STATE OF THE ART
Application of quality principles to managing donor services
Introduction Blood donor services (BDS) consist of a variety of activities, processes and procedures that blood establishments (BE) carry out in order to provide adequate supply and the appropriate type of blood and components required for transfusion. Quality principles (QP) on the other hand is a comprehensive and fundamental rule for leading and operating an organization aimed at continually improving performance over the long term by focusing on customers while addressing the needs of the customers. The application of QP would increase the efficacy and effectives of the BDS.
Application of Quality Principles BE as an organization needs to continually improve its performance by focusing on the needs and expectation of blood donors, the relevant authorities as the stakeholder, as well as the community in which it serves. Through appropriate awareness programmes for donor recruitment and providing a donor care service that meets their expectation will improve the supply and quality of blood to patients. Communicating these needs and expectations is crucial in order to establish good customer relation. Leadership in the BDS is necessary to provide direction, inspire and encourage all personnel to be involved in providing quality service. Full involvement of every individual would benefit the organization. In designing the processes in BDS due consideration must be given to the various steps, activities, workflow, critical control points, training requirement, equipment, methods and other resources to achieve its objectives and target. All the interrelated activities need to be managed as a system to improve efficiency. In order to continually improve its performance, BDS needs to monitor and evaluate its activities. Collection of information and good data allows objective evaluation and decision making. Clear understanding of the relationship between BDS and its suppliers would be beneficial.
Conclusion QP can be adopted by BE to guide the organization towards better and improved performance. The principles of QP would certainly benefit the BDS to function as an efficient service provider in meeting the demand of the healthcare services that depend on a sustainable blood supply.
Blood donor services (BDS) consist of a variety of activities, processes and procedures that blood establishments (BE) carry out to collect adequate supply and the appropriate type of blood and components required for transfusion. Quality principles (QP) on the other hand is a comprehensive and fundamental rule for leading and operating an organization aimed at continually improving performance over the long term by focusing on customers and addressing the needs of the customers . This article is based on the ISO9000 standards published by the ISO technical committee detailing the quality management principles and application guidelines . The recently published AABB Quality System Essential 2011 contains standards that define what the quality systems should have . This document is a good guide to BE to develop their quality system. The application of QP in BDS would improve the efficiency and effectiveness of blood donor recruitment, donor care and blood donor retention which would support the blood programme in providing a sustainable blood supply.
Application of quality principles
BE as an organization needs to continually improve its performance by focusing on the needs and expectation of blood donors, the relevant authorities, the stakeholders, as well as the community in which it serves. It can improve its performance by adopting quality management principles into the organization.
There are two components in any quality management system in an organization, which are its operational infrastructure and the quality infrastructure . Process and procedure are the key features of operational infrastructure. The core activities of the BDS are donor recruitment, blood collection and donor care process, which include a variety of procedures that culminated in collection of blood that is much needed and blood donors who return to donate blood regularly in the future. To support this function, the operational infrastructure of the BDS requires a quality infrastructure which has the quality plan as its key component that describes how it will support the activities of the BDS.
Quality management is becoming increasingly important to the leadership and management of all organizations. Quality management principles provide understanding of and guidance on the application of quality management. By applying quality management principles, the BDS will produce benefits for its customers namely, the blood donors, hospitals, doctors, patients, the relevant authority, suppliers and the community.
As an organization that depends on the community for its core function, the BDS should understand current and future needs of its customers namely potential and established blood donors, and strive to meet customer requirements, which in some instances may be beyond their expectations. An organization attains customer focus when all people in the organization know both the internal and external customers and also what customer requirements must be met to ensure that both the internal and external customers are satisfied .Focusing on the donors through appropriate awareness programme for donor recruitment and providing a donor care service that meets their expectation will increase the number of new donors as well as donor return which subsequently improve the supply and quality of blood to patients.
Communicating these needs and expectations is crucial to establish good customer relation not only with the donors but also with the hospitals and doctors. If the method of communication is right and the message to the community is acceptable, donor recruitment would be successful. Similarly, better use of blood and blood products can be achieved.
Quality management begins with and sustains through effective and efficient organisational leadership. Leadership in the BDS is necessary to provide direction, inspiration and encouragement, as well as create a conducive operating environment in which all personnel are involved in providing services that meet the demand and expectations of blood donors, patients, community and the relevant authority.
The organization generally reflects the leadership. Its leaders set the character and image of the organization. Their directives and, more importantly, their actions establish the basic principles of the organization . It is essential for leaders to have knowledge and understanding of the purpose of the organization and the QP to support these objectives .
