Quality circles originated in Japan after World War II and were inspired by W. Edwards Deming. Quality circles involve voluntary small groups of 6-12 employees who meet regularly to identify improvements in their work area. In healthcare, quality circles are used to (1) identify outstanding features of care, (2) identify obstacles to change, and (3) identify the need for more research. Examples of using quality circles in healthcare include reducing hospital-acquired infections, improving job satisfaction, and enhancing communication.

1. QUALITY CIRCLE
INTRODUCTION
 Quality circles were originally associated with Japanese management and manufacturing
techniques. The introduction of quality circles in Japan in the postwar years was inspired
by the lectures of W. Edwards Deming (1900-1993), a statistician for the U.S.
government.
 Quality circle is one of the employee participation methods. It implies the development of
skills, capabilities, confidence and creativity of the people through cumulative process of
education, training, work and experience.
 It also implies the creation of facilitative conditions and environment of work, which
creates and sustains their motivation and commitment towards work excellence.
 Quality circles have emerged as a mechanism to develop and utilize the tremendous
potential of people for improvement in product quality and productivity.
DEFINITION
 QC is a small group of 6 to 12 employees doing similar work who voluntarily meet
together on a regular basis to identify improvements in their respective work area using
proven techniques for analyzing and solving work related problems coming in the way of
achieving and sustaining excellence leading to mutual upliftment of employees as well as
the organization.
 It is a way of capturing the creative and innovative power that lies within the workforce.

2. FEATURES
1. Voluntary Groups: Quality circle is a voluntary group of employees generally
coming from the same work area. There is no pressure from anywhere on employees to
join quality circle.
2. Small Size: The size of the quality circle is generally small consisting of six to eight
members.
3. Regular Meeting: Quality circle meetings are held once a week for about an hour on
regular basis. The members meet during working hours usually at the end of the working
day in consultation with the manager. The time of the meetings is usually fixed in
advance in consultation with the manager and members.
4. Independent Agenda: Each quality circle has its own agenda with its own terms of
reference. Accordingly, each QC discusses its own problems and takes corrective actions.
5. Quality Focused: As per the very nature and intent of quality circle, it focuses
exclusively on quality issues. This is because the ultimate purpose of quality circle is
improvement in quality of product and working life.
QULITY CIRCLE IN HEALTH CARE
Healthcare quality is also preserved using quality control circles in such areas as drug
safety so that the lives of patients are not compromised in prescribing drugs and taking
the proper dosages. Quality control circles (QCCs) initiate a series of actions with
healthcare team members to inspire teams to take appropriate action, to share ideas, and
to create reciprocally helpful relationships. Clinical staff members must be prepared to
work as a collective unit to improve patient outcomes and to promote efficiency while
reducing medication errors for these patients. Quality control circles are designed to
initiate successful conversations regarding the development of new programs, processes,
and efficiencies that will lead to positive results for patients and for employees. These
efforts are effective contributors in renewing the spirit of the organization and its
healthcare-driven agenda to improve the quality of care that is provided at all times (Hu,
2011). Quality circles initiate conversations among practitioners for the good of the
patients. They are the brains that come together to minimize and prevent accidents in the
clinical area. The final product of any quality circle is viewed as better than that of an
individual doing all the thinking and prescribing
OBJECTIVES
1. Increase the morale of medical workers by improving their awareness of
spotting and solving medical problems
2. Improving medical working environments
3. Eventually increasing the quality of medical care
4. Reducing the costs of medical management
5. Increasing the efficiency of medical services

3. PROCESS OF OPERATION IN QUALITY CIRCLE
1. Problem identification:- Identify a number of problems
2. Problem selection:- Decide the priority and select the program to be taken up first
3. Problem analysis:- Problem is clarified and analyzed by basic problem solving methods
4. Generate alternative solutions:- Identify and evaluate causes and generate number of
possible alternative solutions
5. Select the most appropriate solution:- Discuss and evaluate the alternative solutions by
comparison in terms of better health care system and its effect on public health
6. Prepare plan of action:- Prepare plan of action for converting the solution into reality
which includes the consideration “who, what, when, where, why and how” of solving
problems.
7. Implementation of solution:- The management evaluates the recommended solution.
Then it is tested and if successful, implemented on a full scale
THE USE OF QUALITY CIRCLES IN HEALTH CARE
The use of quality circle in healthcare settings was design to improve the quality of care given to
patients. The intention is to bring health care professionals together in the treatment of patients
and to come up with a treatment that both satisfy the patient and reduce the risk for
polypharmacy. Quality circles have accomplished several benefits in the treatment of patients.

