Quality improvement initiatives in modern healthcare are ubiquitous features because of the perceived and actual gaps in delivering quality healthcare. Evaluation is normally conducted to ensure healthcare objectives are achieved, provide information for healthcare providers, commissioners, and service users among others about the quality of services provided and establish future improvement basis. This paper is a quality improvement process for my medical facility employer.
Methods to Measure Quality Improvement
Quality improvement processes for various areas in my healthcare facility will be evaluated qualitatively and quantitatively using quality improvement methods. The methods will enable understanding of care processes and inform how to provide improvements ( National Academies of Sciences, Engineering, and Medicine, 2015) . The methods will include clinical audits which are a critical and systematic analysis of medical care quality, including the diagnostic and treatment procedures, resource utilization, and resulting patient outcomes by building evaluation into the process. Clinical audits involve evaluation of care ("how the organization is doing") against established standards and criteria ("what the organization should be doing") through which measures in performance, as well as changes in performance, can be achieved. PDSA (Plan, do, study, and act) cycles will be used to investigate processes of care while implementing common sense as well as evidence-based changes to processes of care to ensure efficiency of spreading changes. Individual and focus group interviews will be conducted to gather data about the experience of staff and patients about services. Measurement of change will be conducted using benchmarking.
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Financial and Technological Impact of Quality Improvement
Low-quality care is consistently associated with a heavy human and financial burden on healthcare systems globally. Systematic approaches to capacity or capability building for improvement significantly delivers high performance in quality and cost of healthcare ( Mery, Dobrow, Baker, Im, & Brown, 2017) . Quality improvement capacity building improves the self-sustaining ability of systems and organizations in recognizing, analysing, and improving quality issues by allocating and controlling available resources more effectively.
Technological and financial impacts of quality improvement in healthcare organizations are realized by changes in systems that improve performance levels. Quality improvement enables the replacement of inefficient parts of the structure with new inventions. The inventions, such as Electronic Health Record systems render patient-centred real-time information. The systems improve efficiency and equitability by avoiding wastes in ideas, efforts, supply, and equipment.
Contemporary Quality Improvement Models and Risk Management Programs
Quality improvement in a healthcare organization focuses on identifying inefficiencies, ineffective care as well as preventable errors and then influence system associated changes. Some of the contemporary models for quality improvement include PDSA, Lean, and Six Sigma. PDSA model establishes a causal or functional relationship between processes changes and outcomes. The model determines the scope and nature of a problem, changes that can be made, an action plan for specific changes, parties to be involved, and measures that can help understand the impact of change. Six Sigma measures improvement through comparison of process capability after piloting potential solutions against baseline process capability. Lean model, on the other hand, maximizes value-added activities to enable continuous operations by identifying consumer needs and aiming to improve processes.
Risk management programs in healthcare organizations include structures, instruments, activities, and processes of identification, analysis, prevention, and management of clinical risks. The programs improve healthcare quality and help ensure the safety of employees, patients, and visitors ( Farokhzadian, Nayeri & Borhani, 2015) . Some of the contemporary risk management programs include the international standards of quality and patient’s safety. Organizations put special emphasis on educational programs in a wide range of risk management aspects to educate care providers and build appositive culture.
The effectiveness of the Commonly Used Quality Assurance Tools
The commonly used quality assurance tools have the ability to improve the performance of healthcare organizations. Patient satisfaction is a very critical measure of assessing the effectiveness of the quality of service provided in healthcare organizations. Patients in the 21 st century are aware of their rights concerning the quality of healthcare services delivered (Gupta, K. & Rokade, 2016) . A wide range of research indicates that the quality assurance tools effectively promote strategic planning, the participation of healthcare professionals, alignment of process strategies, and creation of an appropriate control system. The tools ensure healthcare quality by integrating planning, management, and control, promoting effective treatment of anomalies, and ensure agile risk management. However, the tools require healthcare members to demonstrate critical skills that promote flexibility.
Appropriate Quality Measures
Quality measures that can be used in healthcare organizations can be classified into structural, process, and outcome measures. Structural measures provide patients with a sense of capability of healthcare providers, processes, or systems to provide high-quality care. Process measures indicate what healthcare providers do to improve or maintain health, with measures reflecting the accepted clinical practice recommendations. Outcome measures, on the other hand, reflect the impacts of healthcare interventions or services on patients’ health status.
Quality Improvement Plan for a Healthcare Organization
A sample quality improvement plan for my healthcare organization can address the quality dimension of effective transitions on the issue of providing enough information at discharge. The measures or indicator would include whether a patient received enough information from the organization's staff regarding what to do when they are worried about their conditions or treatment after leaving the hospital. The unit or population for this measure would be surveyed respondents by the end of 2019. The current performance as at 31 st January 2019 is 57.4% and our target is 59.1% with a target justification of 3%. The planned improvement initiatives include strengthening and standardizing discharge planning processes within the organization’s three obstetrical programs. Methods of implementing the change will include working in groups to map current state related to discharge teaching, identifying triggers to cue employees to discharge education date, identify opportunities and barriers to earlier teaching opportunities, and evaluate, change, and spread. The process will be measured using patients whiteboard with a 90% target for process measure.
Impact of Quality Improvement on Legal and Ethical Aspects
Quality improvements impact ethical and legal aspects because focusing on improving quality may indirectly lead to wastage in resource utilization, cause harm, or unfairly impact some individuals. Incorporating research regulations in quality improvement interventions and activities can increase costs, cause delays, and promote conflicts. Quality activities and its ethical responsibility contrast with claims in ethics that term research as voluntary ( Lynn et al., 2017) . Healthcare organizations and professionals have no ethical responsibility to conduct research, and individuals have the right to choose to be research subjects.
Quality Measurement Approaches for Improvement Planning
Quality measurement approaches for improvement planning in healthcare organizations entails using established quality improvement framework. The frameworks exist in various forms, but the most appropriate take a methodological and iterative approach. Focusing measures on improvement against accountability is also effective ways to improve processes. Overemphasis on accountability supersedes patients’ needs and quality improvement cannot be applied. The other approach involves getting buy-in on the “meaning” of quality to determine its improvement objectively .
Reference
Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2015). Assessment of clinical risk management system in hospitals: an approach for quality improvement. Global journal of health science , 7 (5), 294.
Gupta, K. S., & Rokade, V. (2016). Importance of Quality in Health Care Sector: A Review. Journal of Health Management , 18 (1), 84-94.
Lynn, J., Baily, M. A., Bottrell, M., Jennings, B., Levine, R. J., Davidoff, F., ... & Agich, G. J. (2017). The ethics of using quality improvement methods in health care. Annals of internal medicine , 146 (9), 666-673.
Mery, G., Dobrow, M. J., Baker, G. R., Im, J., & Brown, A. (2017). Evaluating investment in quality improvement capacity building: a systematic review. BMJ Open , 7 (2), e012431.
National Academies of Sciences, Engineering, and Medicine. (2015, November). Six Widely Used Methods to Improve Quality. In Improving Quality of Care in Low-and Middle-Income Countries: Workshop Summary . National Academies Press (US).
