Basic Concepts of Quality Improvement in the Health Care Industry
Quality improvement is a continuous yet systematic process that is grounded in several key concepts as part of ensuring that it achieves its overall objectives in seeking to promote the quality of care offered (Grossman et al., 2008). The first key concept to note is the establishment of a culture of excellence as part of the industry. By establishing a culture of excellence, it becomes much easier to define critical processes and procedures that are likely to enhance overall capacity for the industry to undergo a continuous process of improving quality outcomes.
The second notable concept revolves around the determination and prioritization of potential areas for improvement. In this understanding, what is essential is that the stakeholders in the health care industry may need to identify a critical area that needs improvement, as this will help in the prioritization; thus, guaranteeing positive outcomes (Kaplan, Brady, Dritz, Hooper, Linam, Froehle, & Margolis, 2010). Thirdly, quality improvement is grounded on the communication of results based on an ongoing process of evaluation. By communicating results, it becomes much easier for the stakeholders to involved to determine areas that they are succeeding and those that they are failing. Generally, this creates a much better platform for continuous improvement of quality outcomes focusing on the care provided in the industry.
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Concepts of Risk Management in the Health Care Industry
Risk management is one of the critical aspects of consideration in the health care industry, as it allows for protection of the stakeholders, including patients, health providers, staff, and health care organizations, from underlying possibilities of risks. In an attempt to engage in effective risk management, it is essential to get a clear picture of the key concepts that help in the establishment of a front through which to promote efficiency in the management of risks occurring as part of the industry.
One of the key concepts associated with risk management is safety measures put in place within the health care industry as a way of ensuring that underlying safety issues are identified and eliminated effectively. Risk management, in the health care industry today, has undergone several critical changes in a bid to improving on the area of safety, especially concerning the individual patients (Rahman & Shaily, 2016). Another key concept that is important to consider as part of risk management is transmission and sharing of information across the industry. The transfer of information serves as a guarantee that health care providers would have a clear understanding of possible risks that they are likely to encounter in service delivery.
Information Needed for Decision-Making Processes in Risk and Quality Management
Decision-making processes in risk and quality management are vital towards ensuring that health providers offer patient-centred care at all times. However, the decision-making processes are determined by access to specific information that would serve as a guarantee for efficiency in the management of quality and risks. Health care providers need patient information, which can be accessed through a patient's medical files and records. Access to such information ensures that the decisions that the health providers can make reflect on improving the quality of services offered while seeking to minimize underlying risks that patients are likely to encounter.
On the other hand, health providers need information relating to patients' wants and needs concerning the services offered during treatment and provision of care services. Such information may be gathered through engagement with the patients as a way of trying to get a clear picture of what they expect concerning expected quality outcomes in the services offered. Generally, this information will be of great value towards improving patient satisfaction levels considering the nature of decisions that are to be made, which would reflect on an established framework for the exceptional quality of care.
Risk and Quality Management Tools
The crucial first risk and quality management tool used in the health care industry is root cause analysis. The purpose of using the root cause analysis is to help in assessing risk or quality management issues based on their root cause. That allows for a much more effective approach in seeking to deal with the problems effectively. The main advantage of the root cause analysis tool is that it provides a generalized analysis of issues; thus, allowing for efficiency in the identification of such problems to allow for relevant measures to be put in place. The disadvantage of this tool is that it presupposes a single source of a problem, as it is only capable of focusing on an individual perspective.
The other critical risk and quality management tool used as part of the health care industry is Six Sigma. The purpose of using Six Sigma as part of risk and quality management is because it helps in defect reduction as a way of ensuring that the risks are minimized while promoting quality improvement. The advantage associated with Six Sigma is that it can be used within seasoned teams much more effectively; thus, meaning that the expected outcomes are likely to be met within a set period. The other advantage associated with this tool is that it paves the way for a higher capacity to improve satisfaction levels. The main disadvantage of the device is that it requires a significant amount of time before it achieves actionable results.
The crucial third tool used as part of risk and quality management in health care is the patient satisfaction survey. The purpose of using the patient satisfaction survey is that it helps in determining whether indeed patients are satisfied with the quality of care being provided. That makes it much easier to determine the need for quality improvement. The advantage of using this tool is that it helps in recognition of possible opportunities for health care organizations in their bid to ensuring that they remain more effective and efficient. Patient satisfaction surveys do not show any viable disadvantages that may hamper their effectiveness towards improving the quality of care being offered.
The last tool used as part of risk and quality management is Failure Modes and Effects Analysis (FMEA). The purpose of using this tool is that it helps in the identification of potential failures associated with the risk and quality management approaches that have been put in place as part of advancing the care services being provided. The advantage of using the FMEA tool is that it helps in the collection of actual and viable data that would be of value in the identification of risks likely to result in failure. The disadvantage of this tool is that it creates an issue concerning lack of reliability, considering that it becomes much harder in the collection of the expected data to help meet its set objectives.
Challenges in Making Risk and Quality Management Decisions in Health Care
The main problem associated with making risk and quality management decisions in health care is the lack of patient confidence, which becomes a vital issue of concern when making most of these decisions. Without patient confidence, the possibility of establishing active risk and quality management decisions reduces significantly, as health care providers find themselves in a position where it becomes much harder to determine the expected outcomes. In such cases, the consequences of the decisions may not reflect on the projected results concerning improving the quality of care being provided to the patients.
References
Grossman, E., Keegan, T., Lessler, A. L., Ly, M. H., Huynh, L., O'Malley, A. J., ... & Landon, B. E. (2008). Inside the health disparities collaboratives: a detailed exploration of quality improvement at community health centres. Medical care , 46 (5), 489-496.
Kaplan, H. C., Brady, P. W., Dritz, M. C., Hooper, D. K., Linam, W. M., Froehle, C. M., & Margolis, P. (2010). The influence of context on quality improvement success in health care: a systematic review of the literature. The Milbank Quarterly , 88 (4), 500-559.
Rahman, Z., & Shaily, S. A. (2016). Critical Factors That Impact International Firms to Raise the Quality of Service In the Healthcare Industry of Bangladesh. American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) , 16 (1), 193-211.
