DFI Led Quality Initiatives in
the Disability sector: What are
the effects?
Dr. Olivia McDermott, Post-Doctoral
Researcher in Lean/Six Sigma at UL
www.disability-federation.ie
Aims
1. To determine if DFI Quality Initiatives are
having an impact:
i) within member organisations
ii) to Service Users
2. To identify next steps on the Quality Initiative
journey
www.disability-federation.ie
Methodology
•
3 students carried out the research as part of the Specialist Diploma in Lean
Systems (UL)
•
The 3 students were based in Wicklow, Mayo and Limerick. To facilitate that, the
organisations and Support Officers nominated to take part in the research were
chosen primarily on proximity to the students
•
30 DFI member Organisations/participants were nominated to take part in the
research
www.disability-federation.ie
Methodology
(continued)
• The organisations/participants were proposed by DFI Support Officers, based on
the following criteria:
- Type of Quality Initiative adopted
- Geographical location
- Size of organisation
- Type of service provided
• Each research student was assigned at least one organisation that was:
-
Local
-
Regional
-
National
www.disability-federation.ie
No. of
participants
nominated
No. of
participants who
took part in
research
No. of
organisations
using this
initiative*
Organisation
Healthcheck
6
3
40
PQASSO
9
8
25
Introduction to
TQM
6
4
38
Specialist
Diploma
3
3
3
Placebo
3
3
21
Support Officer
3
3
n/a
www.disability-federation.ie
How research
was conducted:
www.disability-federation.ie
Designed a
Voice of the
Customer (VOC)
process to
gather data
Interviewed
organisations at
various stages
of Quality
Journey
Reviewed
findings
Recommended
changes
Voice of the Customer
(VOC) process:
In order to have a comprehensive VOC system, the following elements are
required:
• A process for engaging with, and listening to, the customer
• Mechanisms for the effective collection of VOC data
• Meaningful analysis and reporting of data to understand customer
issues and opportunities
• Organisational commitment to address VOC issues and deliver added
value to current and potential customers
www.disability-federation.ie
VOC process:
2 formats
1.
Survey Questions
Used for 10 organisations/participants:
 1 Organisation Healthcheck organisation
 8 PQASSO organisations
 1 Specialist Diploma participant
www.disability-federation.ie
VOC process:
2 formats (continued)
2.
Open interviews:
Used in 22 organisations/participants:
 3 Organisation Healthcheck organisations
 7 PQASSO organisations
 4 “Introduction to Total Quality Management (TQM)”
participants
 2 “Specialist Diploma in Lean Systems” participants
 3 Placebo organisations
 3 Support Officers
www.disability-federation.ie
Findings of Survey Questions
Across all the DFI Quality Initiatives (n = 10):
5.0
4.0
4.5
4.2
4.0
3.0
2.0
1.0
0.0
4.0
4.0
3.3
Strongly Agree = 5
Agree = 4
Neutral = 3
Disagree = 2
Strongly Disagree =
1
Findings from Interviews on the Organisation
Healthcheck (OHC) process
• Data was included from the 3 OHC interviewees and 3 Support
Officers
• Two-thirds of interviewees (4 out 6) found the OHC to be
useful as a reflective process
It showed our
strengths and
weaknesses
www.disability-federation.ie
It gives a baseline to
the organisation’s
existing management
and operating
systems
It highlights the
organisations
opinion of where
they think they are
Findings from Interviews on the OHC process
The primary challenges were found to be:
• Fear/resistance to the OHC process (3 interviewees)
• No process to assess the impact on the service user &
organisation (3 interviewees)
• Sustaining the improvements brought about by the
Healthcheck (2 interviewees)
There is a fear
of what it will
expose
www.disability-federation.ie
If they stop after the
Healthcheck, the
changes may not be
sustained
The key challenge is
to get buy in from
the Board of
Management
Findings from Open Interviews on the
PQASSO process
• 5 of the 7 participants believed that as a Quality Management
System (QMS), the PQASSO process was relevant to their
organisation.
• 2 participants commented that they would like the process to
be adapted to better suit the Irish sector.
The sources of
evidence are
important because
they make us think
about the process
www.disability-federation.ie
Would be beneficial to have an
‘Irish’ version of PQASSO,
where PQASSO headings could
be tailored to meet HIQA
requirements
Findings from Open Interviews on the
PQASSO process
 5 participants stated that they would be unable to implement
PQASSO without DFI Support.
 2 participants believed that without the support from DFI, the
process would be slower/less accurate.
Would not
have had buy
in without DFI
www.disability-federation.ie
Without the support of
the DFI then
implementation of
PQASSO would have
happened at a much
slower rate
It could be
done but not
as easily
Findings from Open Interviews on the
PQASSO process
• All participants were happy with the support they received from DFI
on the PQASSO Core Team.
• 5 participants commented that they found the PQASSO Champions
Network beneficial, with 2 of these stating that they would gain
further benefit from more meetings.
Can draw on
experience from
other
organisations
His (DFI Mentor)
attention to detail is
very important
especially when
working through
supporting evidence
www.disability-federation.ie
PQASSO Champion
Network beneficial with
the sharing of
information and
experiences
Findings from Interviews on the PQASSO
process
 5 participants found that PQASSO was having a positive impact within their
organisation with 2 people stating that there had been no measurable
impact to date.
