Quality Improvement for Montgomery Medical Center - Research Paper Example

?Quality Improvement Plan for G.V. (Sonny) Montgomery VA Medical Center Executive Summary G.V. (Sonny) Montgomery VA Medical Center is concerned about the patient’s safety, health, and care. Over the years, the institution has been faithful to its commitment of giving the best kind of care to the elderly veterans, and make them feel that with them, they are secured of a safe healthcare experience. The goal of promoting satisfactory healthcare knowledge among the medical and non-medical teams and with the patients inspired this plan. Decreasing the rate of patient falls is the priority of the said plan, with special attention to the knowledge and skills of the healthcare providers. Through public reporting and clinical informatics, this goal of educating those who are directly and indirectly involved with the system would be realized. The hospital believes that according to the design and goals of the plan, public reporting would be the best way to jump start education for those who are concerned and the patients in the VA medical center. The hospital is well aware that their primary clients are veterans who were in the national service for many years and sensitive to many aspects, and thus, educating both the medical team and the patients concerned would be the mildest yet most effective way of administering the quality improvement plan. Clinical informatics would help the hospital with a more thorough and organized distribution of information with the help of information technology. This way, the target of educating the hospital team about patient falls would be strategic and sound. The combination of information technology and clinical experiences broadens the opportunities for healthcare education. The institution believes that in order to reduce the patient fall rates, it is necessary to start with awareness of the said situation, and only then can there be action towards it. Summary The G.V. (Sonny) Montgomery VA Medical Center is a hospital honoring the American veterans. The institution’s respect towards them is insurmountable, and thus, they are faithful to their mission of providing the best quality of health care to them, as willingly as they fought for the nation in younger years. As part of the nationwide Veteran’s Administration hospitals, the center ensures that quality healthcare is within reach for every American veteran. In carrying out their vision-mission statements, the hospital has quality services offered whether it is not in-patient care or out-patient care. Major medical services would include “primary, second and tertiary medical, neurological and mental health inpatient care” (“U.S. Department,” 2010). As observed, the hospital sees the necessity of caring for their patients holistically. This VA hospital is currently having 163 active hospitals affiliated with various medical colleges and universities, with facilities including “a 120-bed nursing home care unit, Community-Based Outpatient Clinics, nursing homes and four 150-bed state veterans’ nursing homes” (“U.S. Department,” 2010). In line with the core values of compassion, commitment, excellence, professionalism, integrity, accountability, and stewardship, this plan would follow a goal and an objective of patient-centered service, making the health care more accessible to all American Veterans. The pride of caring for the nation’s heroes is the inspiration of the hospital to do the best it could in providing efficient health care service. This plan targets seven issues surrounding patient fall rates; these are quality services, assurance of safety, accurate medical delivery, knowledgeable line of staff, decrease of infection rate, increase of patient recovery, and continuous medical service for outpatients. As observed, the plan’s primary objective is to ensure that patients are far from a possible patient fall. The secondary objective is more concerned about facility and care accessibility. Although the two objectives are of different areas, its collaboration would mean the success of the plan. Since the plan is centered on the educating the VA medical center human resource and to decrease the amount of patient falls, then it is understood that the Human Resource Department and the Maintenance Department are directly affected. First the HRD should be very selective about incoming prospective employees. Only the best performing health care providers should be employed in the VA medical center. The sensitivity of the patients and their vulnerability to pain and emotional distress should be the basis of hiring prospective employees. Regular performance checking and skills training in patient falls should also be administered by the HRD. Second, the Maintenance Department should keep in mind the task of keeping the physical surroundings of the hospital to be suitable for elderly veterans. The facilities to prevent patient falls such as braces and floor mats should be in good condition all the time, while they should also keep the floor from anything that can make it slippery. These are precautions of patient falls and a good way of treating it just before it occurs. In the primary stages of the plan, there are several data collection tools that are considered to be used; however, the checklist, survey and logbooks seem to be the most qualified, if design and purpose of the plan should be taken into account. One advantage of checklist is that it “record whether a specific action has been performed... [and] is good for studying complex processes with many steps” (Joint Commission Resource, Inc., 2008, p. 65). Checklists divide the qualities and tasks to be assessed making the rating process easy and organized. Observable qualities are also listed in the checklist in such a way that the respondent or any one administrating data collection would not be able to forget important details. The same is true about surveys. Surveys also concentrate on observable qualities, but it has more direct involvement with certain people. In other word, it serves as a documentation about the topic being surveyed. Finally, logbooks also deal with documentation of events inside the hospital, but one disadvantage expressed by Suckow, Weisbroth, and Franklin (2006), is that logbooks’ uniqueness of the events recorded