Total Quality Management in Healthcare - Essay Example

This paper would fathom different issues and ideas concerning evidence-based and quality improvements movements could settle issues concerning patients care and how these practices would further improve Health care not just as a vocation but in the management perspective of this issue. In this case, different tasks and issues would be introduced to further enhance the awareness of everybody concerning quality healthcare with regards to catering the needs of patients as well as for the improvement of Health Care as a service-based Industry. To further realize the importance of this study, several facts would be laid upon for the awareness and to further establish the credibility of claims regarding this issue. Looking into Philosophical perspective of Health with the fusion of management-based theories and practices would further ensure a patient-centered care with regards this kind of practice specifically for the nurses to enable them to provide quality healthcare among patients they handle. Through this kind of practice, medical practitioners would now be aware of giving the patients the proper care they deserve. Introduction Definitions Evidence-based Nursing Practice: A practice which solves problems concerning Nursing Practices Identification of the issues or problem based with regards to accurate analysis of current nursing knowledge and practice Search and Review of relevant and related literature Evaluate the research evidence using established criteria regarding scientific merit Justification of selected premises and issues with merits to further establish the claim with the most valid evidence. Quality is always the outmost concern of everyone if we are to deal with business concerning consumers and producers likewise the service providers. If we are to deal with health care practice, it is one of the important elements to provide the services that a patient needs in this particular kind of situation. It is often said that one cannot compromise life so in dealing with healthcare practice, quality is should not be taken for granted. Here, a delicate and meticulous order in managing quality should be observed. If we are to analyze this premise, discipline is important to make this thing possible. Indeed, cases of medical malpractice have been recorded in the past. There are people who pent tremendous amount of money whether to obtain medical attention and other related endeavors but sometimes, there are cases that the worth that they have spent was not that compensated simply because of one thing-poor service. It is an established fact that though Health Care practice is more of a vocation, consumerism is still attached to this kind of practice and therefore, quality of the services rendered is essential in fulfilling the needs of the consumers which is deemed as the main reason on why a certain business enterprise exist. Given these kind of situation, the principle of Total Quality Management or TQM enters. If we are to analyze, Quality is also a thing to be managed in order to ensure that the kinds of goods or services that are given or rendered to the customers is worth their expense. If we are to further fathom Total Quality Management, It is simply defined as "to a management process and set of disciplines that are coordinated to ensure that the organization consistently meets and exceeds customer requirements (Capezio P and Morehouse D (1997)." This means that this includes philosophical and psychological approaches with the aid of several strategies in business to ensure the satisfaction of the customers in utilizing and purchasing goods and services form that business and for the business to obtain the acceptable output of the enterprise. Going back to Health Care, it is also considered as business as the services rendered as well as the goods that are to be sold involves profit. Consumerism in health care though healthcare is often regarded as a vocation is evident. One cannot say that a certain healthcare provider exist just to extend a hand. Of course, there are organizations that exist in such a format but majority of those who are tangled with this kind of endeavor exist for profiteering. If we are to analyze, collection of taxes for medications, purchasing of medicines that are needed for treatment, professional fees of the medical people are among those proofs that consumerism has its way in HealthCare Practice. In order to obtain the quality that healthcare practice demands, several parameters must be set in order for the assessor to be guided. Several categories include, 1) Good Clinical Care 2) Maintaining Good Medical Practice 3) Relationships with patients and communication 4) Teaching and Training and 5) Professional Behavior (Cheater. F., Keane. M.1998 and http://www.nes.scot.nhs.uk). These are some of the parameters that are to be followed in order to ensure that the quality that the HealthCare personnel is in accordance with the expected kind of services from them. In this case, parameters that are set within hospitals along with the Doctors and Nurses should be properly observed. However, if the assessment is based within the bracket of a certain organization involving the aforementioned variables, then the accuracy of the reports is only limited within the organization itself along with the stagnation of parameters that are set. Here, the need for quality assessors as well as investigating body arises. Here, standard-giving bodies are important and are deemed as vital in determining the needed standards that are to be set in order to ensure quality. In this case, bodies such as ISO or International Organization for Standardization. ISO standards make a positive difference, not just to engineers and manufacturers for whom they