 The main areas of impact were:
- Better Governance (5 partipants)
- Increased involvement of service user in design and delivery of
services (5 participants)
- Confidence to challenge existing processes (3 participants)
- More strategic planning (3 participants)
- Better record keeping (2 partipants)
It has brought about
greater
accountability and
responsibility
www.disability-federation.ie
The
organisation is
more user led
Feedback has
improved and
teamwork is more
evident
Findings from Open Interviews on the
PQASSO process
 5 participants stated that changes had been made in their
organisation as a direct result of the PQASSO process
 1 person stating changes proposed and awaiting
implementation.
 1 person stating no changes had been made as yet
There is more
order and
structure
www.disability-federation.ie
Employee
standards have
been put in
place
Board roles and
job descriptions
are now
established
Findings from Open Interviews on the
Introduction to Total Quality Management
(TQM) process
 All Participants (n=4) in the TQM course found it of value to them.
 Of these, 1 participant reported changes within their organisation as a
direct result of the course.
Training
enabled us to
better identify
scope for
improvement
www.disability-federation.ie
Found the
course relevant
and opened up
new ideas and
areas
Findings from Open Interviewees of the UL
Specialist Diploma
All participants (n=3) in the UL Specialist Diploma found that it
enabled them to make improvements within their organisation.
My studies have
enabled me to make
several improvements
within my organisation
www.disability-federation.ie
The specialist Diploma
has delivered on
efficiency and assisted
the organisation in its
quest for continuous
improvement
Findings from Placebo Interviews
 The organisations involved in the placebo interviews (n=3) had been
offered the opportunity to take part in the DFI Quality Initiatives.
 The reasons given for not taking part were as follows:
• Lack of understanding of process (2 participants)
• Fear of what it would involve (1 participant)
 2 organisations believed there was a desire to improve, but they did
not know how to address this.
They could improve
across all areas if
they had assistance
www.disability-federation.ie
There is fear of what is
involved in introducing
a quality system
Research
Limitations
 Not all targeted organisations took part in the research (24 out of 30)
 The results are for a limited sample size:
- 3 organisations who had completed the OHC (out of a total of 40)
- 8 organisations who had completed PQASSO (out of a total of 25)
- 4 people who had completed the Introduction to TQM course (out of a
total of 38)
- 3 people who had completed the Specialist Diploma (out of a total of 3
- 3 Support Officers
www.disability-federation.ie
Conclusions
 The results from the VOC process
demonstrated that participants believed the
DFI Quality Initiatives were having a positive
impact within their organisation.
 The findings of the survey questions indicated
that the interviewees believed that the DFI
quality initiatives had a positive impact on the
service-user.
www.disability-federation.ie
Conclusions:(Organisation
Healthcheck)
 The Organisation Healthcheck provides a
baseline to enable the measure of progress in
the future.
 The Organisation Healthcheck would appear
to raise awareness of how well an
organisation was functioning, but wouldn’t
necessarily provide the momentum for
continuous improvement steps.
www.disability-federation.ie
Conclusions
(PQASSO)
 PQASSO appeared to show considerable benefit to
those involved, not only raising awareness about
issues within their organisation, but also putting in
systems to ensure they are addressed over the long
term.
 The aim to have service user representation on the
PQASSO core team is a unique approach in a QMS
and one that should ensure that changes affecting
the service user are made with the input of the
service user.
www.disability-federation.ie
Conclusions :(Introduction
to TQM)
 The 5 day “Introduction to Total Quality
Management” course would appear to be of
significant value, however, those that had
completed the course were often not getting
the opportunity to apply the tools they had
learned.
www.disability-federation.ie
Conclusions:(UL Specialist
Diploma)
 The UL Specialist Diploma would appear to be of great benefit
as the 3 participants interviewed had implemented
improvements which would not only benefit the organisation
but also the service user – the ultimate aim of each
organisation.
 The roles of the participants within their organisation may
have contributed in this regard:
- 2 were managers
- 1 was a board member
www.disability-federation.ie
Conclusions:
(Summary)
 Overall, it can be concluded that the DFI Quality
Initiatives are having a positive impact on the
organisations where they have been introduced, but
that more needs to be done to ensure that the service
user is feeling the benefit of these processes.
 This could be facilitated by adopting a whole of
organisation approach, paying particular attention to
the needs of service users.
 PQASSO QMS is particularly useful in this regard as it
requires that service user/service user advocates, are a
member of the PQASSO Core Team.
www.disability-federation.ie
Recommendations for: Organisations
 To ensure that any Quality Initiative is successful, all
stakeholders should be aware of, and kept up to date on the
process.
 Ensure that supports available e.g. DFI PQASSO
Mentor/Support Officers/PQASSO Champion Network, are
used to share knowledge and resources.
 Employing a VOC process within each organisation would
ensure that changes impacting the service user are of value
to the service user.
 Where a DFI Quality Initiative has been introduced but is
not being integrated as planned, follow up with DFI for
advice.
www.disability-federation.ie
Recommendations for:
DFI
 Develop means of addressing fear associated
with introducing the Quality Initiatives.
 Strengthen process of follow up with
organisations that:
a) are hesitant about introducing a Quality Initiative
b) have undertaken the OHC but not proceeded with
PQASSO
c) have begun implementation of PQASSO, but
stalled along the journey
www.disability-federation.ie
Recommendations for:
DFI (continued)
 In order to make sure PQASSO is tailored to the Irish
disability sector, adapt the training course given to
include Irish examples (** now policy for 2014).
 Introduce more frequent PQASSO Champion Network
meetings (** increased to 3 per annum from July
2013).
 Expand present networking between organisations,
and develop clusters (location/organisation based).
 Continue the DFI/UL collaborative partnership to
further develop quality supports for the sector.
www.disability-federation.ie
Thank you for listening
www.disability-federation.ie