Governance in Long-Term Care Quality - Case Study Example

Health Care- Long Term Care Week 5 Introduction: Over the years, the quality of long term health care has been modified with intentions to improve the conditions of the health care systems. In the early times, the focus of the health care used to be on the structural factors, including the applied processes and the results of the implied care. In the present times, the focus has been modified to great extent, thus stressing on the restraints and the functional aspects of the care. The improvement plans in the nursing and long term health care seem to encounter several difficulties associated with the conception of quality among individuals, unavailability of sufficient resources, limitations in the use of technology, as well as lack of the required thrust (Capitman & Bishop, 2004, pp.4-5). It is thus believed that significant knowledge and research are necessary for different health organizations to achieve quality health care for long term purpose (Shaw et al, 2003, pp.92-98). The present study focuses on the quality of long term health care and learns about the impact of governance and/or leadership in the care quality. Also, the study addresses the role of the organizational culture in terms of satisfaction of the care stakeholders in the long term. Governance and Leadership in Long-Term Care Quality: As with the passage of time, several modifications have been realized to have taken place in the process of long-term health care quality in health organizations, there seem to be a huge significance of the governance or leadership on these aspects. In this section, a focus would be placed on two different articles- one by Dana & Olson, and another by Mor- that throw light on these issues as related to the quality of long-term health care for individuals. The process of health care improvement encountered with several barriers, the role of the leaders in a team and their governance rules need to play significant roles in order to achieve the desired care for long term process. In his article, “Improving the Quality of Long-Term Care with Better Information”, Mor has talked about the usefulness of efficient clinical information that can assist the leaders and the governance process to a great extent enabling the achievement of good quality long-term health care. In a health organization leaders require to set up targets for achievement of health care quality. This would involve incurring improved measures in areas of clinical treatments, as well as stressing on proper reporting of the measures to the public. Such measures would enhance the level of governance in a health organization. The impacts of proper leadership or governance are significantly obtained when greater number of consumers starts preferring a particular health organization for their long-term treatment (Mor, 2005, pp.333-334). Mor through his article has focused on three issues that can be considerably discussed in the particular study. These are: (i) the conceptual issues regarding the health care quality, (ii) the technical issues, and (iii) the experiences on improvement efforts. In regard to the conceptual issues, Mor stressed on the facts that an understanding of the level of quality depends on the experiences of the patients as they receive treatments from the health organizations. In this context, it becomes necessary to determine the aspects of quality that include the different functions, the care and treatments provided and the satisfaction of the patients and their families. Consumers generally tend to compare the quality of care that they receive from different health organizations. Also, the results or the consequences of the health care provided determine the manner in which the concept of quality for long-term health care is understood (Mor, 2005, pp.337-339). Technical factors include the reliability measurements of the health care, the adjustment in the risk factors, the metrics through which consumers would be able to measure the quality, as well as the differences in the level of special facilities provided by different health organizations. It is important to understand the real effects of the reliability that nursing or treatments might provide to the patients since variations might lead to unpopularity. Risk factors need to be avoided by providing equal long term treatments to all patients. In regard to the experiences on improvement efforts, Mor discussed that earlier opinions are capable of enhancing the determination of newer ways for the achievement of the long term care quality (Mor, 2005, pp.342-346). This on the other hand, reflects on the need for significant governance and leadership without which the above mentioned steps of long term health-care would be difficult to achieve. In another article named “Effective Leadership in Long Term Care: The Need and the Opportunity”, Dana and Olson has talked about the leadership, its effectiveness and hence the impacts in the achievement of long term health care. According to them, leaders are capable of managing and optimally using the available resources towards achievement of organizational goals. This also takes into consideration the management of the human resources who would actually enable the execution of the plans which in case of the health organizations would be represented by the satisfactory treatments or the long term care they would provide to the patients. Also the leaders play the significant role of motivating their teams towards the new and enhanced measures that are advantageous for the organization (Dana & Olson, 2007, pp.4-5). The major three points that Dana and Olson have reflected in their articles are (i) the need and importance of leadership within organizations, (ii) the changing needs and demands of the consumers, and (iii) higher expectations of skills from nursing departments. Thus in the changing needs and demands of the long term health care, effective leadership and governance prove to be highly essential as part of the management team. In the present times, the leaders in health organizations are not only required to look after motivating their teams, but to also keep their focus on the changing demands, the regulations as well as the financial aspects associated with the treatments and care provided to the patients. Consumers now have higher expectations for quality of long-term care provided to them. Dana and Olson have reflected on the studies that have been considered over long periods of time determining the differences in the roles of managers and leaders and the level of knowledge and expertise that are now expected from the nursing departments in the health care organizations, as also focused on by the National Association of Boards of Examiners of Long Term Care Administrators (NAB) (Dana & Olson, 2007, pp.9-10). Role of Organizational Culture: From the leadership and the governance as required for the achievement of organizational goals, even in cases of health care organizations, it can be realized that the culture prevailing within an organization also influences the effectiveness of the leadership, governance or other management procedures. Over the years, with the changing demands and expectations of health