This procedure describes the processes for Opportunities for Improvements and related Customer Satisfaction Monitoring, the monitoring and measurement of processes, the implementation of corrective actions and lessons Learned (including the management of customer complaints) and the continual improvement of the Educational Organisational Management System (EOMS) effectiveness.
This procedure contains the following sections:
5.1 Opportunity for Improvement;
5.2 Process monitoring and measurement;
5.3 Risk Audits - Analysis of data and evaluation of conformance;
5.4 Control of non-conformity and or Incidents;
5.5 Continual Improvement and Customer Satisfaction;
5.6 Corrective action and Lessons Learned.
MR: Management Representative;
QRA: Quality Systems Risk Auditor;
CI: Continuous Improvement;
EOMS: Educational Organisational Management System.
Whilst the MR is responsible for the overall implementation of this procedure, including the gathering of customer satisfaction data and the implementation of improvement activity the whole of the Leadership Team including both Directors are ultimately responsible for the EOMS. The MR is also responsible for planning and overseeing ACI Global’s Key Objectives, Goals and Programs.
The Leadership Team along with the Quality Systems Risk Auditor are responsible for the monitoring of the Eduactional Organisations Management System (EOMS) effectiveness through audit and process review.
All opportunities for improvement are monitored and analysed to ascertain ongoing continual improvement and customer satisfaction. Any service problems or improvement suggestions can be received by any member of staff. A record of correspondence related to opportunities for improvement is maintained within the “Quality” Improvements Register.
Improvement suggestions can also be documented by any member of staff and logged within the e- Quip tracker program. Improvement actions are also reviewed and documented as an output of ACI Global’s Business Review.
If the Organisations Key Objectives and Goals have been reached and can be maintained, then the targets are stretched to ensure that ACI Global meets its objective of continual improvement and performance growth.
The Managing Director is responsible for planning and overseeing the Organisations Key Business Objectives, and associated Targets and Programs in accordance with the following business objectives which are further supported by its Corporate Social Responsibility Report, Mission, Vission and Values and Culture and Business Review Process:
"Quality" Business key processes and procedures are verified by ongoing audit activities and process monitoring – this includes key characteristics of the business that can have a significant “Risk” impact. These measures are used to monitor “Quality” business and operational processes to determine that planned results have been achieved including conformity with the organisations objectives and targets. Audit non-conformities and their associated corrective actions are recorded on an Audit Report form e-Quip Exemptions Report.
Where process monitoring and review identify that planned results are not being achieved or performance could be improved, the NC or improvement suggestion is recorded on the e-Quip tracker program. Where appropriate, corrective action is taken to ensure continued conformity of service is maintained at all times. The following Key Processes are closely monitored as high risk:
ACI Global's process approach applies systematic definition and management of its core processes and their interactions, so as to achieve the intended results in accordance with the organisations Business "Quality" Policy and the strategic direction of the organisation. Key processes are monitored through both self assessment and business review.
Appropriate data is determined, collected and analysed to demonstrate the effectiveness of the EOMS and operational processes through Risk based audits. This data is then used to evaluate where improvements in business system effectiveness can be made.
The data generated from monitoring and measurement or other relevant sources is analysed to provide performance information relating to:
Results of data analyses through Risk based audits are reviewed monthly and tracked through both the e-Quip tracker program and Outlook 365 and further reviewed during Annual Business Review meetings.
The evaluation of conformance with applicable legal requirements is included in the risk auditing activity and Business Review. This also includes other requirements to which ACI Global subscribes – these other requirements are generally included within the website under Accreditations.
Where a non-conformity is identified with the activities and services provided by ACI Global, this will be recorded within the Exemptions Report for ACI Global, investigated and acted upon as appropriate. All such instances are subject to review in line with the degree of concern. Records of non-conformity are maintained and analysed as part of Business Review. Products or services are reviewed by authorised staff in order to determine any remedial action and any remedial work is subsequently inspected.
Where non-conformity has a significant "Risk" impact or has resulted in an emergency situation that has an adverse organisational impact, this will be dealt with in accordance with Emergency Response Procedure as outlined within the ACI Global ERM Policy and ACI Global’s Continuity Plan.
The effectiveness of the EOMS is continually improved through the review of the Business “Quality” Policy Statement and Key Organisational Objectives and Goals, the analysis of audit results, corrective and preventive actions, customer feedback and associated data.
Planned changes and Improvement suggestions can also be documented by any member of staff within the e-Quip tracker. Planned changes and improvement actions are also reviewed and documented as an output of the Business Review.
Once changes are approved the required changes are adopted within e-quip, proofed and validated against the courses (Needs Analysis, Key Competencies, Learning Outcomes) before release to learners.
If the Business "Quality" Objectives have been reached and can be maintained, then the targets are stretched to ensure that the company meets its objective of continual improvement and performance growth. The Managing Director is responsible for planning and overseeing Key Organisational Objectives, Targets and Programs in accordance with the organisations approved organisational objectives and goals.
Any non-conformity is analysed to develop corrective actions which eliminate root cause and prevent re-occurrence. This reporting procedure includes the activities and requirements for:
Records of corrective actions are reviewed at six monthly Management Review meetings to establish if any trends can be identified. If so, these trends are used to allocate resources for corrective actions and improvement activities.
Any changes to management system procedures found necessary are implemented, verified and recorded as appropriate.