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Quality Management System Powerpoint Presentation Slides

A Quality Management System (QMS) is a framework that helps organizations to manage their quality assurance and quality control processes. Quality management systems are designed to help organizations to improve their performance and meet their customers' expectations. SlideTeam has put together a comprehensive package of quality assurance ppt templates to help you get up to speed on the basics of quality management. Our templates are easy to use and can be customized to fit your specific needs. Plus, they’re free to download so you can start using them right away! So get started today and see how our quality assurance ppt templates can help you improve your business processes.

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• Quality management systems: An introduction

How do successful businesses thrive in our ever-more competitive world? Some are driven by a charismatic leader; others rely on the power of the collective. But there is one ingredient which, from corner store to corporate powerhouse, is essential for healthy long-term success. Quality.  

That is why effective quality management is an imperative for any successful business today. In our age of innovation and rapidly shifting expectations, keeping pace with the times means committing to a journey of continuous improvement. And achieving this goal requires a foundation of sound quality management systems .  

An effective quality management system (QMS) provides the means to consistently meet consumer expectations and deliver products and services with minimal waste. In today’s highly competitive global economy, having a QMS in place is the prerequisite for sustainable success. 

Table of contents

What is a quality management system .

In the most simple terms, a quality management system is a clearly defined set of processes and responsibilities that makes your business run how it’s supposed to. Each organization tailors its own QMS, comprising a formal set of policies, processes and procedures established to elevate consumer satisfaction. A QMS guides organizations as they standardize and enhance quality controls across manufacturing, service delivery and other key business processes. 

The core benefits of a QMS include: 

• Elevated consistency and standardization of processes and outputs 
• Reduced errors and increased operational efficiency 
• Improved customer satisfaction through the delivery of quality products and services 
• Continuous evaluation and improvement of organizational operations 

What is a digital QMS? 

A QMS can be delivered digitally rather than using paper checklists and forms. This saves organizations time, mitigates risk and minimizes the chance of human error. Implementing a digital QMS requires meticulous planning and execution, and needs to be designed to comply with relevant regulations and industry standards, incorporating robust digital security measures to protect data. 

All of these approaches call for expert guidance. 

Types of quality management systems 

A QMS may be based on either domestic or international standards. Different QMSs respond to different needs and scenarios, and organizations can choose to implement just one, or integrate a blend of different approaches. Among the most common are: 

• Standardized systems : These set the bar for established standards and agreed-upon codes and practices, such as certifications against ISO standards. ISO 9001 outlines requirements for a comprehensive QMS and provides guidance for organizations looking to implement or improve their quality management strategy. 
• Total quality management (TQM) : TQM is a management philosophy centred on customer satisfaction through the active participation of every employee. Its goal is to support the continuous improvement of quality across all levels and business functions. 
• Lean management : Inefficiencies can result in unnecessary waste. Lean management strives to maximize customer value while minimizing waste using tools like value stream mapping, which helps fine-tune an organization’s processes for optimum efficiency. 
• Six Sigma : Although perfection is almost impossible to reach, the pursuit of it is still worthwhile. Six Sigma uses data-driven techniques in the pursuit of producing near-perfect products and services, with a defect rate of 3.4 per one million opportunities. While that’s not perfect, it is pretty close. 

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Benefits of using a quality management system 

There are numerous reasons to establish a QMS. Standardized processes improve efficiency and enhance productivity through the reduction, or even elimination, of redundancies and waste. Defect prevention reduces costs associated with reworking or scrapping. 

QMS audits excel at recognizing potential problems before they occur, thereby significantly reducing risk. What’s more, a QMS streamlines the record-keeping process, with improved documentation facilitating traceability and accountability  – and aiding in regulatory compliance . A QMS also functions as a troubleshooting process, providing performance metrics and built-in audits to uncover weaknesses, establishing a solid foundation for improvement.  

Consistent quality leads to happy, satisfied customers who become informal brand ambassadors within their communities. So they create further business opportunities and the potential for increased market share. Any real-world example of a QMS will aptly demonstrate this: Companies who have built a successful quality system are more likely to achieve their business goals, driving higher-loyalty, frictionless customer journeys. 

Why is a quality management system important? 