services and long term care, health organizations have been found to concentrate on the environment in which the treatment or care is provided to the patients. The need for a positive atmosphere and hence a positive attribute of the organizational culture has been realized in order to achieve positive results of the treatment being provided to the patients intending for improved impacts on them (Joint Commission Resources, Inc, 2005, p.1). A healthy culture prevailing within a health organization would enable the organizational members to share their views and opinions without any hesitation such that different innovative and advanced solutions may be discussed and attempted towards better care for the patients. Safety culture has been considered to be important in the present day health organizations where a mutual trust between the members work towards common goals. Such safety cultures also ensure that proper standards of health care are followed and maintained in the organization (Joint Commission Resources, Inc, 2005, pp.1-2). The role of the organizational culture also holds significant since the cultural values and principles influence the health care to focus on the changing expectations of consumers and accordingly plan and implement advanced systems of long-term health care (Scott et al, 2002, pp.111-118). The concern of the organizational culture also involves the role of the management and the leaders who are the members of the particular organization. Thus while the environment, in which the members are supposed to work, and the health care treatments are followed, the role of the leaders or the governance role is significant for maintenance of the culture implying a satisfactory long-term health care for the patients. In other words, it can be said that the culture prevailing within an organization determines the degree and effectiveness of performance. It would thus involve effective strategies on the part of the team of management and leaders resulting in a healthy environment and work culture. This might not be an easy task since a healthy organizational culture needs to have the contribution of each and every member through their cooperation and effective performance (Scott et al, 2002, pp.111-118). Here the role of leaders seems to be more significant than ever expecting them to motivate the entire team to perform in accordance with the needs of the organization. An organizational culture also represents the level of satisfaction that the organizational members possess. The culture can be considered to be healthy if the members are found to be utilizing their time more on performing rather than only making decisions (Kane-Urrabazo, 2006, pp.188-189). In case of health organizations, this can be visibly proven through the treatments and long-term health care that the nursing departments provide satisfactorily to the patients. However, such organizational culture might vary from one organization to another depending on the nature of the organizational members, their performances, the level of expectations of individuals- patients and their family members- from the health organizations. An organizational culture involving trustworthiness, empowerment, consistency in performance, delegation, authorization, and mentorship generally tend to be healthy and more effective in their activities and maintenance of their goals and objectives (Kane-Urrabazo, 2006, pp.190-192). Thus all the factors and issues as mentioned above need to work together and positively in order to reach for a healthy organizational culture. For a health organization, as the current study is focused on, the culture in which the nursing personnel as well as other organizational members work requires to be a healthy one such that the entire team together can provide the desired long-term health care with good quality to the patients. This is primarily necessary since assuring quality health care is challenging and hence would need the cooperation and team-work efficiently for the achievement of the goals. The leadership role thus is highly significant ensuring the participation of all the members of the health organization trying to overcome the challenges and result in good quality long-term health care services to patients. Conclusion: From the above study it has been observed that over the years several studies have been conducted on the impacts of the leadership and governance activities on the delivery of quality health care in health organizations. Also, the organizational culture has been found to have significant effects and influences on its members thus capable of enhancing their performances for providing satisfactory long term health care services to patients. While quality is considered, its concepts, technical understandings as well as experiences count a lot in determining the advanced measures in health services. Also, the changing demands and expectations of individuals from health organizations, and several options being available to them in the current times, it is necessary that organizations keep greater focus on the leadership and management roles in their organizations to effectively perform and keep their positions among the competitor as well. Thus from the overall study it can be concluded that in order to achieve a quality long-term health care the organizational culture and the role of leadership and governance need to be efficiently planned and executed with effective performance of the members and intentions to overcome the challenges that they encounter, and thus gain the satisfaction of the stakeholders. References 1) Captiman, J. & C. Bishop (2004). Long- Term Care Quality: Historical Overview and Current Initiatives, newschool, Retrieved on February 4, 2012 from: http://www.newschool.edu/ltcc/pdf/txBackground03-10-05FINAL.pdf 2) Dana, B. & D. Olson (2007). Effective Leadership in Long Term Care: The Need and the Opportunity, achca, Retrieved on February 4, 2012 from: http://www.achca.org/content/pdf/ACHCA_Leadership_Need_and_Opportunity_Paper_Dana-Olson.pdf 3) Joint Commission Resources, Inc (2005). Reducing the risk of falls in your health care organization, Illinois: Joint Commission Resources 4) Kane-Urrabazo, C. (2006). Management’s role in shaping organizational culture, Journal of Nursing Management, 14, pp.188-194, Retrieved on February 4, 2012 from: http://www.sjsu.edu/people/phyllis.connolly/courses/c17/s1/kane_umanageroleorgcul20060177.pdf 5) Mor, V. (2005). Improving the Quality of Long-Term Care with Better Information, The Milbank Quarterly, 83(3), pp.333-364, Retrieved on February 4, 2012 from: http://www.rwjf.org/files/research/Mor.pdf 6) Scott, T. et al (2002). Implementing culture change in health care: theory and practice, International Journal for Quality in Health Care, Oxford Journals, 15(2), pp.111-118, Retrieved on February 4, 2012 from: http://intqhc.oxfordjournals.org/content/15/2/111.full 7) Shaw, S.et al (2003). Developing research management and governance capacity in primary care organizations: transferable learning from a qualitative evaluation of UK pilot sites, Family Practice, Oxford Journals, 21(1), pp.92-98, Retrieved on February 4, 2012 from: http://fampra.oxfordjournals.org/content/21/1/92.full Read More