The BDS needs leaders to provide unity of purpose and direction. They are important for creating an environment, in which every personnel can become fully involved in achieving the organization’s quality objectives . These objectives include analysing operational and feedback information, strategising, quality planning and managing both the BDS processes and the BDS personnel development.
Involvement of people
Full involvement of personnel at all levels is the essence of an organization as this would allow each and everyone to utilize his or her capabilities for the good of the organization. The BDS requires a lot of coordination among individuals with different types of skills that are utilized to perform different tasks. Generally, they are the best people who know in detail the task they perform. Their ideas and suggestions are important in planning and implementation of activities such as those in awareness programme, blood collection and other related function. They should be encouraged to share knowledge and experience as well as to be innovative in improving the organization and creating value for the customer.
Personnel are more likely to perform better if they are involved in decision making as they have a sense of belonging, responsibility and ownership. This would also allow them to derive satisfaction from their work and feel enthusiastic and proud to be part of the organization.
The processes of blood procurement need to be clearly defined to achieve the established target. In designing the process the BDS must give due consideration to the various steps, activities, workflow, critical control points, training requirement, equipment, methods and other resources to achieve its objectives and target. All the interrelated activities need to be managed as a system to improve the efficiency and effectiveness of the BDS.
All the processes involved in the BDS and their objectives need to be clearly identified and defined. The input and output of each of the processes need to be measured. The interfaces of the processes need to be managed in relation to the function of the organization. For example, the procedure in determining the suitability of a particular individual to donate blood can affect blood collection procedure, blood component preparation process and eventually the supply of blood. Thus, the possible risk, consequences and impact of the processes on the customers whether they are internal or external, would have to be evaluated.
In managing the processes, clear line of responsibility, authority and accountability would have to be established. A desired result is achieved more efficiently when related resources and activities in the BDS are managed as a process .
System approach to management
An organization’s effectiveness and efficiency in achieving its quality objectives are contributed by identifying, understanding and managing all interrelated processes as a system .
For example, in blood collection there are various processes such as determining donor eligibility, the actual blood collection and the management of blood after collection including storage and transport. These processes made up a system that has the objective of getting units of blood that meet established standard. Identifying, understanding and managing a system of interrelated processes for a given objective improve the organization’s effectiveness and efficiency. The whole system can be managed more efficiently if the interdependencies of the processes are understood and continuous monitoring and evaluation are carried out. However, in doing so, the BDS need to take into account resource availability and requirement.
Continual improvement should be a permanent objective of the organization . Improvement of products, services, process and system should also be the objective of everyone in the BDS. Regular assessment and identifying areas of potential improvement are starting points in this process. Every member of the organization should be given appropriate training on the methods and tools of continual improvement such as the Plan-Do-Check-Act cycle, problem solving, process re-engineering, and process innovation.
In Plan-Do-Check-Act cycle, the BDS should plan to achieve certain objective. In order to do so, the BDS should analyse the organization current situation and establish the overall objectives. Short term targets can be set in a stepwise manner in order to achieve the final objective. The BDS would then carry out the plan. The result should then be monitored and measured to assess whether what has been implemented in the plan has achieved the desired result. In this way the plan can be improved and mistakes can be learned and corrected.
The BDS can establish measures and goals to guide and track improvements. Improvements achieved should be given due recognition as this would encourage personnel to initiate further improvement and consequently create a culture of continuous improvement that would increase the efficiency and effectiveness of all processes.
Factual approach to decision making
In order to continually improve, BDS needs to monitor and evaluate its activities. Collection of information and good data allows objective evaluation and decisions making. Data and information collection should be relevant to the objective of the BDS. This includes the number of blood units required, the prevalence of disease markers among donors, the rate of deferral, among other things. However, the data and information must be accurate and reliable so that appropriate decision on intervention and action can achieve the desired result. Effective decisions are always based on data analysis and information .
Mutually beneficial supplier relationships
The BDS is also dependant on its suppliers in ensuring its operations are running smoothly. Clear understanding of the relationship and open communication with these suppliers would be mutually beneficial. Joint development and improvement of products and processes and sharing information for future planning can assist the BDS in meeting its objectives and target as well as continuously improve its performance.
Quality principles can be adopted by BE to guide the organization towards better and improved performance. The principles of QP would certainly benefit the BDS to function as an efficient service that respond to external and internal environment effectively. With its focus on the community and the blood donors it will achieve its objectives in meeting the demand of the healthcare services that depend on a sustainable blood supply.
No potential conflict of interests to declare.