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  Management
  Alternatives Pty Ltd
  ABN 23 050 334 435


Contents | 1. Introduction | 2. QI Maze | 3. Principles | 4. Tools | 5. Resources


2. The Quality Improvement Maze

The QI Maze

In Australia in recent years there have been may changes happening that are related to quality improvement, for example:

  • The introduction and ongoing development of the Australian Business Excellence Framework
  • The development of the Service Excellence Framework
  • The growing use of ISO 9000 Standards
  • The introduction of standards and accreditation for many funded programs
  • The growing use of Quality Accreditation by human service organisations
  • The growth of program reviews and evaluation by organisations and funding bodies
  • The expansion of auditing from financial auditing to program auditing and quality auditing.

Some key observations are:

  • The Australian Business Excellence Framework is a framework that attempts to cover the whole organisation. Is it a useful framework for community organisations and has a set of interpretive guidelines for community organisations.
  • The Service Excellence Framework is a useful framework for human service organisations. Resources available include standards and accreditation processes.
  • The ISO 9000 series standards while theoretically useful in human service organisations have not been widely adopted in human service organisations. However, they provide an internationally agreed framework for quality improvement processes.
  • There are numerous approaches to standards and accreditation. They are not consistent with each other or consistent with frameworks such as the Australia Business Excellence Framework. There has been a growth in organisations setting standards and accreditation procedures for specific human service sectors (eg, disability services, out-of-home-care, home and community care, universities).
  • The Quality Improvement Council's Core Standards for Health and Community Services is a useful generic framework for human service organisations including smaller organisations.
  • There is considerable overlap between ISO 9000 series standards, standards and accreditation, evaluation and auditing. For example a client survey could be part of a quality improvement process, an evaluation process, an accreditation process or an auditing process.

Key decision(s): Which of the following do you want?

  • Good management incorporating quality improvement principles and processes
  • An agreed organisational quality improvement model or system (an Business Excellence Framework or ISO 9000 standards)
  • Independent accreditation for the model or system

Are there standards and accreditation that we require because of funding agreements? How do these relate to what we want?

Australian Business Excellence Framework

The Australian Business Excellence Framework is a useful framework for nonprofit and community organisations.

The Australian Quality Council has developed a set of "Interpretive Guidelines for Community Organisations".

"The Australian Business Excellence framework is an integrated leadership and management system that describes elements essential to organisational excellence. It is based on a set of 12 time-honoured principles of leadership and management, drawing heavily on the teachings of leading management and organisational theorists and practitioners.

"The Framework was developed by a team of management and leadership experts and is updated annually to reflect leading edge global thinking..

"The aim was to describe succinctly the principles and practices that create high performing organisations and then use these criteria to recognise successful enterprises. Recognition was to be achieved through the introduction of national Quality Awards (currently the Australian Business Excellence Awards."

Extract from The Australian Business Excellence Framework 2003 Section 1. The Framework - at a glance page 5.

Service Excellence Framework

The Australian Service Excellence Standards is an internationally accredited quality improvement program funded by the Department of Commuinities and Social Inclustion in South Australian. It is a generic quality and continuous improvement management tool. It can be applied to a wide and diverse range of human services, both government and non-government. It contains the requirements necessary to meet legislative and other standards, and provides a developmental approach to continuous improvement, change management and benchmarking across ‘like’ areas or services.

 

ISO 9000 Standards

The ISO 9000 series standards are international standards designed to help organisations establish quality management systems. In principle there are many aspects of these standards that are relevant to nonprofit and community organisations. However in practice they need appropriate interpretation and implementation, particularly in human services. Quality management systems were originally developed in manufacturing processes and need to be suitably adapted and modified for human services..

The ISO 9000 Standards are International Standards and are accepted in Australia.

"The ISO 9000 family of standards listed below has been developed to assist organisations, of all types and sizes, to implemented and operate effective quality management systems.:

  • ISO 9000 describes fundamentals of quality management systems and specifies the terminology for quality management systems
  • ISO 9001 specifies requirements for a quality management system where an organisation needs to demonstrate its ability to provide products that fulfil customer and applicable regulatory requirements and aims to enhance customer satisfaction
  • ISO 9004 provides guidelines that consider both the effectiveness and efficiency of the quality management system. The aim of this standard is improvement of the performance of the organisation and satisfaction of customers and other interested parties.
  • ISO 19011 provides guidance on auditing quality and environmental management systems."

AS/NZS ISO 9000:2000 Quality management systems - Fundamentals and vocabulary. Standards Australia, page v.

Standards and accreditation

In the last decade there has been a big increase in the movement to accredit quality organisations.

This has taken many forms:

  • Industry standards and accreditation
  • Government or funding program standards and accreditation
  • Quality management accreditation consistent with the ISO 9000 series standards, or other quality improvement standards

There are many players in the standards and accreditation field. Some examples are:

Independent nonprofit organisations that develop standards for specific industries, for example:

  • The Australian Council on Healthcare Standards
  • The Quality Improvement Council
  • National Childcare Accreditation Council

Government departments or agencies that develop standards (and/or or accredit organisations), for example:

  • Disability Service Standards Department of Family and Community Services
  • Home and Community Care Standards Department of Health and Ageing
  • Out-of-home Care Standards NSW Office of the Children's guardian
  • The Aged Care Standards and Accreditation Agency

Independent accrediting organisations, for example:

  • Quality Management Services

Further details and links to these and other organisations is on the Resources page

Evaluation

Evaluation is a process of asking and answering questions about worthwhileness. Is something worthwhile happening? Could something more worthwhile be happening? We often judge worthwhileness in terms of effectiveness, efficiency, adequacy and appropriateness.

There are different kinds of evaluation, for example:

  • Program evaluation: For example, evaluating the ‘family support program’ in NSW or evaluating the national Supported Accommodation Assistance Program (SAAP)
  • Program monitoring and review: For example, gathering data to monitor and review what is happening in the program (eg family support or SAAP)
  • Service capacity evaluation: For example, evaluating the network of services supporting families in a particular area or region
  • Agency focused evaluation: For example evaluating the local family support service or disability service
  • Client focused evaluation: Evaluating the work with individual clients.

Overlaps

In practice there are many overlaps between excellence frameworks, quality improvement, standards and accreditation and evaluation.

For example a client survey (or a staff survey, client focus group, client database data analysis) could be:

  • part of a quality improvement process initiated by staff to improve a particular client service
  • part of an internal process for meeting service standards
  • part of an external accreditation process
  • part of a service evaluation
  • part of a national program evaluation
  • part of an audit process.