by Lee Fried, on 20 Mar 2007 05:04 pm
The Journey
The Value of the Audit
As a consultancy we have been working closely with several managers in assessing the current status of their Quality Assurance systems. Like most organizations we many processes that have an audit function that is located at the very last point in the process within the function. There is typically two reasons why we audit: to ensure that we are not passing defects downstream and to catch mistakes in order to measure and hold individuals accountable for their performance. By its very design an audit function is reactive since the problems have already occurred and we are now attempting to catch them. Additionally, holding individuals accountable for process issues leads to many forms of waste as well as a culture of hiding mistakes.
In a couple of these functions we are changing the focus of how we utilize the audit function and are doing some experiments. First, we are moving the audit function into the team and having audits take place in real time. The purpose is no longer to rate people’s performance, but instead to identify process problems or training opportunities. Our goal is to make the audit proactive so that we can error proof and build team competencies. Second, we are establishing production system audits where senior leaders gather data and conduct gemba walks to identify the capability/reliability of processes. The goal is to get better every day and set up the right incentives to promote proactive work whenever possible. These are big changes and have been met by different levels of resistance, but I am confident it is the right work.
on 21 Mar 2007 at 9:11 am 1.robert thompson said …
I find the 2000 version of ISO9001 to be useful when adopting a process approach to auditing. Here you are expected to focus not only on the process but on risk, status and importance of the issues identified. “How will the process add value to a business” is the fundamental question and “is there a better way to do it?” are all key points to bear in mind during the audit itself.
Rob
on 22 Mar 2007 at 4:41 am 2.ram said …
Lee,
That would be very interesing to know how it would work. We’ve tried to change our care delivery in our nursing units and there have been several issues and everything ends at only one point saying “needs to be audited”. Finally I decided to take a look at all the audits every nursing unit conducts and I ended up with a thick pile of policies written to audit almost every function a clinical staff is performing.
So now we audit almost everything right from taking vitals to medications, everything is audited.
I would be very much interested to know a little more in detail about what you are doing with the your audit process.
Thanks a lot for all the valuable information you and Ted are sharing.
Ram.
on 23 Mar 2007 at 12:13 pm 3.Greg Burnworth said …
It definitely has its challenges Ram. Lee has me working on our Audit department as we speak, primarily in Claims. In the delivery system, I can imagine that it’s even more challenging. Auditing is simply a fancy business term for checking, and it has become so ingrained in our thinking because it gives the false illusion of security or QA. First time quality eliminates this need - as for the auditors themselves, small steps…
on 28 Mar 2007 at 8:47 am 4.ram said …
Thanks for the reply Greg, I was wonering what kind of audits do you have inplace for your clinical stuff. In our organization we have atleast one clinical person every in-patient unit spending most of their time doing audits. And we have audits for almost every clinical step.