solve basic problems in production and distribution, but to society as a whole (www.iso.ch 2006). Also, bodies such as the EFQM model which is used for Self-Assessment,Benchmark with other organizations, Identify areas for Improvement, as the basis for a common Vocabulary and a way of thinking, Structure for the organization's management system. Also, criterions such as Leadership, policy and strategy, people, partnerships and resources, the response from the consumers and the likes are among those things that should be taken into consideration. The Evidence-Based Nursing Evidence Based Nursing is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and patient preferences. Three areas of research competence are: interpreting and using research, evaluating practice, and conducting research. These three competencies areimportant to EBN (University of Minnesota 2001).To carry out EBN the following factors must be considered:1)sufficient research must have been published on the specific topic, 2)the nurse must have skill in accessing and critically analyzing research, 3) the nurse's practice must allow her/him to implement changes based on EBN. In this case thorough and intensive research is a must in order for the Nurses who will supervise and conduct this kind of task in order to ensure the accuracy of the study. During the process, nurses who are involved with this kind of study must be open to several changes that are to be implemented in case such occurrences would affect their previous studies as well as the quality of the services that they render per se. Leadership This is an important task in order to implement changes as well as the study that is being conducted as a whole. In the case of Leadership in Nursing Community, it is often regarded that the quality of care rendered by the Nurses depends on the availability of the resources, the technologies that are being utilized, the process of treatments, and the qualification of personnel are among those that are to be considered in order to ensure the quality of services that are being rendered. The conception of Nursing Information Systems is said to be the answer to the need of nurses with regards to alleviating the quality of services that they render in order to derive Nursing practice from conventional/traditional way to modern and new methods. In the United States, several alliances have been formed in order to monitor the quality of services given by nurses through modern method. In this case, the alliance for Nursing Informatics has been conceptualized. "The Alliance for Nursing Informatics is a collaboration of organizations that represent a unified voice for nursing informatics. The Alliance represents more than 3,000 nurses and brings together 20 distinct nursing informatics groups in the United States. The alliance is supported by both HIMSS and AMIA. NISNCE has been a member of the alliance since its inception. Each NI organization provides a representative for four meetings a year. (http://www.niscne.org 2005)" With the continuous changes of technologies, the documentation of medical records through electronic devices presently invades most of hospitals and health care organization based on its accuracy and speed compared to the traditional/conventional method of recording and it also greatly enhances nursing abilities to benchmark, monitor, audit and report quality measures in support of JCAHO and MAGNET initiatives. This kind of innovation ensures the patient as well as the nurses themselves of an accurate and more reliable data, which is deemed as one of the most necessary elements in medical practice with regards to the treatment and provision of medical attention among patients and related people who rely on these kinds of services. Also, these kinds of data can be easily retrieved electronically. Advances to Achieve Effective Patients Care If we are to deal with the advancements and positive changes with regards to the improvement of quality in Nursing and Health Care practices, the feedback from the patients as well as the families are essential for the assessment of changes that are to be made in order to point out strong and weak points of the services that are being rendered. In this case, the variation of data collection maybe through simple testimonials or more complicated methods such as surveys and the likes is a big help in achieving the objective to further formulate changes and standards which will be used to further achieve quality output among Nurses and Health Care Personnel. Also, the treatment process of patients to date includes devices which enable the patient to avoid boredom and other related scenarios. There are instances which health care providers and personnel offers the use of personal computers, installation of television sets as well as hiring of extended personnel such as clowns and magicians to entertain patients which most of these providers claim that such offerings are of big help for the patients recovery as well as for the nurses to easily deal with patients. Also, in 2006, wireless Voice-over-IP (voice carried over internet protocol networks) phones were implemented in all nursing units (in US and in some parts of UK) to facilitate ease of communication and coordination of patient care between staff, physicians, ancillary departments and patients to further ensure the quality immediate response of nurses particularly in times of need of the patients. New Level in Attending Patients Needs Technology regarding Health Care Practices as well as Nursing practices definitely paved its way in achieving the needed change for the advancement of attending medical needs of the patient. In this case, the conception and provision of new electronic tools and equipment proved that there is no room for excuse not to give people