Quality dimension
The quality dimension can be defined from the sub-area of quality development. Most quality development instruments contain several quality dimensions with the help of which different subcategories in quality management can be viewed individually. The sequence of dimensions that is listed is unimportant and has no influence on the procedure. The various quality dimension models can be used for quality assurance in many areas, such as in business or medicine.
Quality dimensions according to Garvin
There are many different ways to describe the term quality dimension. For this reason, there are also different understandings of the term. However, it turns out that the operationalization of quality is quite similar in all the explanations recorded, as they overlap in their model on the one hand and show numerous similarities on the other. If you take a closer look at the individual models, you can see that each author has a different focus. There are also different densifications and omissions with regard to the model.
Many authors, including David A. Garvin and Robert Maxwell, explicitly deal with the term quality dimension. In 1988 the book "Managing Quality: The Strategic and Competitive Edge" was published, which was recorded by the American Garvin. The economist in his book, among others, describes his known views on the notion quality . As a result, he also developed his eight dimensions, which are summarized as quality dimensions. This definition is not only of great importance for the quality of products, but it also plays an essential role in the quality of service . It can therefore be used in both areas.
The 8 dimensions of Garvin relate to the areas: performance , equipment (features), reliability (reliability), conformity (conformance), durability (durability), customer service (serviceability), aesthetics (aesthetics) and quality image (perceived quality) ). The eight dimensions are described below.
Performance
This dimension describes the scope and functionality of the service. The operation and use of a product are the primary functional product characteristics. This is comparable, for example, to the performance of a kitchen appliance. In comparison to a service, attention is paid to the appropriateness of the creation of a service and its goal to the core service.
Equipment (features)
In the equipment dimension, the services that are particularly functional are considered. These are summarized as secondary performance characteristics that have a supplementary effect on the primary performance characteristics. Thus they differ from the dimension “performance”. One example of equipment in the automotive sector is leather seats.
Reliability
This dimension focuses on the reliability and safety of a product in its use. It also makes it clear how likely it is that the product will be inoperable within a certain period of time. With regard to the services, the individual faults and errors within the process are considered.
Conformance
The conformity describes how closely the characteristic values match the previously set requirements. If the characteristics do not meet the specified requirements, the degree of conformity is low. Attention is paid to whether the desired standards were adhered to or whether there were some deviations. In addition to the standards, reference is also made to requirements that are superordinate, job-specific or internal to the institution. Superordinate requirements would be e.g. B. Laws and Policies . Requirements that are job-specific are e.g. B. Guidelines or standards. The institution's internal requirements include: B. the corporate goals and procedural instructions.
Resistance (Durability)
This dimension illustrates the shelf life or service life of a product until it is finally used. In the area of services, other parameters are taken into account or taken into account. Here the results of the services are checked for durability. These can adapt to certain changing conditions over time or remain in place. This dimension has an obvious commonality with the process-related "reliability".
Customer service ability (serviceability)
This type of dimension pays attention to both product preservation and repair. If this dimension is applied to services, the focus is on ease of service and aftercare. The aftercare includes competence and speed. For example, the service friendliness includes politeness.
Aesthetics
Aesthetics is about beauty. Thus, this dimension describes the external appearance of products and services. It is about the appearance of a product. The taste and smell of a product are also referred to. Accordingly, the end product or the product speaks to the sensory organs during the production of the service. This dimension shows a dense composition with the last dimension “Quality Image” by Garvin.
Quality image (Perceived Quality)
In this context, the customer perceives the quality of the product or service. There are numerous influencing factors regarding the perception of a product such as: B. the experience of the customer or their attitudes towards the product. The image also influences the perception of customers or user groups of various kinds.
Quality dimensions according to Maxwell
background
Robert J. Maxwell is the chief executive officer at King Edward's Hospital Fund in London. In 1984 he designed a quality model that was to be used primarily in medicine. He believes that quality control should follow a standardized approach. In contrast to other models, Maxwell refers not only to the micro quality, i.e. exclusively to the economic aspects, but also to the macro quality. This also takes economic and social aspects into account, which is why it is used today in many medical development processes . For example, the US quality initiative Joint Commission on Accreditation of Healthcare Organizations (JCAHO) uses this model as a model.
The six quality dimensions according to Maxwell
Maxwell also refers in his work to the quality dimensions according to Donabedian , since this already - in comparison to more general models - included the interpersonal and consumer-oriented aspects. With these aspects in mind, Maxwell designed a model that includes six quality dimensions. The dimensions should be considered individually:
- Accessibility (Access to services): In this dimension, needs-based availability is considered. The distance (e.g. accessibility of the supply), time (e.g. waiting times) and the ability to finance the supply play an important role.
- Relation to needs (Relevance to need (for the whole community)): This is one of the dimensions that has not yet been considered in other models. The service provided must be geared towards the individual patient needs, and the relevance and appropriateness of the service should also be considered. This includes, for example, whether the treatment is carried out according to the latest knowledge. However, there is the risk that an increased amount of work is required by the staff, which under certain circumstances cannot be provided.
- Effectiveness (for individual patients): The effectiveness considers the results of the treatment under aspects of technical quality and evidence-based . This includes, for example, whether the goal was achieved and the best possible performance was achieved.
- Equity (fairness): This dimension was also not yet integrated in earlier quality assurance models . The equality is understood primarily as the equal treatment of all patients without discrimination . For this purpose, it is considered whether the services provided always meet the necessary needs (same services with the same needs). Above all, this dimension has led to patient needs being put in the foreground when quality management is improved in the healthcare system.
