Quality Improvement and Patient Safety - Essay Example

? Quality Improvemet Introduction Health care is something important for any necessary country, and the reason the different nationshave been held in close discussions and political approaches towards having a better health care policy which addresses the health issues of the greatest majority of the individuals in the country. Reflecting on research, quality improvement defines a formal approach to the analysis of performance and efforts to improve it. Basically, there are a number of models used to improve the services of patient safety. In that sense, the need for quality and safety improvement services initiatives permeates quality health care (Bannet, 2012). Quality health care can be defined as the degree to which health services for individual patients and populaces increase the likelihood of desired health outcomes (Swayne, Duncan & Ginter, 2012). It is worth noting that quality health care must be achieved in one way or another in order to attain an effective quality improvement, especially when it comes to patient safety. In line with this, it is my opinion that quality improvement and patient safety are totally inseparable fields. Quality Improvement Quality improvement is a necessity for all people, whether they are normal people or even when the people have some serious complications which might be impacting negatively on their developing processes. The development of an appropriate quality improvement plan for any given patient suffering from a given disease is a right move in ensuring that the individual has been able to get the necessary treatment he or she deserves (Angle, 2004). This plan is a guideline which ensures that the person does follow the outlined guidelines towards having appropriate treatment in the long run. Having been hired as an assistant to the chief executive officer in a hospital that is experiencing vast growth, I will be heading up the new quality improvement department of the organization. The hospital deals with patients who have asthma and my core goal is to reduce the incidence of severe asthma exacerbations. As mentioned earlier, the hospital is experiencing vast growth and with this growth comes many problems being faced. It is worth noting that the hospital has recently reported twenty five percent asthmatic infections. Most of these problems have to do with patient safety. Patient safety is probably the newest healthcare discipline that puts emphasis on the reporting and prevention of medical error that leads to adverse healthcare events (Bannet, 2012). It is worth noting that indeed, patient safety has over the years emerged as a rare healthcare discipline supported by a scientific framework. In that case, the key plan is to achieve the goal, which is to reduce the asthma aggravations by providing a detailed asthma action plan to each and every patient who has asthma. Defining some specific measures is very critical to any quality improvement project, which can be challenging thus there are two basic types of measures. They include outcome measures and process measures. To point out these measures, outcome measures gauge the adverse impact of the initiative on a patient population whilst a process measure quantifies compliance with the practices being implemented (DeMuro, 2007). With this in mind, then a process measure for this project might be the number of patients who actually have an action plan documented in their medical records, with the numerator being the total number of patients with asthma having an action plan and the denominator being the total number of patients in the practice who are infected with asthma. A clinical outcome measure for this initiative in this case might be the reduction of emergency department frequent visits or inpatient hospitalizations for asthma aggravations once adequate compliance is achieved. However, there are instances in which measuring outcomes cannot be done after an initiative has been implemented. If then that’s the case, tracking process measures and improving compliance can be a reasonable doubt. Embarking on a Quality improvement and all its prospects initiative can be overwhelming. It is however important for me to be involved in such work. Collaborating with other pediatricians will provide a rich opportunity to perform quality improvement work. This approach facilitates exchange of knowledge, and experiences and allow for pooling of resources (Swayne, & Duncan & Ginter, 2012). I may also want to check locally for foundations that support health-care quality improvement projects within my community. SIERRA which is an acronym stands for Simple initiatives, Interdisciplinary teams, Early adopters, Rapid pilots, Rapid feedback, Advertise gains, offers some simple guiding principles for implementing a successful quality improvement initiative (Angle, 2004). Through my past experiences, pediatricians have a natural tendency to try to solve too large a problem. Often, as I would put it, less is more. Simple initiatives that focuses on one key goal with one key change are often more achievable and always leads to an increase of likelihood and a successful outcome. Interdisciplinary team creation increases the scope of skill brought forth to the table, thus creating a collaborative environment. I will choose early adopters (who are individuals well respected by their peers, are open to any form of change and can aid in spreading new ideas) when recruiting members for my team. To add on to that, colleagues who resist change and are not willing to accept new ideas can readily derail a project and impede progress. Quality improvement are rarely a perfect out of the starting gate (Bannet, 2012). And by this I mean that rapid cycles of change within a small defined patient populace make implementation more manageable. I will consider making changes to one patient at a time. As has been stated earlier, medical errors were frequently experienced. Since errors are caused by system or process failures, it is important to adopt and be up to date with various process-improvement techniques to identify inefficiencies, ineffective care, and to then influence changes associated with these systems (DeMuro, 2007). It is important to note that there is a number of effects’ analyses, that I am going to include in this and they include the plan-Do-Study-Act, Six Sigma, Lean, and root-cause analysis that have been used to improve the quality and safety of health care. Quality improvement projects can use the Plan-Do-Study-Act model (Swayne, & Duncan & Ginter, 2012). This method has been widely used by the Institute for Healthcare Improvement for rapid cycle improvement. One unique feature of this model is the cyclical nature of impacting and assessing change, most effectively accomplished through small and frequent Plan-Do-Study-Acts rather than big and slow ones. The quality purpose of Plan-Do-Study-Act quality improvement efforts is to establish causal relationship between changes in processes and outcomes. As an assistant of the chief executive officer, I will probably ask myself these three credible questions, What is the goal of the project, how will it be known to me and to my employers whether the goal was reached or not and what exactly will be done to reach the goal? With these questions being put into considerations, then the Plan-Do-Study-Act cycle starts with determining the problem and what changes can and should be made, which parties should be involved, and where will the strategy be targeted. Another one of the effects analysis is the six sigma which originally was designed as a business strategy which effectively involves designing, improving and monitoring process to minimize waste while optimizing satisfaction (DeMuro, 2007). The performance of a process is mainly used to measure improvement by comparing the baseline process capability with the process capability after leading potential solutions for quality improvement (Bannet, 2012). I will use the two primary methods used with Six Sigma. One of the two method inspects process outcome by counting the defects and then tabulates a defect rate per million. This method is applicable to pretest and post-test studies. The second method which is suitable for analytical processes in which accuracy can be determined can use estimates of process variation to predict process performance. Root cause analysis, which is used extensively in engineering and will implemented in my undertaking is a problem-solving approach focused so much on identifying and understanding the underlying causes of an event. The Joint Commission requires Root cause analysis to be performed in response to all sentinel events and expects. To sum up everything in few sentences concerning the root cause analysis is that it is a technique used to identify the trends and assess risk whenever human error is suspected. Conclusion In conclusion, quality improvement and patient safety requires three essential elements for success and they include sustaining a culture of change and safety, developing and clarifying an understanding of the problem and involving key stakeholders. Building on the above discussion, we can deduce that a good quality improvement plan should rotate around three parts: the first one detailing the overall description of the patient, the second one giving information of the disease process he or she is suffering from, and the third part is on the age and developmental issues. References Angle, S. (2004). Occupational safety and health in the emergency services, Cambridge University Press, Cambridge. Bannet, E. (2012). Practical Techniques for Strategic Planning in Healthcare Organizations . Tulsa, OK: Hogan Press. DeMuro, R. (2007). Fundamentals of Managed Care and Network Development. New York: McGraw-Hill. Swayne, E. & Duncan, J. & Ginter, M. (2012). Strategic Management of Health Care Organizations. New Jersey. John Wiley & Sons. Read More