Quality improvement, commonly referred to as QI, consists of systematic and continuous actions that lead to quantifiable improvements in the healthcare services, as well as the health status of the patient groups in consideration. This concept builds upon the traditional quality assurance strategies that emphasize on the need for organizations or system to concentrate more on the process rather than the people. Quality is directly linked to the service delivery approach of every organization. An organization needs to change its current system if it wants to achieve different levels of performance and improvements on quality. While every QI program is unique in itself, successful programs incorporate the following key principles; focus on patients, focus on the use of data, QI work as systems and processes and the focus on being part of the team. On the other hand, risk management refers to the efforts aimed at reducing the likelihood of errors. In particular, it aims at reducing the errors that may be costly in terms of discomfort, damage, distress, disability and to cushion the organization against financial loss. Risk management achieves these goals by detecting potential risk, reporting to the relevant authorities and correcting possible deficiencies that could cause a costly mistake. An established and well-managed risk management program helps in providing healthcare services that are free from risks, and it also contributes to the quality of healthcare being provided. Good quality care incorporates competent and appropriate technical care that gives the patients the opportunity to discuss their concerns and fears, make choices relating to the quality of service they receive. The purpose of this paper is to discuss the concepts of quality improvement, risk and quality management in healthcare. It goes further by highlighting the four quality management tools used in the healthcare industry. Lastly, the paper describes the challenges associated with making risk and quality management decisions in the healthcare sector.
Management tools used in the healthcare industry
Plan-Do-Study-Act
Quality improvement studies and projects that are aimed at initiating positive changes in the healthcare sector to effecting favorable outcomes can rely on the PDSA model. A unique feature of this model is its cynical nature of assessing and impacting change accomplished through small and frequent PDSAs as opposed to big and slow ones before changes are initiated in the system. PDSA quality improvement efforts are meant for initiating a functional relationship between the changes in processes and the outcomes (Barbeau, 2018).
Delegate your assignment to our experts and they will do the rest.
The following considerations are taken into account before using PDSA cycles; the goal of the project, measurement of progress and lastly, strategies necessary for achieving the goal that has been set. At the onset, the PDSA cycle begins with the determination of the nature and scope of the problem, changes that should be and can be made, a plan for change, people to be involved, what should be measured when determining the impact of change and where the strategies will be targeted to (Barbeau, 2018). Changes are then implemented, and data and information are collected. Lastly, the results from the implementation studies are assessed and interpreted based on the review of the key measurements that indicate successes or failures before being implemented.
Six Sigma
The Six Sigma model involves designing, improving and monitoring the process with the intention of eliminating or reducing wastes, while increasing financial stability and optimizing satisfaction (Barbeau, 2018). The performance of a process is measured by making comparisons on the baseline process capability before improvement with the process capability, after the piloting of the possible solutions for quality improvement. In the healthcare sector, the central belief of Six Sigma about defects is that they are things that lead to the dissatisfaction of patients.
Barbeau (2018), asserts that the Defects could mean anything from confusing instructions, long waits for appointments or injurious or ineffective procedures and treatments. By reducing defects, health providers can achieve high levels of performance that includes fast turnaround times, very few defects or errors and low cost. Effective performance of this model also helps in reducing staff turnovers. It increases retention by doing away with the cumbersome, complicated procedures and routines. Though this method is effective, incorporating it in the healthcare system is not easy because, the process of learning the extensive methodologies of applying the Six Sigma is demanding (Bunting & Groszkruger, 2016).
The advantage of the Six Sigma is that it entirely focuses on the patient. It goes beyond the simple error by taking into consideration the entire process of healthcare delivery as well as the sentiments of patients. Furthermore, healthcare centers using this model stand out among their competitors, given their exceptionality in service delivery. Notably, Six Sigma can be implemented in various categories, and this will help in reducing risks as well as reducing the operational costs in healthcare centers (Barbeau,2018).
However, this method intended at creating improvements can bring problems to healthcare organizations as well. To begin with, this method can create an overwhelming rigidity and bureaucracy because the methodology of this model covers the whole process of the healthcare institution leading to problems in creativity and delays. Furthermore, this method is also not viable for small healthcare centers since it is expensive to run. Lastly, this method follows a strict and rigid process that hinders creativity and innovation (Bunting & Groszkruger, 2016).