- Social acceptability: This is about the consideration of humane aspects in the provision of services, such as respect for privacy and consideration for the individual wishes of the patient.
- Efficiency and economy: This dimension is about achieving the best possible result with the least possible effort in terms of costs and work. Here, an economic approach is in the foreground.
With these six dimensions Maxwell wants to achieve that quality is viewed as a whole, but a better analysis is made possible through evaluation processes in different areas. In his article "Quality assessment in health" he makes this clear: "... keep it simple, while providing a framework within which the quality of care may be studied, discussed, protected, and improved." In addition, Maxwell points out that the Dimensions should not be taken too literally, but should rather serve as orientation and starting point, for example to facilitate the creation of new concepts. Above all, care should be taken to ensure that both the individual and the community are taken into account in quality assurance . Even if the division into six different dimensions is advantageous for more precise analyzes, there are also certain disadvantages. On the one hand, some dimensions overlap, which means that some evaluation criteria appear in several dimensions. On the other hand, the assessments in dimensions such as equality and social acceptance can be subjective.
Application examples
The Maxwell model of six quality dimensions was used in some areas of medicine and health care , for example in the organization of patient discharges, general quality management in intensive care units or in the development of audits . The latter is described in more detail below. However, when developing a concept, the audit commission summarized the dimensions of accessibility and equality, arguing that most problems in equality are based on a lack of accessibility. In this case, Maxwell accepted this, but stressed that despite some overlap, these dimensions could not always be grouped together. Even if the division into the individual dimensions cannot always be clearly differentiated, the main thing is not to see quality as a big whole. Maxwell describes this as follows: "The root idea is that the recognition of multidimensionality makes it far more possible to see where any specific criterion fits into a comprehensive, rounded view of quality." The division into the individual dimensions made it easier to see Which areas should be focused on in order to improve quality management . So they decided to put the technical quality and individuality of the patients in the foreground, this corresponds to the dimensions of effectiveness and social acceptance. At the same time, the other aspects of quality were not forgotten.
Rules for implementing quality
In addition to the six quality dimensions, a few years later Maxwell named eight rules that are necessary in the implementation of quality:
- 1. Employee commitment to achieve the best possible performance
- 2. Turning good ideas into action, these can also be implemented in small steps
- 3. Emphasis on teamwork, as a combination of different skills and abilities is required in all areas
- 4. Systematic elimination of obstacles and poor performance
- 5. Realizing that all work requires responsibility, which includes both good execution and continuous improvement in performance.
- 6. Implementation of interventions based on concepts such as the six dimensions
- 7. Development of systems for recording process optimization
- 8. Consider quality initiatives in a larger, systematic context
Individual evidence
- ↑ Heike Baum: Quality development and quality dimensions explained using teamwork. In: Martin R. Textor, Antje Bostelmann (Hrsg.): Das Kita-Handbuch. June 24, 2018. (kindergartenpaedagogik.de)
- ^ P. Hensen: Quality management in health care: Basics for study and practice. Springer Gabler, Wiesbaden 2016, p. 21.
- ↑ S. Fillip: Market-oriented conception of product quality. Springer Verlag, 1997, p. 29ff.
- ↑ S. Fillip: Market-oriented conception of product quality. Springer Verlag, 1997, p. 34.
- ^ P. Hensen: Quality management in health care: Basics for study and practice. Springer Gabler, Wiesbaden 2016, p. 23f.
- ^ J. Ribbeck: Quality Management in Social Enterprises: Basics - Systems and Concepts - Implementation and Control. Wallhalla Fachverlag, 2017.
- ↑ K. Parsley, P. Corrigan: Quality Improvement in Healthcare: Putting Evidence Into Practice. Nelson Thornes, 1999.
- ^ P. Hensen: Quality management in health care: Basics for study and practice. Springer Gabler, Wiesbaden 2016, p. 23f.
- ^ J. Ribbeck: Quality Management in Social Enterprises: Basics - Systems and Concepts - Implementation and Control. Wallhalla Fachverlag, 2017.
- ↑ K. Parsley, P. Corrigan: Quality Improvement in Healthcare: Putting Evidence Into Practice. Nelson Thornes, 1999.
- ↑ K. Parsley, P. Corrigan: Quality Improvement in Healthcare: Putting Evidence Into Practice. Nelson Thornes, 1999.
- ^ P. Hensen: Quality management in health care: Basics for study and practice. Springer Gabler, Wiesbaden 2016, p. 23f.
- ^ J. Ribbeck: Quality Management in Social Enterprises: Basics - Systems and Concepts - Implementation and Control. Wallhalla Fachverlag, 2017.
- ^ RJ Maxwell: Quality assessment in health. In: British Medical Journal. May 12, 1984, pp. 1470f.
- ^ M. Gottwald, G. Lansdown: Clinical Governance: Improving The Quality Of Healthcare For Patients And Service Users. McGraw-Hill Education (UK), 2014.
- ^ RJ Maxwell: Dimensions of quality revisited: from thought to action. In: British Medical Journal. 1992, p. 171ff.
- ↑ K. Parsley, P. Corrigan: Quality Improvement in Healthcare: Putting Evidence Into Practice. Nelson Thornes, 1999.
- ^ K Parsley; Corrigan, P .: Quality Improvement in Healthcare: Putting Evidence Into Practice. Nelson Thornes, 1999.
- ^ RJ Maxwell: Dimensions of quality revisited: from thought to action. In: British Medical Journal. 1992, p. 171ff.
- ^ RJ Maxwell: Dimensions of quality revisited: from thought to action. In: British Medical Journal. 1992, p. 171ff.