Every organization wants to strive for excellence. Because, ultimately, the quality of a product or service is what the customer gets out of it and is willing to pay for. Quality management plays a crucial role in delivering a superior experience, which in turn influences a company’s growth and performance.  

Here are six good reasons to consider investing in a quality management system: 

• Brand reputation : This is priceless, of course. A brand is more likely to gain international recognition when an organization surpasses established quality benchmarks. 
• Customer retention : Consistently meeting, or exceeding, customer needs and expectations fosters loyalty. When high standards are met or surpassed, why would customers go anywhere else? 
• Business sustainability : Consistently delivering excellence ensures and maintains a steady supply of customers. Doing business sustainably, and producing minimal waste, is the best way to grow and future-proof an organization. 
• Compliance : Meeting regulatory, safety and quality standards is a must and a QMS seamlessly facilitates this process. 
• Competitive edge : Higher-quality products and services give businesses a competitive advantage in complex times. 
• Staff engagement : Employees who feel they are involved in quality improvements tend to experience higher engagement and productivity. 

Journey to excellence 

Developing an effective quality management system doesn’t happen overnight, but requires careful planning and execution. So, what are some of the key steps to success for an organization starting out on its QMS journey? 

• Secure leadership commitment : Building a QMS requires alignment at the executive level. 
• Document processes : Identify and thoroughly document procedures associated with existing quality processes. 
• Define metrics : Performance-tracking metrics should be determined to ensure they meet QMS requirements. 
• Training : All employees will need initial and ongoing training in order to build understanding and engagement with the QMS. 
• Audits : Regular self-audits on processes and procedures will ensure compliance and effective implementation. 
• Review system performance : Regularly assess system performance in order to make improvements as needed. 

It’s important to note that while the steps outlined above provide a high-level overview, building and sustaining an impactful QMS takes considerable effort and commitment across multiple areas of an organization.

ISO 9001  Quality management systems

The bottom line 

In today’s competitive marketplace, maintaining high-quality standards is more crucial than ever. As a business owner, you’re aware that customers will continue coming if they know that you will deliver them the product or service they need. This calls for company processes that are reliable, effective, trustworthy and streamlined – aligning business objectives and bottom lines with consistency and excellence. While this may sound like a no-brainer, how do you ensure a formalized process that documents each step, the desired outcomes, ways to improve, and the end results? 

A quality management system may be just the solution you’re looking for. 

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Quality Management System

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Quality Management System Templates for PowerPoint & Google Slides

Download our 100% editable Quality Management System Template to make analysis more accessible, faster, and accurate. The QMS assists businesses in documenting their quality procedures. This template makes it easier to communicate the idea to your audience or employees by displaying the entire process at once.

These Quality Management System Presentations are professionally and creatively designed, utilizing all necessary PowerPoint elements such as icons, shapes, charts, graphs, colors, clip-arts, etc. Download one of these templates to enjoy creativity at its peak.

Taguchi’s Quality Loss Function Curve PowerPoint Template

PDCA PowerPoint Template

Muda 7 Types Of Waste PowerPoint Template

9 Steps Circular Diagram With Service Icons

Flat DMAIC PowerPoint Template

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Quality Management System Circular Diagram for PowerPoint

A Quality Management System (QMS) is a system deployed by organizations to document the internal strategies, methods, and management. It helps develop and produce high-quality products or services for customers. We have several-made templates that can assist you in analyzing your company’s quality. The Muda 7 Types Of Waste PowerPoint Template is one of these visually appealing templates that can help you identify loops that waste company resources and provide solutions.

In addition, QMS assists a company in reaching the regulatory and consumer standards and constantly modifying its processes. Furthermore, you must prioritize quality as it is critical in any business. It represents the company’s integrity, ensuring buyers always buy your products. Quality contributes to increased brand loyalty. It even promotes word-of-mouth marketing, lowering the cost of other forms of marketing. These templates include everything you need to make your Quality Management System Presentation flawless and communicate effectively with your audience.

What Are the Advantages of Having a Quality Management System Template?

