Quality Improvement Plan - Part Three
Quality improvement initiatives are effective only when the organizational structure and culture are aligned with a similar vision for the provision of quality care delivery and a commitment to continuous improvement. Organizations must take an active approach to measure, assess, and improve processes creating an environment supporting quality improvement initiatives (Spath, 2014). The creation of this type of environment should be evident from the top tier of leadership to the front-line employees, creating a culture supporting the delivery and sustainability of quality care. The following paragraphs will identify and discuss the authority structure of the quality improvement plan including the roles and responsibilities of the members involved in the plan implementation. Additional discussion will include the roles of communication, education, and evaluation of the quality improvement plan. Finally, identification and discussion of the impact external entities have on the project and the strategies needed to overcome potential challenges to the project implementation.
Authority Structure
Traditional quality management systems employ a tiered authority structure appointing the highest level of authority to the board of directors. In 1990 the Central Office of Veterans’ Health Affairs decentralized the quality management structure to empower facility staff to develop a tailored approach to quality improvement based on the needs and circumstances of their individual facilities (Young, Martin, Charns, & Barbour, 1997).
The individual facilities of the Veterans’ Health Administration have employed a quality management structure appointing the facility Director as the official with absolute a...
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...nd preparation to overcome obstacles preventing the successful implementation of quality improvement plans.
References
Institute for Healthcare Improvement (2008). 5 million lives campaign. Getting started kit: reduce surgical complications how-to-guide. Retrieved from http://www.ihi.org/resources/Pages/Tools/HowtoGuideReduceSurgicalComplications.asp x
Kelly, D. L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press.
Spath, P. (2014). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press.
Young, G. J., Charns, M. P., & Barbour, G. L. (1997). Quality improvement in the US Veterans Health Administration. International Journal for Quality Health Care, 9(3), 183-188. Retrieved from http://www.intqhc.oxfordjournals.org/content/9/3/183.full.pdf
Department of Veteran Affairs. (1997). Master Agreement between he Department of Veteran Affairs and the American Federation of Government Employees (VA Pamphlet 05-68). Washington, DC: U.S. Government Printing Office
Given the long duration of patient quality problems, over ten years, at SGH, the communication plan may need to include not only the internal SGH stakeholders such as employees, but also external stakeholders both in the community, shareholders, and third party vendors. SGH is at greater business risk due to their previous attempts at improving quality and now potential lack of stakeholder confidence. Including stakeholders in the change management process allows the stakeholder’s viewpoint to coevolve with SGH to create a shared view of the change plan and how to measure change success (Windsor, 2010). Engaging with the stakeholders in change plan definition and focuses their energy on helping SGH with the change process, rather than undermining it (Windsor, 2010). Identifying all of the stakeholders for SGH, and engaging them in change communications and planning will assist SGH leadership in evolving the hospital towards a high patient quality
The DVA provides the highest quality ensuring that all veterans and families receive the care and support they deserve by using people-centric, result-driv...
The purpose of this paper is to identify a quality safety issue. I will summarize the impact that this issue has on health care delivery. In addition, I will identify quality improvement strategies. Finally, I will share a plan to effectively implement this quality improvement strategy.
In her paper emerging model of quality, June Larrabee discusses quality as a construct that includes beneficence, value, prudence and justice (Larrabee, 1996). She speaks of quality and value as integral issues that are intertwined with mutually beneficial outcomes. Her model investigates how the well-being of individuals are affected by perceptions of how services are delivered, along with the distribution of resources based on the decisions that are made (Larrabee, 1996). She speaks of the industrial model of quality and how the cornerstone ideas of that model (that the customer always knows what is best for themselves) does not fit the healthcare model (Larrabee, 1996). Larrabee introduces the concept that the patient va provider goal incongruence affects the provide (in this case the nurse) from being able to positively affect healthcare outcomes (Larrabee, 1996). The recent introduction of healthcare measures such as HCAHPS: Patients' Perspectives of Care Survey has encouraged the healthcare community to firmly espouse an industrial model of quality. HCAHPS is a survey where patients are asked questions related to their recent hospitalization that identifies satisfaction with case based solely on the individuals’ perception of the care given. This can lead to divergent goals among the healthcare team or which the patient is a member. Larrabee’s model of quality of care model
... is an abstract model that proposes an exploratory plan for health services and evaluating quality of health care. In accordance with the model, information about quality of care can be obtained from three categories: structure, process, and outcomes. In addition, not long ago The Joint Commission include outcomes in its accreditation valuations (Sultz, & Young, 2011, p. 378).