4. This paper will discuss three ways in which quality circles and feedback loops have been used in
health care settings.
1. Identification of outstanding features for care
The use of quality circle helps identify feature of care for patients in the same health population.
This process helps bring uniformity and standardization of care for patients suffering from the
same disease. It helps also in identifying what matters for patients and for the care providers.
This method bring the patient and the provider together on how to proceed with the treatment
and what are the goals and objectives to achieve. In providing the use of feedback loops,
providers are able to review patient’s conditions as a team and work together to better coordinate
care for that individual patient. In addition, the quality circle helps identify cultural obstacle to
seeking care and encourage the need to seek care whenever needed.
2. Identification of obstacles for change
By finding the reasons behind certain behaviors, quality circles and feedback loops can help to
identify barriers to practice change. Success will be more likely if the methods used to
implement change are chosen to address the prevailing barriers. The coming together of different
entities helps in identifying areas in which the procedures in use by the organization needs to be
reviewed or changed all together.“The complex structures and behaviors of healthcare
organizations are increasingly recognized as critical factors in determining the quality of care.
Qualitative methods offer a potential approach to assisting leaders of organizations to appreciate
some of the local issues to be considered when introducing new ideas or transforming systems of
care. However, more research is needed to investigate which qualitative methods could be most
useful, and in what circumstances they should be used. The need for collaboration is absolute in
all areas of healthcare, and the need for change based on clinical results and data is and should
more than welcome. In addition, those changes should be made after a series of consultation
between the clinical staff and the leadership.
3. Identify the need for more researches.
The use of quality circle and feedback loops has called for more researches and more evidence
practice to be part of the development of change and progress in the care of patients. What has
been proven in with the use of quality circle is that no system can remain homogenous for too
long, especially in the healthcare setting. The system needs to be challenged and changes need to
take place no based on one’s financial situation, need for renovation, but on the fact that clinical
data demands it. The quality circles challenge the in statu-quo and demand change in the system.
Such changes are often beneficial for the patients and the healthcare system in the same way.

5. EXAMPLES OF USES FOR QCS IN HEALTH
1. Patient Safety – Hospital Acquired Infections
Hospital acquired infections (HAIs) are a significant and ongoing problem for healthcare
organizations. Reduction and prevention of infection is best achieved through optimizing
processes and protocols between staff and patients. Infection Prevention Control Teams work
diligently to put strict guidelines in place and develop policies and procedures in organizations to
prevent, and if necessary, control an outbreak.
In spite of policies, procedures, and control measures, HAIs continue to plague healthcare
organizations. This may be attributed to high bed occupancy rates where patients with active
infection are forced to be cohorted with non-infectious patients; staff movement between
infectious and non-infectious patients, lack of designated equipment for infected patients, poor
cleaning processes, and failure to decontaminate surfaces are among reasons why infections
occur. HAIs are costly for an organization; and can lead to high morbidity and at worst mortality.
QCs can play an important role in management of HAIs as staffs are closest to the issues that
foster the chain of infection. Regardless of how much resource allocation is invested into HAIs,
it is not likely to improve if a culture of prevention is not pervasive throughout the organization;
down to the level of the front line.
QCs at the unit level can diagnose risk potential, analyze what factors are contributing to chain
of infection risk, and identify possible solutions. QCs can analyze and share surveillance data;
perform random audits, and provide immediate correction of potential risk factors, over and
above IPCTs, when staff are aware of, have ownership of and actively engaged in prevention.
Staff at the unit level may be more aware of factors that lead to non-compliance and therefore
can identify possible solutions to improve compliance.
2. Job Satisfaction
Many health care fields are facing a chronic professional shortage. High job stress, chronic staff
shortages, and poor employee morale lead to higher rates of staff turnover in many healthcare
organizations. Nursing in particular have well-documented issues pertaining to workload stress
and burnout.
Communication, participation in identifying issues, and problem-solving solutions can go a long
way toward improving morale. Participation can enhance a sense of personal ownership.
Recognition that staff aware of unit problems and recognition that this knowledge can in turn
contribute to problem-solving can create a sense of personal and unit empowerment.
QCs at a unit level can play a significant role in improving staff satisfaction; especially if
findings and recommendations that are born out of this group are heard and taken seriously by
management and executive. Staff satisfaction can reduce costly turnover.

6. 3. Communication
Healthcare organizations constantly introduce initiatives to improve quality and efficiency within
the organization. Every day there are numerous decisions made at the executive and management
level designed to maximize efficiency, balance staff to patient rations, manage costs, and direct
practice. Numerous committees, leadership and supportive personnel establish clinical practice
strategies, guidelines and initiatives to improve patient safety and satisfaction.
In spite of these well intentioned efforts, healthcare organizations all too often continue to be
plagued with error, patient and staff dissatisfaction, and soaring costs.
Often at the heart of these challenges is a poor or non-existent communication flow to the front
lines. Front line staff rarely has time during a busy shift to hear about the activities or initiatives
within an organization. Staffing challenges often preclude employees from having an opportunity
to participate in education sessions; or are forced to participate outside work hours. Many
organizations do not have company-wide electronic communication strategies such as email, etc.
Failure to communicate with or receive feedback from the front line can result in a sense of
disconnect or sense of feeling undervalued.
Quality initiatives are most successful when all internal stakeholders are actively engaged in QC.
Quality circles are important at the unit level to identify potential problems and together identify
potential solutions to quality.