Qualmed in Japan

Thursday, 29 March 2007

Quality and Audit and its application to health care in primary care is a rapidly developing topic throughout the world. The reasons for this interest will be discussed including demographic change, technological development, public expectations and financial constraints.

The principles behind Quality will be covered, many of which be familiar to the delegates as several of these principles are of Japanese origin. The ideas of Shewhart, Demming, Pareto, Ishikawa, Taguchi, Ohno and many others will be considered in relationship to their application in the field of Primary Care. Specific tools such as “Pokayoke” should be very relevant to a speciality in which risk and mistake reduction is so important. The concept of the “customer” and who that really is in a modern complex health care system is the key to much of our ongoing thinking.

Challenges of this changing environment are to be presented. In particular the stresses for the workers of a rapidly changing world for which, in the main, they have not been trained. The pressures to constrain expenditure and the move from an individual, bespoke service, to a computerized managed system are points that may be of interest. The chaotic nature and variability of humans is a real problem for ideas that are based on repeatability and standardisation.

There may well be enquiries from the conference as to the Quality & Outcomes contract which has been in operation for the last few years in the UK. How this functions, is applied and is received by both Doctors and patients is presented. This will cover the audit principles and the idea of Targets whether for good or bad. The difficulty for a long term vision in a politicised environment can put real Quality improvement behind headline grabbing objectives.

Dr John G. Schofield MB BS LRCP MRCS DObst RCOG

John qualified in Medicine at the University of London (Guys hospital & Kings College hospital) in 1969 and after training became a General Practitioner (GP) in 1973. He continues to work as a GP and to advice on Quality matters relating to health care. During his years as a GP he became involved with the training of students and GP Registrars. He was for several years the Associate Dean at the London Deanery for Quality and Audit and during this time helped to write several books on aspects of health care with special emphasis on the quality aspects. John has assisted with the development of medical training of Doctors in a number of countries. In particular he has, for some time, been involved with the development of General Practice in Central Asia. His continuing interest is in the application of Quality principles to the delivery of excellent care to patients.