Standards and Quality Management in Health IT

Health care traditionally has lagged behind other industries in quality improvement. It has been suggested that medicine should follow the lead of the airline and other industries by using quality management to decrease unnecessary variation and improve quality (Leape, 1994). An IOM report supported this contention when the authors suggested that the American health care system can improve the quality of care by borrowing techniques used in other industries to standardize processes (Kohn, 2000). Many of these techniques are based on systems theory. 

Chapter 20, Applied Ergonomics Significance and Opportunity, and Chapter 21, On Quality Management and the Practice of Safety, address the design, engineering, and risk assessment aspects that are fundamental in those endeavors. Comments are included in Chapter 18, Prevention through Design The Standard, on the extensive involvement at the National Institute for Safety and Health (NIOSH) on its PtD initiative. 

The establishment of a standard in general, and for an occupational health and safety system in particular, takes a lot of time. This is especially so because employers federations have been against the development of an occupational health and safety standard for fear of the proliferation of certification. However the new ISO 9000 (2000 version) is a formal management system, which defines the environment within a business and can also take into account requirements for an occupational health and safety system. It offers opportunities, for example through ITA s, to add health and safety requirements to the management system, even if there are no regulatory requirements or standards to date. This being the case, it is questionable whether there is a real need to have a separate standard for an occupational health and safety system, because it can be treated as part of (Total) quality. 

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