On the second day of the seminar, the Tokushukai Group TQM office reported progress on its Tokushukai/Total Quality Management project, explaining fiscal 2017 priority Quality Improvement/Indicator (QI) measures and new BI tools.

BI tools are management systems that analyse the large volume of information generated in daily care. The office reported that fiscal 2017 Group QI indicators had been available in the tools since July. Demonstrations showed screens for setting each hospital's targets for Group priorities, comparing results with targets and the same month of the previous year, and reviewing safety and infection indicators.

The office emphasised that the standardised mortality ratio, one of the Group's priority indicators, is best used to monitor trends within an individual hospital. The current calculation uses standardisation coefficients from the National Hospital Organization. If Japanese national coefficients based on nationwide Diagnosis Procedure Combination (DPC) data become available, comparisons with other hospitals in Japan and abroad will be possible.

The standard clinical pathway project was then explained. Clinical pathways aim to standardise evidence-based treatment and care by incorporating guidelines; analyse outcomes using the Japanese Society for Clinical Pathway's Basic Outcome Master (BOM) to improve care through variance analysis; explain treatment schedules to patients and strengthen informed consent; prevent necessary procedures from being missed; and standardise costs.

On patient safety, Shonan Kamakura, Sapporo Higashi Tokushukai and Chubu Tokushukai hospitals presented measures to improve dialysis unit safety. For infection prevention, results of a prior survey were presented on influenza precautions, whether prophylactic antivirals were used and the criteria for their use.

Systems are being developed for four standard pathways: inguinal hernia, laparoscopic cholecystectomy, gastric endoscopic submucosal dissection and acute myocardial infarction. The schedule calls for distribution through the EMR in August and trial operation from September.

Source: Tokushukai Newspaper, 7 August 2017, No. 1094