The following are some of the reasons why you should use the QMS template:

• It assists businesses in maintaining consistency in the production and delivery of their products and services.
• It aids in the identification and analysis of compliance issues.
• Internal audits benefit from QMS data.
• It educates employees about an organization’s integrity and increases collaboration to meet customer expectations.
• It reduces waste and lowers business costs.
• It assists the company in identifying errors and risks and provides a better way to prevent them.
• Our pre-made templates simplify the analysis of QMS data.

How Can You Tell if a Quality Management System Is Working?

There are two primary methods for determining a quality management system’s effectiveness.

Data Comparison means comparing data obtained before QMS implementation to data obtained following implementation. The comparison will reveal whether the procedure is effective or not. This analysis will also highlight areas that require further investigation.

In Qualitative Feedback , we recognize: that the primary goal of QMS is to assist an organization in meeting the needs of its customers. Create a channel for your customers to provide honest feedback; this will reveal how effective the QMS you implemented was. You can collect data by conducting surveys.

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Quality Management System: Implementation

Sep 18, 2012

2.18k likes | 5.7k Views

Quality Management System: Implementation. Objectives. To provide information on implementation of a quality management system including: An implementation plan Quality manager Document and records Policies, processes and procedures Quality system essentials Quality policy statement

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Objectives To provide information on implementation of a quality management system including: • An implementation plan • Quality manager • Document and records • Policies, processes and procedures • Quality system essentials • Quality policy statement • Quality manual • Continual quality improvement

Implementing a Quality Management System: Some Tips • QMP-LS does not dictate how a facility must approach the task of implementing processes or their QMS • Our program requirements lay out the basic elements of a quality management system • How a facility develops its QMS is up to facility management • OLA assesses the end result, not the manner in which your system was implemented • CLSI (NCCLS) outlines one approach in HS1-A and GP26-A • The following slides lay out a simplified version

Implementation of a Quality Management System 1. Get commitment from top management 2. Communicate your intent to all staff 3. Appoint a responsible individual (“quality manager”) 4. Review OLA requirements 5. Prepare an implementation plan 6. Prepare quality policy statement 7. Prepare quality manual: a compendium of policies* 8. Map processes as they are now * 9. Determine the gaps in processes and associated documentation * Note: Steps 7 and 8 can be reversed

Implementation of a QMS (continued) 10. Prioritize the redesign of processes 11. Plan and document the new processes 12. Verify the new processes 13. Plan and document the associated procedures 14. Communicate and train staff 15. Implement the processes 16. Measure the effectiveness of the processes 17. If problems are identified, modify the processes and go back to step 11

Quality Manager • An individual responsible for ensuring compliance with the quality management system; director retains ultimate responsibility • Can be either a full-time or part-time activity • Ensures the quality manual is kept up to date • Plans internal audits • Reports directly to the level of management where decisions are made on laboratory policy and resources

Define and Document What is Done • Take a systematic approach to address all operations in the path of workflow: pre-analytical, analytical and post-analytical • This is an enormous task, and will not take less than a year • Define what you currently do, then move toward improvement • Laboratory management should set priorities based on which processes most directly affect outcomes to patient results, and improve those first • Input from the people actually doing the work is essential • Input from users of the service is essential • Process mapping is essential

Documents and Records: Definitions • Documents: any information that provides direction • Policies, processes, procedures • Specifications • Plans • Regulations and standards • Records: any information that produces evidence • Requisitions • Examination results and reports • Quality Control and EQA records • Incident/Accident reports

Documenting the System • There are three types of documents used to describe laboratory protocols: • Policies • Processes • Procedures • The means of documentation can be electronic or paper • The next ten slides describe policies, processes, and procedures in detail

Policies Processes Procedures Documenting the System

Policies • Statements describing what is done and why • Define goals, briefly state the intent and direction • If your laboratory chooses to follow the CLSI model, typically, there is one policy for each Quality System Essential as listed on slide #24 • The twelve QSE policies form the basis for the Quality Manual • There may be additional “operational” policies that require documentation • Refer to supporting processes, procedures or other documentation, i.e. a list of related documents should be included

Processes • A series of inter-related steps involved in an activity or examination that uses resources and is managed to transform inputs into outputs • Usually displayed as flowcharts and illustrate the path of workflow and who is responsible • They do not include step-by-step instructions for individuals wanting to know exactly how to do something • Example: Process for Specimen Reception and Accessioning (a flow chart to show the steps involved in specimen reception and accessioning, involves more than one individual, but does not give detailed work instructions)

Processes • CLSI (NCCLS) documents HS1-A and GP26-A have some excellent examples of processes in both table and flow chart formats. • Typical processes for a laboratory service include those that follow a test from the time a health-care professional decides the test is needed through to the receipt of the test report: test ordering, specimen collection, specimen transport, specimen receipt, specimen referral, testing, interpretation, reporting. That is, pre-analytical, analytical and post-analytical processes. • Note that half of these processes do not occur within the laboratory itself, but that the laboratory still has a responsibility to document them.

