Applications of industrial quality improvement in health care

Article Abstract:

Corporations that have not been able to adapt their paradigms (rules and regulations aimed at successful implementation of goals) to competitive and environmental pressures have often failed to survive. In the case of the medical care industry, the pressure is on to become more efficient, without sacrificing quality. A series of articles in the December 1990 issue of the Journal of Occupational Medicine presents discussions concerning physicians' changing roles in health resource management. After a discussion of the concept of quality, the dominant health care paradigm is described and evaluated, with predictions concerning the ways it is most likely to change. Traditionally, quality in medical care has meant care which leads to the greatest improvement in health. When the idea of quality control in industry entered the picture, it emphasized that variation in product characteristics was partly the result of the manufacturing process. Other models are discussed, including the most recent, wherein total quality involves activity on three levels: strategic, managerial, and operational. Health care organizations often use these concepts, forming networks to make the adjustment to new management strategies work better. The organization must attend to the voices of the customers and to the transformation process itself. Statistical thinking is essential for health care workers who want to understand what these voices are saying. The FOCUS-PDCA paradigm is introduced in flow-chart form as a model of how to improve a health care process. Ultimately, dissatisfaction with the present paradigm and the pressure induced by increasing costs will provoke the development of a new health care paradigm. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Models, Evaluation, Medical care, Quality management, Medical care quality, Quality control, Industrial organization

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Lead exposure at uncovered outdoor firing ranges

Article Abstract:

Lead exposure can be a significant health hazard. Lead is found in a number of sources, including bullets fired from guns. Studies have shown that shooting instructors in indoor firing ranges can be exposed to hazardous levels of lead; they are tested regularly for lead absorption. It has been assumed that instructors at outdoor ranges are not at risk because ventilation is much better. This study examined the level of lead exposure of instructors at outdoor firing ranges, and if using copper-jacketed bullets decreased exposure. Air samples were analyzed, as well as blood samples that were taken from seven instructors before and after copper-jacketed bullets were used. Air levels of lead decreased when the copper-jacketed bullets were introduced. Blood tests showed that instructors' blood levels of lead also decreased after the new bullets were introduced. The results indicate that firing instructors at outdoor ranges may be exposed to significant levels of lead. Using copper-jacketed bullets can help decrease this exposure. Regular blood tests to monitor lead levels are also advised. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Equipment and supplies, Lead, Shooting, Police shooting ranges, Rifle-ranges, Rifle ranges

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