Quality improvement in health care services involve systematic and sequential events which lead to a certain degree of improvement in the quality of service provided. According to the Institute of Medicine, quality improvement (QI) in terms of quality, healthcare is defined by the relationship between the quality of services given and the expected outcomes (Kim et al. 2017). The aim of this paper is to elaborate how quality improvement is important in healthcare services and to discuss how it can be implemented to overcome a specific challenge in a medical setup.
Quality improvement can only be achieved if one is able to identify the problem. It is only after identification of the problem that the quality of health care services can be analyzed and areas that need improvement can be identified. Hospitals nowadays are faced with numerous challenges. Some of these problems are traced back to pre-existing problems. Other problems experienced in the health industry today are recent. These health issues are experienced globally. Poor information technology systems in hospitals have been a challenge in the provision of quality healthcare. Health care services provided need to be well integrated for best results to be achieved. Unfortunately most of the IT equipment used in most facilities are inefficient, generally slow compared to the amount of services required and are difficult to work with making them very cumbersome.
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Information technology has become an important part of almost every service in the hospital. All computerized services in the hospital depend on efficient information technology systems to ensure quality services are provided. IT systems are useful tools in documentation and in conducting CPOE. Unfortunately, most hospitals lack efficient IT systems. The result is that doctors and nurses experience hard times working with the slow and cumbersome systems that are available. In a research done in 2017, it was shown that 53% of IT problems were associated with patient harm and death (Kim et al. 2017). Cases of near miss were also reported at 29 %. The problems experienced involve medication errors as a result of issues with system functionality. System functionality issues include poor user interface, delayed care delivery, and fragmented delays. Delayed service delivery is further caused as a result of problems with the system configuration, system access and software updates. These activities result to the entire system running slowly therefore causing unnecessary delays.
The challenges Faced by hospitals as a result of poor information technology systems are mainly five. This is according to a conclusion drawn by the members of the round table meeting at Becker’s Hospital Review 4 th Annual Health IT and Revenue conference. The conference which was attended by twenty C-suite heath care executives was held in 2018 to discuss the major technological challenges that were faced by hospitals (Khennou et al. 2018). Upkeep of old technology, interoperability, physician adoption, asset tracking and the overarching challenge were the listed problems. All these challenges were faced by all hospitals managers in attendance apart from asset tracking which was not experienced in some hospitals. However, only one issue will be addressed by this paper.
Interoperability as seen earlier, is a major IT challenge in most hospitals today. Interoperability is said to be the ability of data to be exchanged between different software. The EHR, crucial equipment in keeping records in hospitals has its efficiency limited to the fact that retrieving information once keyed in is always a problem. One of the IT directors in attendance also explained that the time taken to interact with the EHR while retrieving data was excessively long. This was because the data had to be input manually and that a way to export actionable data from the machine had not yet been developed. Data output from the EHR in most cases is not user friendly and this creates a problem in terms of service delivery (Khennou et al. 2018). Service has to be delayed to patients since the data obtained has to be converted into a user friendly form.
Making the EHR more interoperable as agreed by most physicians during the conference would help to improve the quality of service. According to a survey conducted by Deloitte, most facilities found it difficult to work with the EHR and as a result, most physicians were concerned about quality improvement on this device (Kim et al 2017). Currently, EHR systems are used to store data necessary for improving quality of health services provided in hospitals as expected. However, the complexity of the system has limited its efficiency. Improving the efficiency of this system would therefore help greatly in improving the quality of service. In addition to that, there have been claims raised over medical data breach as a result of using EHR to store patient’s data. According to EU public, the Cross Border Health Directive and the EU Commission’s plan to have a centralized health record would breach their privacy. They argued that the government and the health care organizations could not be trusted with the public’s private data.
To improve the quality of service delivered through the use of the electronic health recording system, it would be necessary to do away with the challenges posted by its usage. First, it would be easier and faster for physicians to access stored data if the system could be linked to other software. This would allow sharing of data and as a result, the data obtained could easily be retrieved in any form require by the user. Total data encryption an implementation of anti-breach measures against unlawful access of personal data in the EHR is also a measure of quality improvement. This would ensure that only authorized and qualified personnel have access to patient’s data and as a result, quality services can be given since only qualified personnel handle the data. In addition to that, making the system more interoperable would ensure swift data input and output. The result would then be quick access to patients’ database which would allow for quick services even in case of emergencies.
Previously, the information within the EHR could be updated continuously (Miron-Shatz et al. 2014). However, this was only able to happen within certain legal limits. Making the system interoperable would mean unlimited ability to update the information. This would greatly help doctors and nurses to modify their patients’ data in ways that would create easier access and easier referencing. The previous manual input types of EHR were cumbersome and time consuming which in most cases led to delayed service delivery. Having automatic systems in place of the manual ones would greatly help ensure fewer complications in clinical decision making and record retrieval.
Like any other change implementation in any event, there are steps to be followed. The same case would also apply in ensuring quality improvement with the use of HER. The management team in every facility would have to invest in the purchase of modern EHR systems. Investing on the new machines would also mean training the medical practitioners on how to handle the machine (Miron-Shatz et al. 2014). It would as well go further into involving new IT technicians so that the machine could be integrated with other software. This would probably mean that the relevant procedures of creating awareness about a change in an organization would be followed.
In conclusion, quality improvement in health facility is must do activity in health facilities. Evaluation of the system to ascertain functionality is important in ensuring that the improvement made was relevant. For instance, assessing quality improvement in the case of automation of the EHR would be done by studying the time taken during data output and input processes. Since with the automatic EHR allows relatively faster data input and output, it would be concluded that the qualitative improvement was relevant. Successful encryption of patients’ information and protection of data from breach with the newly integrated system would also serve as proof of a successful qualitative improvement activity. Interoperability in EHR would ensure more effective methods of retrieving medical data that is useful in examining the trends in patients and long term changes that are likely to occur. Finally, the efficiency of the electronic health records can be justified with the increased portability, transparency, and accessibility of data in these systems.
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