Processes • Beyond these obvious processes all of the 12 Quality System Essentials (QSE) listed on slide #24 require process mapping • Examples of all of these can be found in CLSI (NCCLS) HS1-A and GP26-A • Each of the quality system essentials requires one or more processes, most of which will be linked • The output of one process is often the input to the next • Rarely is there a process that is not linked to another

Mapping Processes: Step One Map the BASIC process: • Identify and map the primary process in your facility • Begin at the highest and simplest level possible: a simple flow chart that traces a laboratory examination from physician order to the reported result • Identify the input (physician order) and the output (reported result) and all of the major steps that transform the physician order into a reported reported result • Begin with the “AS IS” process, i.e. what you are doing right now. This will allow you to identify problems and revise the process • You need to know where you are at, before you can determine where you are going!

Mapping Processes: Step Two Map the processes down to greater detail • Map processes for each of the essential elements of a quality management system: these are discussed in greater detail in unit 5 • Determine the sequence and interaction of the processes • Usually the output from one process will form the input to the next, but the relationship may be far more complex in some cases • Clarify the start and stop of each process to avoid creeping beyond the boundaries of the process being defined • Identify the personnel position responsible for each step of a process • Be sure to involve these individuals when mapping • Remember to map the processes AS THEY ARE NOW to allow you to identify problems and improve the processes

Implementation of Processes Define the criteria for determining that the process is effective. • This involves setting goals for quality performance, for example: • The Westgard rules for the quality control of quantitative results • The criteria for an acceptable and an unacceptable specimen • Target turnaround times Ensure that there are adequate resources available to implement the process • A primary function of laboratory management is to ensure that there is adequate staff and that the staff have the materials they need to do the job right Train staff and implement the process. • Effective communication and training is the key to success

Procedures • A procedure is the written work instructions that specify a way to carry out an activity, examination or step in a process. It is a set of step-by-step instructions that each individual follows • Form the classical procedure manual • Example: Procedure for performing an ABO group (the step-by-step instructions for a technologist to follow when performing the test)

Procedures • These should be written so that any individual who has a role in a process has detailed instructions to follow. • There must be step-by-step instructions available for a good number of tasks beyond technical procedures, such as responding to complaints from users of the laboratory service, validating equipment before use, accessioning specimens, entry of results into a laboratory information system. • The process flowcharts will prove to be invaluable tools to help pinpoint activities for which written procedures aremissing. • CLSI document GP2—A: Laboratory Documents: Development and Control is an excellent resource for procedure templates.

What is required for formatting? • Laboratories have the latitude to write their manuals in keeping with their own unique situation and scope of practice. • Laboratories are NOT required to revise manuals to conform to a specific template. • Assessors do not need to look for any particular format. • We do require that that appropriate document control procedures for review, identification, revision, etc. as described in section II.F (summarized on slide 21) are followed. • All analytical procedures must have the elements as described in program requirement VI.3. • The templates provided in CLSI GP26-A, and GP2-A meet our expectations and are an excellent resource.

Identification of Documents All quality management system documents must have an identification in the form of a header or footer that contains the following information: • Date of issue • Edition and/or current revision date and/or revision number • The number of pages within • Authority for issue • An electronic identification, if applicable

Document and Record Control • All documents must be approved prior to use • Changes to documents must be approved by authorized personnel • May be on any appropriate medium • Available at all locations • Reviewed periodically • For obsolete documents • Remove promptly or assure against inadvertent use • Retain for a defined length of time • Identify the document as obsolete

Documentation Hint • Since a major goal of implementing a QMS is CONTINUAL IMPROVEMENT, be sure that the system documenting policies, processes, and procedures can be easily modified by authorized personnel. • The expectation is that laboratory management will respond to opportunities for improvements, possibly by modifying protocols.

