (IQM), around 500 hospitals are currently committed to improving the quality of medicine across all countries and institutions. In Germany and Switzerland, the members of the IQM care for approximately 7.8 million medical inpatients per year. This corresponds to a share of just under 40% in Germany and around 35% in Switzerland.

For the best possible medical and nursing treatment quality

With the conviction that further quality improvements in health care are possible, fifteen leading hospital operators have joined one another as founding initiators of the Initiative Quality Medicine (IQM). Founded in 2008 as the "Club of the Brave", IQM has since established itself as the largest voluntary quality initiative in the German health care system.

Municipal, non-profit, church, private, and university hospital operators founded the Initiative Quality Medicine as an inter-agency platform with the aim of exchanging ideas and learning from each other. Johanniter GmbH was one of the founding members.

IQM stands for...

... an open approach to errors and a practically-tested way to achieve significantly higher quality in medicine

... the stimulation of inter-agency exchange and the internal quality management of its member hospitals

... hospitals that are highly-motivated and courageous in their efforts to improve the quality of their medical treatment.

... responsible managers who see active quality improvements as their own task and have the openness to learn from each other via a constructive and critical dialogue.