The Seven New Quality Tools used in Healthcare Project Management

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  • Topic: Tree, Diagram, Ishikawa diagram
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The Seven New Quality Tools
The affinity diagram is an effective technique used to handle large numbers of ideas, typically during a brainstorming session. It helps with organizing, prioritizing, and categorizing diverse views and opinions based on each team member’s knowledge of a particular subject. The team should consist of people with different backgrounds, knowledge, and skills. Diversifying the team members helps present new, out-of-the-box ideas and facilitates in melding opinions and perspectives. It also allows discovery of root causes, common themes, and unseen connections between ideas and information.

After choosing the appropriate team members and inviting them to the meeting, the key steps for hosting the group discussion using the affinity diagram are as follows: 1. Introduction of self, team members, topic of discussion, and objectives. 2. Invite all to participate in contributing ideas and opinions and write them down on large individual Post-It notes (or equivalent). 3. Place the notes in the middle of the table and ask the members to re-arrange and organize the ideas into related groups silently. If an idea falls into more than one category, place another Post-It with the same idea in both groups. 4. Participants can now discuss on the different grouping patterns and focus on controversial ideas. If a conflict arises, try and reach a general consensus and make any necessary changes in grouping. 5. After the ideas have been arranged, select a short heading to categorize each group. 6. Finally, move groups under each heading to view the affinity diagram. Once the affinity diagram is complete, the prioritized ideas are now ready for further management decisions and approvals. A simplified example of the affinity diagram process is shown below in Figures (A) and (B)

Figure (A) – Example listing of all team members’ ideas to be categorized

Figure (B) – Example of a completed affinity diagram.

The affinity diagram could be used in reforming a specific area of a health care system that needs to become more efficient in terms of process flow and organization. For example, the CEO of a hospital discovers that the most coding and billing errors are made in the outpatient center, specifically in the laboratory-draw station (aka blood testing center). Because of these coding errors, the hospital is not getting reimbursed for performing the tests and patients have to come back to have their blood drawn for a second time, which now has to be funded by the hospital since they are responsible for the mistake. The CEO has also been informed that many patients have been complaining about the excessive waiting time at the outpatient lab center. Upon first impression of the situation, the CEO concludes that the lab workers must be performing at a slow pace, don’t understand how to properly code, or they don’t realize the importance of coding and the severity of mistakes.

If the CEO decided to conduct a meeting using the process described for an affinity diagram, he would invite several key individuals from different departments to participate in resolving the issue. Key individuals would include one or two of the phlebotomists, receptionists, and medical laboratory technicians who work during the busiest hours at the lab as well as the outpatient lab supervisor. As they take the steps to create an affinity diagram, the CEO would discover that the true reasons for the problems at the outpatient lab center are described from each of the individuals as: * Phlebotomists

* Constantly short staffed with high volumes of patients * Insufficient training on how to properly code
* Doing the same type of coding as medical assistants * Not paid to perform the level of coding required
* Lack of communication when a code/procedure changes
* Unfairness in scheduling/problems and favoritism among co-workers * Lack of proper supplies
* STAT lab...
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