could not be easily retrieved in case of loss and tampering. The hospital is well aware of this and decides to have a back-up file through computer systems to assure that the recorded events would not be lost. After careful assessment of each data collection tool, it would be implemented in the quality improvement plan based on the performance measures of the hospital. It would be best for the plan if the quality improvement strategies are made proportional with the hospital’s performance measures. Smith, Mossailos, and Papanicolas (2008) contend that quality improvement strategies can be maximized if applied to performance measures. According to the plan’s design and objectives, it would be best to have a robust conceptual framework, implement public reporting, and utilizing information systems. Initial planning should contain an organized body of framework, in which the plan should concentrate. That way, identifying the succeeding stages of the plan would be less complicated. Furthermore, a step by step implementation of the plan would offer a holistic overview and helpful hypothesis of the future results. Answering the objective of educating the health care providers and health care recipients, this plan suggests the use of public reporting as a quality improvement method. The hospital believes that public reporting can aid with informing the public and health care providers about the proneness, risks, and ways to avoid patient falls and could be the first step in patient fall prevention. The hospital acknowledges the use of technology as part of this plan. Information systems play broad and useful roles in the implementation of the plan. Records, surveillance, and patient fall protection can be monitored using various information systems. Part of the monitoring of effectiveness of the plan, the hospital chooses another institution which also caters to elderly or veteran’s care. Based on their standard and mode of quality improvement, the hospital sees James A. Haley Veterans Hospital in Tampa, Florida as the best comparative benchmark. The wider range of services and effective implementation of their objective is ideal in terms of patient falls. The hospital’s equipment are almost complete with all the necessary tools present for patient fall prevention such as bed side floor mat, chair or bed alarm, and hip protectors. Authority, Structure, and Organization The implementation of the plan requires the overall participation of the whole hospital hierarchy. Although the first parts of this plan identified two departments which would be affected, it does not mean that the participants are exclusive in the said departments. The quality improvement committee, with the middle management, is in-charge of the monitoring and implementing of the step by step procedures of the plan. The medical staff’s task is to ensure the reliability of health care providers under their supervision and also handle seminars and training once in a while, since they have direct knowledge about the matter. Other department would do their part in patient fall control by doing their responsibility according to their line of duty. For example, the maintenance department would see to it that all facilities for patient fall control are working well. The hospital understand that the plan is not a work of a single person, and its success depends on how the hospital staff from all departments are working together to achieve the target. Communication After the plan has been implemented and all necessary record is made as observation, it is the obligation of the hospital to transmit whatever the result there is to the U.S. Department of Veterans Affairs and American Hospital Association. The VA hospital would be true to their promise of transparency so as not to derail the consumers to make the right choice of health care institution preference. The quality improvement plan committee shall communicate to the two major institutions about the result of the implementation. Education As stated in the previous parts of the plan, the target is to distribute knowledge regarding patient falls and its prevention. In doing so, the plan suggests that there should be seminars and trainings regarding the latest trend in administering prevention of patient falls. Up to date methods to maneuver patient falls should be taught to all medical personnel such that the patient fall prevention would not be a sole obligation of the healthcare provider on duty. For employees outside medical responsibilities, it is a must that their tasks are well practiced. Since the hospital does not believe that the plan can be done by a single division of the hospital, it is encouraged that every employee should be informed about this latest plan. For example, the maintenance team is far from assisting patients but they can do so by seeing to it that all equipments for patient fall prevention are still in good shape; those equipments which are under the hospital’s standards should be fixed or disposed. Annual Evaluation The plan hopes to have a continuous and effective means of patient fall prevention. As part of the quality improvement measures, the hospital would implement annual evaluation on specific areas concerning patient falls. Other areas which are directly related to patient fall prevention should be monitored as often as possible to ensure that there would be growth and development. Facility enhancement and continuous medical knowledge are two things that the hospital should prioritize and should always be up to date. The inconsistency of the two aspects should be eyed upon the institution, seeing to it that changes within the two areas are only for the good and the improvement of the plan. References Joint Commission Resources, Inc. (2008). Tools for performance measurement in health care: A quick reference guide. Illinois: Joint Commission Resources. Smith, P.C., Mossailos, E., & Papanicolas, I. (2008). Performance measurement for health system improvement: Experiences, challenges and prospects. Denmark: WHO. Suckow, M. A., Weisbroth, S. H., & Franklin, C. L. (2006). The laboratory rat. London: Academic Press. U.S. Department of Veterans Affairs. (2010). National center for patient safety 2004 falls toolkit. Retrieved from http://www.va.gov/ncps/safetytopics/fallstoolkit/index.html#notebook Read More