Root cause analysis
The Root Cause Analysis is a structured methodology that is used in analyzing serious adverse events. It was developed to help in analyzing industrial accidents, but as we speak, it is widely being used for analyzing errors in the healthcare sector. It is one of the most sophisticated methods used for detecting safety hazards (Papp, 2018). This model uses the systems approach for identifying both latent and active errors that contribute to adverse events in the healthcare system.
Papp (2018), alleges that although root cause analysis is one of the most used methods of improving patient safety, its effectiveness is questionable. Studies have indicated that this method has often failed in giving sustainable systems-level solutions. The causes for the ineffectiveness of this model include; over relying on week solutions, failure of combining data across the organization and the failure of incorporating human factors in error analysis and improvement efforts. Root cause analysis is essential given that it helps healthcare providers in prioritizing the needs of patients; which problems should be addressed and those that should wait. Also, this method is time efficient given that one does not waste time on things that do not require fixing.
Failure Modes and Effects Analysis
In healthcare settings, errors will always occur; they occur when least expected. This model identifies and eliminates the potential, problems, and failures from a system. The Failure Mode and Effects Analysis can be used in improving the safety of patients. FMEA is an approach that is used for identifying and mitigating risks that can lead to patient tragedy. This method is significant since hospitals have not been focusing on preventing accidents. The society also holds a belief that healthcare providers perform their duties faultlessly. FMEA is applied when a new function, process with an associated hazard has not been implemented or when a current function or process is being used in a similar or new location. FMEA is important given that it has the capacity of tracking product failure modes, their causes as well as effects that provide significant for future process design. Also, this method allows actions to be taken to reduce or eliminate failures in a quantitatively RPN order (Bunting & Groszkruger, 2016).
However, apart from this method being important in reducing risks in healthcare centers, tracing failures through the FMEA is a tedious and time-consuming exercise. Secondly, since this method is applied late, it cannot affect decision making in healthcare facilities. Also, this model disregards the relationship existing among different failure components. Too important to note, the FMEA is a complicated method that requires skilled personnel, making it to be out of reach for many healthcare centers (Goodman et al., 2017).
Challenges in making risk and quality management decisions in the healthcare sector
On a daily basis, healthcare providers make decisions that affect their patients directly or indirectly. A single mistake in decision making can lead to deadly consequences. There have been reports regarding the numerous lawsuits relating to cases such as medical negligence by healthcare providers (Barbeau, 2018). In order to avoid such agony, there is need for devising the risk management strategies. As they strive to provide quality services to their patients, health workers face several challenges. Doubt is one of them, which arises when the doctors are unable to ascertain the patient’s ability to make informed decisions.
Secondly, another challenge they face is the scenario in which patients withdraw from a consent they had agreed upon. On the same note, It is a challenge to ascertain the amount of information that should be availed to the patient. Healthcare providers are supposed to avail the information that is sufficient to inform. Another challenge arises by patients refusing any information given while relying on healthcare providers to make decisions for them. It is challenging to deal with adults who are unwilling to make their own decisions (Barbeau, 2018).
Conclusion
In summary, the goal of every healthcare provider is providing quality health services to their patients. In achieving this goal, they have put up mechanisms that guarantee patient safety by reducing or eliminating the risks that may occur in the process of treatment. The Healthcare industry is also bringing up reforms in the healthcare sector by using various tools for change as discussed above. However, the overreliance on one strategy cannot bring the necessary changes in the healthcare industry. It is, therefore, a requirement that these tools are used interchangeably to yield productive results.
References
Barbeau, J. M. (2018). Risk Management in Transfusion Medicine. Elsevier Health Sciences.
Bunting Jr, R. F., & Groszkruger, D. P. (2016). From To Err Is Human to improving diagnosis in health care: the risk management perspective. Journal of Healthcare Risk Management, 35(3), 10-23.
Goodman, S. G., Nicolau, J. C., Requena, G., Maguire, A., Blankenberg, S., Chen, J. Y., ... & Yasuda, S. (2017). Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study. International journal of cardiology, 236, 54-60.
Papp, J. (2018). LIC-Quality Management in the Imaging Sciences. Elsevier Health Sciences.