The standards of the Joint Commission are a foundation for an objective evaluation process the may help healthcare organizations measure, assess and improve performance. These standards are focused on organizational functions that are key for providing safe high quality care services. The Joint Commission’s standards set goal expectations of reasonable, achievable and surveyable performance of an organization. Only new standards that are relative to patient safety or care quality, have positive impact on healthcare outcomes, and can be accurately measured are added. Input from healthcare professionals, providers, experts, consumers and government agencies develop these standards.
Due to WellStar being a multi facility health system, its organizational design is constantly being reviewed for simpler and more efficient processes. WellStar’s two smallest hospitals, WellStar Paulding and WellStar Douglas, previously under went reconstruction with regards to their hierarchical structure in Patient Access Services (PAS). WellStar Paulding, the smallest facility of the five hospitals, renovated their managerial chain of command in PAS. WellStar Paulding’s patient volume is less than half in comparison to the 4 additional hospitals. As a result, their staff is smaller and only requires minimal supervision. In the past WellStar Administrators requested supervisors for every department, a manager of the entire department, and a director that managed PAS’ management directly and PAS staff indirectly. Recent cuts ...
In the healthcare system, quality is a major driving compartment for patient outcomes. The quality of care reflects the outcomes in a patient’s care. According to Feeley, Fly, Walters and Burke (2010), “quality equ...
Bengoa, R. (2006). Quality of care: a process for making strategic choices in health systems.. Geneva: World Health Organization.
Maintenance and promotion of quality improvement initiatives are essential for the successful growth and development of the health care industry. Nurses are key to all quality improvement initiatives as they are in the frontlines and have the most contact with the healthcare consumers. Therefore, nursing professionals are good at putting in their valuable inputs for quality improvement efforts. On a daily basis nursing professionals strive to deliver safe, efficient, effective, patient-centered care in a timely manner. With the growth and development in the health care industry, there is an increased need to provide competent and high quality services. Nurses are equipped with distinctive proficiency required for delivery of patient care
Quality improvement (QI) involves the regular and constant actions that enable measurable improvement in health care. QI results in enhanced health services, organizational efficiency, quality and safe care to patients, and desired health outcomes for individuals and patient populations (U. S. Department of Health and Human Service, 2011). A successful quality improvement program is patient-centered, a collaboration of teams, and uses data in systems. QI helps to develop a culture of excellence in nursing, identify and prioritize areas of improvement, promote communication and collaboration, collect and analyze data, and encourage continuous evaluation of systems and processes (American Academy
improving the quality of care, it is important to begin by defining quality. Quality is purposed by
To achieve the goal of health care safety by providing quality services throughout their leadership role. Quality management provides a specific framework to consider the successful implementation of the risk management and improve the programs where participation is needed to share experiences. The governing body demonstrates that commitment of all stakeholders to sufficient management resources for effective mitigation. Quality of system increases patient satisfaction and will help people and employees to achieve the target goals. When an organization plans to increase needs and considers the improvement of quality, it will perceive the needs of patients.
Understanding quality measurement is essential in improving quality. Teams need to be able to understand whether the changes being made are actually leading to improved care and improved outcomes. For data to have an impact on an improvement initiative, providers and staff must understand it, trust it, and use it. Health care organization must understand the measurement of quality provided by the Institute of Medicine (patient outcomes, patient satisfaction, compliance, efficiency, safe, timely, patient centered, and equitable. An organization cannot improve its performance if it does not know how it is performing. Measuring quality improvements is essential as it reflects the quality of care given by the providers and that by comparing performance