with medical needs the quality of attention and treatment they deserve. The introduction of medical record system has been a big help for these practitioners to further improve the quality of services that they render based on the accuracy and the speed of giving medical attention to the patients. Also, the use of electronic documentation as an answer to stockpiles of medical records in hospitals and other related institutions also has its part in ensuring the safety of the records as well as easy access on them should the situation requires. Also, the availability of procedures and standards that are being implemented by the nursing board with regards to the access of vital information of the nurses have been made available through the internet and this paved the way to enable the nurse to be educated and for them to further familiarize the steps and procedures that is acceptable to the quality of the majority of the health care institutions as well as the authority requires. This kind of innovations also broke the distance barrier of health care providers as well as the patients even though patients or Nurses and Healthcare providers are out of the hospital. In this case, the health care providers would have easy access on vital records whenever or wherever they need those. What the Future Holds With the continuous process and implementations that Nursing and Health Care providers offer, definitely it is inevitable to assume both technological and practical changes within the scope of Health Care and Nursing Practice. The present technology that nursing offers slowly alters the traditional way of attending the patient's need and would likewise eradicate traditional methods in the future. Also, it cannot be discounted that a possible fusion of Nursing and Health Care practice with Information Technology would be at hand. Although these changes would require tremendous effort and expertise, this thing could be conceptualized solely on the basis of satisfaction of the people that are in need of medical attention as well as for the convenience of these Medical Personnel to be able to expand their scope and to do more than they can solely on the notion of having a variety of options to be made through the use of latest technologies in Nursing and Health Care Practices. The current trend of involving technology in health care practices has brought ease and comfort to both patients and attendants per se. In this case, the improvement of the intended outcome in nursing practice has been established through a concise and accurate data which results to accurate analysis and would end up in accurate treatment. If we are to analyze, the room for errors have been minimized by this kind of practice. If we are to further involve information technology in this kind of practice, then the assurance of having an accurate data as well as analysis would be further established. Analyzing these facts would make us conclude that it is inevitable for Technology and Nursing and Health Care practice in the Future. Conclusion It is often said that the only constant here on earth is change, in the case of Nursing and health care practices, these practices are not spared in this kind of change. Of course, traditional nursing and health care practices are the main reason why these kinds of practices still exist. However, there is a huge need for these practices to adopt new methods to fare with the demands of this changing world. Of course, the accuracy of data that are to be analyzed is essential and therefore the acceptance of technological methods in keeping methods and securing data should not be taken for granted. If we are to instill quality among Nursing and Health Care practice, especially that these fields focuses on the service side, accuracy is very important to obtain the needed output with regards to securing medical attention. The inclusion of technological touch in response to medical needs is vital to ensure quality service to the patients. These occurrences would also change medical perspective into another point of standard which is to rely on accurate details in attending medical needs. The inclusion of technologies in the field of Health care and nursing practice should be regarded as a vital change to obtain a more accurate attention which is a requisite of a quality service. Reference: 1) Capezio P and Morehouse D (1997) "Taking the Mystery Out of TQM: A Practical Guide to Total Quality Management, Second Edition" 2) Cheater. F., Keane. M. (1998) Nurse's participation n audit: a regional study. Quality in Health Care. Vol. 7 (1): pg. 27-36. 3) Tools and Techniqueshttp://www.nes.scot.nhs.uk/medicine/GPVT/Ntrainers/Training_Tools/documents/TrainingLogBlankMMC1.xls 4) www.iso.ch "Overview of ISO." Opened January 21, 2007, URL Available http://www.iso.ch/iso/en/aboutiso/introduction/index.html 5) http://www.idigitalbridge.org/saeto/efqm.htm 6) University Of Minnesota (2001) "Evidence Based Nursing" Opened January 21, 2007 URL Available http://rds.yahoo.com/_ylt=A0oGknHiRrRFWnwAqk9XNyoA;_ylu=X3oDMTE2anQzYW1tBGNvbG8DdwRsA1dTMQRwb3MDMQRzZWMDc3IEdnRpZANGODYyXzcz/SIG=11njirf9v/EXP=1169528930/**http%3a//evidence.ahc.umn.edu/ebn.htm 7) http://www.niscne.org/ With Important Notes From Haller, K. B., Reynolds, M. A., & Horsley, J.A. (1979). Developing research-based innovation protocols: Process, criteria and issues. Research in Nursing and Health 2, 45-51; 2. Horsley, J.A., Crane, J., & Bingle, J. D. (1978). Research utilization as an organizational process. Journal of Nursing Administration, July, 4-6; 3. Horsley, J. A., Crane J., , Crabtree, M. K., & Wood, D. J. (1983). Using research to improve practice. Orlando, FL:Grune & Stratton. 4. Fowkes. FGR. (1982) Medical audit cycle. 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