Organization Personnel Equipment Purchasing and inventory Process control Documents and records Information management Investigation of non-conformities Assessment Process improvement Service and satisfaction Facilities and safety The Quality System Essentials (QSE) • The QMS must encompass all management activities and processes relating to quality assurance. • These can be categorized into twelve essentials:

Quality Policy Statement • A document that defines the overall intentions and direction of the quality management system • Demonstrates the facility’s commitment to quality with clear leadership by top management • Leaders shape the culture of the lab: their commitment is the key to success

QMP-LS Quality Policy Statement • QMP-LS commits to maintain a quality management system to support high quality laboratory accreditation, external quality assessment and education services that: • Meet all clients’ needs; applicable regulatory, statutory and contractual requirements; and relevant national/international standards. • Evaluates and continually improves the effectiveness of the services provided. • Ensures this policy is communicated to and understood by all employees. • Provides a process for establishment, review and modification of quality objectives. • Reviews and modifies this policy for continued suitability.

Quality Manual • A compendium of policies to describe the laboratory’s quality management system • Format can vary, usually will be contained in a single volume • Can be electronic or paper • Must be easy to update • All personnel given instructions on its use • Maintained and reviewed by the quality manager

Quality Manual • Includes a description of the laboratory • Includes quality policy statement • Defines policies of the laboratory • Makes references to supporting processes and procedures, but does not include them • If a policy is documented and included in the quality manual, it must reflect actual laboratory practice • Validation of policies will be sought during the assessment visit

Quality Manual Review • Prior to each assessment visit, laboratories are asked to submit the results of a self-assessment of their quality manual. • Self-assessment form includes an evaluation of the physical aspects of the manual (i.e. table of contents, introduction, glossary, identification). • In addition, the form provides a pre-assessment of the facility’s policies as defined by the requirements and serves as a guide for assessors to locate laboratory documents when on-site

Continual Quality Improvement • Once your Quality Management system is fully documented, do not expect it to stay static for long. • The next phase is continual improvement through the use of quality indicators, internal auditing, investigation of non-conformities, and management review. • This is a primary objective of the QMS. • Continual improvement is a never-ending loop wherein a facility : • plans for a policy/process/ procedure (PLAN); • communicates it and implements it (DO); • monitors it to see if it works (CHECK) and • if a problem is identified, formulates a new or revised plan (ACT).

Continual Quality Improvement

Analysis of Indicators • Term used to describe ways of measuring how well the quality system is working. • The analysis of daily quality control charts is the indicator most familiar to laboratory personnel, but there are measures of the pre- and post-analytical phases as well. • OLA does not dictate the use of any specific indicators. • Facilities are expected to choose indicators to reflect critical issues to outcome, or problematic issues. • Facilities should include all aspects of the service, pre-analytical, analytical and post-analytical, inpatients and outpatients, referral labs, point-of-care tests

Analysis of Indicators • Analysis is conducted by comparing against a “benchmark” where available • Lab’s own experience • Practice guidelines • Published references • Trend analysis • Remember that something must be done with the data gathered: identify opportunities for improvement and formulate an action plan.

Analysis of Indicators • Examples of pre-analytic indicators: • Specimen transport times • Wrist band checking • Quality of phlebotomy • Specimen acceptability rates • Examples of analytic indicators: • QC and EQA results • Computer downtimes • Correlation of tests e.g. POCT vs lab based results • Examples of post-analytic indicators: • Critical value reporting • Reflexive testing • Turnaround times • Reporting errors

Non-conformities • Non-fulfillment of any requirement in the performance of a laboratory examination or test. Identified from many sources, including audits, quality control, staff comments and clinician complaints. • Instances where something has gone wrong in a process. • Laboratories are expected to keep records of non-conformities and corrective actions taken. • Non-conformance reports are the biggest and best source of information for continual improvement.

