The Institute of Medicine defines quality in health care as the connection between preferred health outcomes and the level of improved health services. Quality improvement takes into account endless actions that result in the development of health care services of a targeted setting. The underlying principle of measuring quality improvement is that it encourages better performance and improvement efforts to demonstrate good quality practice. Quality evaluation and measurement can be tracked using benchmarks. Internal benchmarking entails identifying and comparing best practices with an institution. On the other hand, external benchmarking involves analyzing data between various organizations to identify improvement pointers that are successful in different platforms. Assessment and evaluation of health care quality evaluate the unique dynamics of health care delivery. Adequate representation of perspectives from stakeholders in the healthcare system is also key in providing a quality evaluation that incorporates all important aspects.
Health Care Quality from A Variety of Stakeholder Perspectives
Stakeholder involvement is critical in outlining development indicators of healthcare services. Patients, healthcare professionals, and administrators are key stakeholders in quality performance and improvement. Opinions from patients are essential in order to quality improvement. This is because they give an unbiased reflection on the standards of service based on individual experiences on an existing care structure. A patient’s opinion on the quality of care takes into account the skills of medical personnel, patient satisfaction, hygiene, nurse-physician relationship, and organizational structure. Collection of views from patients can be done via surveys, interviews, focus groups, or feedback. Furthermore, perspectives from healthcare professionals offer both a technical outlook as well as interaction characteristics between a patient and provider (Piligrimienė & Bučiūnienė, 2008). Such perspectives are an indication that a physician has the necessary skills to provide treatment optimally. The concept of healthcare quality in the eyes of managers integrates both the societal expectations as well as the institution’s objectives. In a journal paper published in 2008, Piligrimienė & Bučiūnienė stated that healthcare administrators strive to meet demands from both patients and physicians. Despite such impartial opinion, administrators tend to focus on an institution’s mission with emphasis on financial implications. Even though differences in perspectives makes quality measurement complex, it is important to integrate expectations from the stakeholders. For instance, physicians tend to concentrate on medical outcomes, patients concentrate on functional determinants while administrators focus on managerial logistics.
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Quality and Performance Improvement Within the Context of the Health Care Organization
Mental health care offers a unique challenge that requires use of innovations for measurement and improvement. For instance, in the Netherlands, aspects of quality, client satisfaction and effectiveness of treatment are evaluated and incorporated into health insurance reimbursement mechanisms. The collected data is then published to stimulate continuous quality improvement. Another tool that offers quality improvement strategies is the PHQ-9 form (Patient Health Questionnaire) This tool integrates strategies that can be implemented in clinical settings (Kilbourne et al., 2018). In the long run, a framework of establishing accountability in providing quality healthcare is outlined, and a commitment towards achieving this goal is established. Improvement of mental health quality requires coordination across various stakeholders. For instance, there is a need to take note of views from frontline staff, such as social workers who can provide essential information on quality improvement. Mental health care service goes beyond the immediate receipt of these services. Opinions from family members ought to be embraced.
Leading Model of Quality Improvement
Quality improvement models present a structure for establishing processes in a given system. Plan-Do-Study-Act (PDSA) model incorporates two QI models, namely Rapid Cycle Improvement (RCI) and Total Quality Management (TQM). PDSA is often used due to its ability to impact and assess change on a small scale. This offers a blueprint before the interventions are made systemwide ( Hughes, 2008). By so doing, the interested parties can assess if the proposed interventions will work or not.
The structural framework of the PDSA cycle is built on three pillars, namely objective statement, measurable success pointers, and the concepts to be tested. The PDSA cycle is made up of four stages. The first part is the plan. This plan entails giving an outline of questions, objectives, and expectations. The second part, Do, calls for collection and analysis of data. Questionnaires can be used to collect data from patients. Any implemented change offers a measurable impact that can be demonstrated over a given time. The study is the next stage. A comparison is drawn between the analyzed data and the desired outcomes. The last part of the cycle is Act. It serves as the conclusion of the cycle and a platform to plan the next cycle.
It is quite evident that quality measurement and improvement is an essential factor in healthcare. The three identified stakeholders (patients, healthcare professionals, and administrators) are critical in providing components to the practice. Incorporation of these opinions is vital in quality evaluation. This helps in establishing a culture of quality as well as determining areas for improvement. This paper has also extensively explored PDSA, a quality improvement model that creates a relationship between interventions and outcomes. This cements the aspect that quality measurement and performance improvement comprises of more than one dimension that is dynamic.
References
Hughes, R., & United States. (2008). Patient safety and quality: An evidence-based handbook for nurses . Rockville, MD: Agency for Healthcare Research and Quality.
Kilbourne, A.M., Beck, K.E., Spaeth-Rublee, B., Ramanuj, P.P., O'Brien, R.W., Tomoyasu, N., & Pincus, H.A. (2018). Measuring and improving the quality of mental health care: a global perspective. World psychiatry : official journal of the World Psychiatric Association, 17 1 , 30-38
Piligrimienė, Ž., & Bučiūnienė, I. (2008). Different perspectives on health care quality: is the consensus possible?. Engineering economics , 56 (1).
