Two Suggested Improvement Models to Address the Quality Assurance of an Infection Control Procedure

PDCA Model

(Plan | Do | Check | Act)

PLAN

1. Determine WHAT regulations/recommendations (R/R) apply to the procedure being assessed by reviewing the Bloodborne Pathogens Standard from OSHA¹ and the infection control guidelines from the CDC.²
2. Confirm that personnel performing the procedure have an understanding of WHY the specific R/R are needed and what the procedure is supposed to accomplish when performed correctly. Provide training if necessary.
3. Analyze the R/R to determine how to comply, obtain what is needed to comply and state when it should be performed.
4. Decide HOW to perform the procedure and write a Standard Operating Procedure (SOP) with total staff input.

DO

1. Perform the SOP.

CHECK

1. Directly observe performance of the SOP and document details.
2. Receive feedback from those performing the SOP to identify any problems and obtain suggestions for improvements.
3. Confirm that the SOP is providing compliance with the R/R.

ACT

1. Make any necessary changes in the SOP to achieve process improvements and Quality Assurance.
2. Periodically monitor performance to assure continuous compliance (consistency).

¹OSHA. Bloodborne Pathogens. Accessed December 2019 at: osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030.

²CDC. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health; May 2016. Accessed December 2019 at: cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm.

DMAIC Model

(Define | Measure | Analyze | Improve | Control)

DEFINE

1. Identify WHAT specific procedure will be analyzed.
2. Determine WHY the procedure is performed and what R/R apply.
3. State what the procedure is supposed to achieve and when it is to be performed.
4. Identify the SOP if available.

MEASURE

1. Observe the procedure as currently performed.
2. Document each step in detail, including what is done, what is used to perform the procedure and when it is performed.

ANALYZE

1. Have the office staff review and analyze the measurements.
2. Compare with any current SOP.
3. Identify root causes of any problems detected.

IMPROVE

1. Determine ways to eliminate the causes of the problems detected.
2. Brainstorm with the team and select the final solutions that address the root causes.

CONTROL

1. Perform trial runs using the improved procedure.
2. Create the new final SOP.
3. Institute the improved procedure.