Internal Audits • Recommend conducting once per year • Planned by the quality manager • Personnel should not audit their own work • Reviewed by management • Corrective or preventive actions identified, documented, and measured

Management Review • Recommend that the quality management system documentation be reviewed and signed periodically by laboratory management. • Review: reports from managerial/supervisory personnel, internal audits, external assessments, non-conformity reports, indicator analyses, feedback, etc. • Recommend that action plans for improvement are appropriately identified, developed, implemented and monitored.

Final Comments • Everyone is responsible for ensuring that the protocols of the QMS are followed. • This includes top management, directors, managers, MLTs, laboratory assistants and clerical staff. • All personnel need to be aware of what is expected of them as individuals. • It is NOT ENOUGH just to write down a series of protocols—they must be followed and they must be proven to WORK. • Each laboratory should be able to provide evidence that its processes are effective in meeting the goals defined in their policies. • It is up to the laboratory to define what records and documentation are necessary to provide this supporting evidence.

Self-Assessment

Question 1 Which of the following statements is correct? • A process states the goals of the facility. • Processes do not include step-by-step instructions. • A process only involves one individual. • Processes should always be discrete and never linked.

Question 1 The correct answer to question 1 is b) Processes do not include step-by-step instructions, these are PROCEDURES.

Question 2 Which of the statements regarding procedure manuals is correct? • Laboratories have the latitude to write their manuals in keeping with their own unique situation and scope of practice. • Laboratories are required to revise manuals to conform to the templates in CLSI GP2-A • Assessors must ensure that all manuals conform to the QMP-LS format. • Procedure manuals do not fall under the rules for document control.

Question 2 The answer to question 2 is a) Laboratories have the latitude to write their manuals in keeping with their own unique situation and scope of practice. While GP2-A is an excellent resource for those looking for a template, we do not require every facility to revise their manuals to conform to it.

Question 3 A suitable plan for continual improvement can be summarized as: • CHECK  PLAN  DO  ACT • DO  ACT  CHECK  PLAN • PLAN  DO  CHECK  ACT • PLAN  ACT  CHECK  DO

Question 3 The answer to question 3 is c)

Question 4 To be in compliance with OLA program requirements, each facility must designate a full-time “Quality Manager” • TRUE • FALSE

Question 4 The correct answer to question 4 is b) FALSE The responsibility for quality management must be assigned to an individual (quality manager or otherwise titled), but this can be either a full-time or part-time activity given in addition to other responsibilities.

Question 5 Which of the following statements is incorrect? • OLA assesses the manner in which each facility implemented their QMS. • Policies define goals and briefly state the intent and direction of the facility. • There must be step-by-step instructions for tasks other than technical procedures in the analytical phase. • The quality manual makes references to supporting processes and procedures, but does not include them.

Question 5 The answer to question 5 is a). OLA assesses the end result, not the manner in which a facility’s QMS was implemented.

Additional Optional Resources • ISO 9000:2005. Quality management systems—Fundamentals and vocabulary. • ISO 9001:2000. Quality management systems—Requirements. • ISO 9004-2000. Quality management systems—Guidelines for performance improvements • ISO 17025. General Requirements for the Competence of Testing and Calibration Laboratories.

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• About Adverse Childhood Experiences
• Risk and Protective Factors
• Program: Essentials for Childhood: Preventing Adverse Childhood Experiences through Data to Action
• Adverse childhood experiences can have long-term impacts on health, opportunity and well-being.
• Adverse childhood experiences are common and some groups experience them more than others.

What are adverse childhood experiences?

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). Examples include: 1

• Experiencing violence, abuse, or neglect.
• Witnessing violence in the home or community.
• Having a family member attempt or die by suicide.

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding. Examples can include growing up in a household with: 1

• Substance use problems.
• Mental health problems.
• Instability due to parental separation.
• Instability due to household members being in jail or prison.

The examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and well-being. This can include not having enough food to eat, experiencing homelessness or unstable housing, or experiencing discrimination. 2 3 4 5 6

Quick facts and stats

ACEs are common. About 64% of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six (17.3%) adults reported they had experienced four or more types of ACEs. 7

Preventing ACEs could potentially reduce many health conditions. Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs. 1

Some people are at greater risk of experiencing one or more ACEs than others. While all children are at risk of ACEs, numerous studies show inequities in such experiences. These inequalities are linked to the historical, social, and economic environments in which some families live. 5 6 ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work. 7

ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States. 8

ACEs can have lasting effects on health and well-being in childhood and life opportunities well into adulthood. 9 Life opportunities include things like education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, and involvement in sex trafficking. They can also increase risks for maternal and child health problems including teen pregnancy, pregnancy complications, and fetal death. Also included are a range of chronic diseases and leading causes of death, such as cancer, diabetes, heart disease, and suicide. 1 10 11 12 13 14 15 16 17

ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, can cause toxic stress. Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning. 18

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. 18 These effects can also be passed on to their own children. 19 20 21 Some children may face further exposure to toxic stress from historical and ongoing traumas. These historical and ongoing traumas refer to experiences of racial discrimination or the impacts of poverty resulting from limited educational and economic opportunities. 1 6

Adverse childhood experiences can be prevented. Certain factors may increase or decrease the risk of experiencing adverse childhood experiences.

Preventing adverse childhood experiences requires understanding and addressing the factors that put people at risk for or protect them from violence.

Creating safe, stable, nurturing relationships and environments for all children can prevent ACEs and help all children reach their full potential. We all have a role to play.

• Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1 .
• Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Science Direct. 2022; 22:7; 1105-1114. DOI: https://doi.org/10.1016/j.acap.2022.04.010 .
• Smith-Grant J, Kilmer G, Brener N, Robin L, Underwood M. Risk Behaviors and Experiences Among Youth Experiencing Homelessness—Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts. Journal of Community Health. 2022; 47: 324-333.
• Experiencing discrimination: Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health | Annual Review of Public Health https://doi.org/10.1146/annurev-publhealth-090419-101940 .
• Sedlak A, Mettenburg J, Basena M, et al. Fourth national incidence study of child abuse and neglect (NIS-4): Report to Congress. Executive Summary. Washington, DC: U.S. Department of Health an Human Services, Administration for Children and Families.; 2010.
• Font S, Maguire-Jack K. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390-399.
• Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2 .
• Bellis, MA, et al. Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences Across Europe and North America: A Systematic Review and Meta-Analysis. Lancet Public Health 2019.
• Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021 | MMWR
• Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004 Feb;113(2):320-7.
• Miller ES, Fleming O, Ekpe EE, Grobman WA, Heard-Garris N. Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes. Obstetrics & Gynecology . 2021;138(5):770-776. https://doi.org/10.1097/AOG.0000000000004570 .
• Sulaiman S, Premji SS, Tavangar F, et al. Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review. Matern Child Health J . 2021;25(10):1581-1594. https://doi.org/10.1007/s10995-021-03176-6 .
• Ciciolla L, Shreffler KM, Tiemeyer S. Maternal Childhood Adversity as a Risk for Perinatal Complications and NICU Hospitalization. Journal of Pediatric Psychology . 2021;46(7):801-813. https://doi.org/10.1093/jpepsy/jsab027 .
• Mersky JP, Lee CP. Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample. BMC pregnancy and childbirth. 2019;19(1). https://doi.org/10.1186/s12884-019-2560-8 .
• Reid JA, Baglivio MT, Piquero AR, Greenwald MA, Epps N. No youth left behind to human trafficking: Exploring profiles of risk. American journal of orthopsychiatry. 2019;89(6):704.
• Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. Child Abuse & Neglect. 2020 Jun 1;104:104468.
• Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, & Section on Developmental and Behavioral Pediatrics (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
• Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, Masten AS. Intergenerational continuity of adverse childhood experiences in homeless families: unpacking exposure to maltreatment versus family dysfunction. Am J Orthopsych. 2017;87(1):3. https://doi.org/10.1037/ort0000133 .
• Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, Leeb R. Intergenerational continuity in adverse childhood experiences and rural community environments. Am J Public Health. 2018;108(9):1148-1152. https://doi.org/10.2105/AJPH.2018.304598 .
• Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relationships as a moderator of intergenerational continuity of child maltreatment: a meta-analysis. J Adolesc Health. 2013;53(4 Suppl):S32-38. https://doi.org/10.1016/j.jadohealth.2013.05.004 .

Adverse Childhood Experiences (ACEs)

ACEs can have a tremendous impact on lifelong health and opportunity. CDC works to understand ACEs and prevent them.