The quality improvement movement is not a new term to the healthcare industry considering that back in the 19 th century, efforts to improve healthcare were already in existence, with epic figures such as Ignaz Semmelweis, Florence Nightingale and Ernest Codman being at the forefront in campaigning for improved quality of healthcare. Florence Nightingale was an English nurse who established that there was a relationship between poor living conditions and high mortality rates. Ernest Codman was a surgeon and he initiated the introduction of hospital standards, while emphasizing and implementing strategies that were used for assessment of healthcare outcomes. Similarly, an obstetrician Ignaz Semmelweis was at the forefront in championing for adoption of handwashing technique in healthcare. However, since the last century, there has been tremendous transformation in the healthcare quality movement, with inclusion of aspects such as more stakeholders, more distinctive and modified approaches as well as evolved set of goals ( Marjoua & Bozic, 2012) .
Great changes have occurred in the health care industry in the United States over the last few years. In the earlier times, i.e. the ears preceding the 18 th century, healthcare and medicine was regarded as a “family affair”. The medical practices conducted back then were blanketed as “domestic medicine” where doctors would combine home remedies and a few scientifically practiced procedures. It’s in the early 1800s when medically trained physicians began attributing social conditions and “germs” to spread of diseases. Consequently, cities throughout the country instituted health departments as a result of the spread of communicable diseases such as cholera and tuberculosis. Later in the mid-1800s, private hospitals, more medical schools and medical institutions spawned. It is the establishment of the American Medical Association (AMA) in 1846, that led to great changes in how medicine was practiced. Since then, numerous healthcare improvement movements have spawned, all of which are focused on improvement of the quality of healthcare ( Marjoua & Bozic, 2012) .
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Several notable efforts to improve healthcare spawned in the last half-century where most of these were engendered by the academic healthcare quality movement. The path to improvement began with the deficiencies in the healthcare system being outlined in a series of articles, which then prompted efforts to improve healthcare quality. These efforts included actions such as encouraging competition among healthcare providers through incentivisation, encouraging peer-review and restructuring of healthcare delivery systems. In addition to these, there were other more direct efforts such as identification of processes affecting the health of patients, honoring good performance, monitoring and evaluation of performance, restyling professional medical education and making quality data publicly available ( Speziale, 2015) .
It’s with no doubt that quality improved has an extremely complicated nature, and therefore building as well as maintenance of a program of improvement that has sustained outcomes has never been an easy task. For this reason, most healthcare organizations find themselves overwhelmed. However, efforts to successfully improve quality of healthcare involves a number of critical elements which can be considered essential in accomplishment of sustainable quality assurance systems. The most important elements include prioritizing quality of healthcare within an organizational culture as well as infrastructure support and physician leadership ( Marjoua & Bozic, 2012) .
For improvement efforts to be successful, senior leadership support is important ( Speziale, 2015) . In addition, an organization’s culture needs to be an adaptive learning one where everyone is committed to data-ridden quality improvement. Another important element of sustained quality improvement is analytics which basically plays a very crucial role in all the phases of quality improvement cycle. Evidence as well as Consensus-Based practices are the basis of successful quality improvement efforts. Development and integration of these practices, accompanied by their periodic measurement of their use and their related outcomes. For the involvement of these elements to lead to improved quality of healthcare, resources that can encourage smooth implementation needs to be allocated. In addition to this, financial alignment with the initiatives is critical as it prevents wastage and operational inefficiencies (Winston, 2012).
According to Winston (2012), o utlining long term goals through strong strategic plans is a shared attribute of most healthcare organizations. Implementation of a strategic plan highly depends on a number of structural elements. Therefore, key elements of a strategic plan include; a vision, core values, clearly defined outcomes, accountability and key performance indicators ( Speziale, 2015) . In addition to the above named elements, a strategic plan an important element is SWOT analysis, which describes strengths, weaknesses, opportunities and threats. A vision basically sets an organization’s overall direction. It describes the actions that the organization plans to take as well as the reasons for taking those actions. For the organization to achieve a stated vision, core values are paramount. Core values are the organization’s beliefs and behaviors. Clearly defined outcomes are generally long term goals and short term objectives. These articulate the steps needed to achieve the vision while including the appearance of success at each step. Articulating goals and objectives ensures that all the key players in the organization stay focused on the “bigger picture”. Assigning individual persons to various tasks of the strategic plan promotes accountability which consequently ensures that performance is addressed and problems that leads to “blame games” are avoided. Finally, key performance indicators measure outcomes while comparing the performance of the organization with the components of the vision statement. These basically track the progress of the plan (Winston, 2012).
Once a strategic plan is described, bringing it into life is known as implementation strategy. implementation planning is the development of a tactical plan for the completion of strategic initiatives. Incorporation of new programs into a healthcare’s facility operations requires that the program implementation is in alignment with the strategic plan of the facility. This can be achieved through modification of the strategic plan or of the program ( Speziale, 2015) .
References
Marjoua, Y., & Bozic, K. J. (2012). Brief history of quality movement in US healthcare. Current Reviews in Musculoskeletal Medicine , 5 (4), 265-273. doi:10.1007/s12178-012-9137-8
Speziale, G. (2015). Strategic management of a healthcare organization: engagement, behavioral indicators, and clinical performance. European Heart Journal Supplements , 17 (suppl A), A3-A7. doi:10.1093/eurheartj/suv003
Winston, W. (2012). Fundamentals of Strategic Planning for Healthcare Organizations. doi:10.4324/9780203357866
