Effective Tools to Increase the Level of Service Quality Exhibited by Nurses - Literature review Example

Introduction Promoting and improving the quality and safety of the patients’ acts as a driving force that helps as a factor aiming at achieving the vision of any hospital. The vision mainly is to provide a world class patient centered integrated academic medical center. The quality and performance improvement is interdisciplinary process that is dynamic and strives so as to achieve the annually established outcomes by the leadership of the hospital. Every hospital must always establish a framework that places the nurses on the frontline of transforming healthcare throughout the globe (Morton et.al, 2014). There are certain reasons that require an improved and efficient work by the nurses in any hospital. These reasons include, firstly, avoiding unnecessary injuries to the patients that may be derived from the care that aims and intends to help them in need. Secondly, by improving the efficiency of the nurses, the response time of the nurses will be decreased. This is important since this will reduce the time wait as well as the potentially harmful delays for those who provide the care as well as for those who receive the care. Thirdly, the work performed by the nurses needs to effective. This is vital since it allows providing the services that are based on the scientific evidence to each and everyone who can benefit from the services. Fourthly, the work of the nurses must be equitable. This is vital because the nurses must never discriminate their patients on the basis of age, gender, geographical background or socioeconomic status. Lastly, the nurses must work in an efficient manner. This is attained by preventing them from wasting the equipment supplies, by avoiding the operational and administrative waste as well as the human resources (ANA, 2008). Body There are certain tools that can be made use of in order to allow an efficient and effective service quality of the nurses. The foremost tool used would be aimed at transforming leadership at all the particular levels of nursing across the hospital and allowing the head nurse to act as a catalyst for improving the work quality (Titler, 2006). This would be attained by becoming partners with the nursing homes in order to identify the appropriate assessment tool and to conduct the analysis of the gap that exists between the state of knowledge of the nurses regarding the quality of work and patient safety. It is also vital that the nursing shared governance model must be utilized along with the notice boards that serve as platform that involves the nurses in leading the improvement and safety initiatives and improvements. Furthermore, all the nurses must be trained at all the levels in quality improvement as well as the care processes that will redesign the work efficiency of the nurses via a series of programs that will include poster presentations and educational programs, Exploring Executive Excellence (E3) mentoring program, