Guest editorial

Citation

Sinha, M. (2010), "Guest editorial", Clinical Governance: An International Journal, Vol. 15 No. 2. https://doi.org/10.1108/cgij.2010.24815baa.001

Guest editorial

Article Type: Guest editorial From: Clinical Governance: An International Journal, Volume 15, Issue 2

About the Guest Editor

Madhav SinhaPresident and CEO of the Total Quality Research Foundation Canada and Founder and Chair of the Canadian Quality Congress, Winnipeg, Manitoba, Canada.

The collection of papers in this special issue of Clinical Governance: An International Journal come from the “first” annual Canadian Quality Congress presentations held last August 2009 in the campus of the University of British Columbia, Vancouver, Canada, sponsored and organised by Total Quality Research Foundation (TQRF) Canada.

Under the theme, Quality, Innovation and Social Responsibility, approximately 200 delegates were in attendance from 23 countries around the world. Healthcare dominated the agenda. It was no surprise. In an era when civilians and politicians alike in and around North America appear to be rightfully indignant about problems in healthcare, the truth is that the enormous wastes and the medical errors that cause thousands of deaths each year are making people nervous. There seems to be no end in sight and no one seems to have an answer. There were many excellent papers and keynote speeches on a wide variety of healthcare topics. At the end of the day, however, there were more questions, than answers.

For example: what are the root causes of the decline of quality in healthcare? Why aren’t health care organisations applying the proven tools and techniques of quality management fast enough to reduce the sufferings of their customers? What are the specific roles of governments everywhere in all countries? There are tons and tons of laboratory data and result charts, are they all useful and are they all used? Misused resources create enormous waste amounting to billions of dollars and why is nothing is being done about it? The list goes on.

The papers that we have selected are attempts to answer a few of these questions. In the first paper by David Birnbaum and Jude Van Buren, the work is about a new model and opportunities for raising standards of practice through continuous quality improvement approaches with hospitals as partners in order to keep the trust and transparency at the core. This article is about reporting hospital-associated-infection (HIA) cases to the public that is clearly an uncharted territory for many hospitals.

A conceptual model based on behavioural dimensions of patient-physician relationships and patient satisfaction criteria are used by Hatice Camgöz-Akda and Mosad Zineldin, in the paper “Quality of healthcare and patient satisfaction: an exploratory investigation of the 5Qs model at Turkey”. They find five quality-related dimensions (hence the name 5Qs) to be the re-engineering mechanism for the future directions in making quality programs in hospitals more effective. Conclusions are that the deaths in hospitals due to medical errors are preventable and a nation’s healthcare system must reach the point where no patient should ever be the victim of a medical error.

In the next case study on a quality management system application to investigate process failures in a DNA research laboratory, a team of researchers led by Mirunali Balasundaram describes a practical approach for utilizing the non-conformance/event management and failure investigation system to formally troubleshoot the cause of poor quality sequence data in cases of DNA sampling of tumour-associated genome rearrangements. The proposed model helps ensure that underlying causes get effectively identified, so that immediate corrective actions can be taken and a preventive measure instituted in place to avoid and/or minimize reoccurrences of the problem.

The rest of the papers describe familiar cases and situations which show the continuous pressure to improve patient care in hospitals. Author Yasmeen S. Alhatmi, in a paper entitled, “Quality audit experience for excellence in healthcare”, proposes a model that incorporates the fundamentals of quality auditing in a step-by-step manner and shows how excellent results can be achieved with measurable results. The next paper by Jay Kalra, Lyndon Entwistle, Sudhir Suryavanshi and Rajeev Chadha titled, “Quality assessment using concordance and discordance rates in medical findings”, discusses a retrospective record review of the medical and autopsy charts which was carried out for the deceased adult in-patients admitted during a three-year period. By determining the concordance rate and the discordance rates in the study of a population of 3,416 deaths, the results suggest that despite the technical advances in medical science and diagnostic models, diagnostic discrepancies in the present systems remain prevalent and hence residents and physicians must continue to use autopsy as an important tool to extend their understanding of the disease processes. The last paper by Badran Al-Omar and Saad Al-Ghanim, on “Utilization of hospital resources: a survey-based study of Saudi hospitals in Riyadh City”, discusses how to track down the wastes and inappropriate utilization of resources in hospitals that occur every day in all healthcare settings whether civilian, private or military. It explores how to avoid these situations which carry a huge burden on organisations and adversely affect the delivery outcomes of service to patients.

Finally, I would like to use this opportunity to express my sincere thanks to all board members of Total Quality Research Foundation (TQRF) Canada, the National Advisory Council members of the Canadian Quality Council (CQC) and editorial committee members who have worked so hard to stage the Congress and put together the proceedings in a timely manner. The valuable sharing of their time, energy, ideas and experiences in starting this new initiative in Canada will be truly remembered. I must also say that I feel honestly very lucky in this project to have received an admirable support and trust from the Emerald Publishing Group members, in particular from Ms Nicola Codner, the publisher.

Let me welcome everyone to the Second Canadian Quality Congress taking place in the University of Toronto campus, Toronto, Canada, August 23-25, 2010. Looking forward to see you there!

Madhav Sinha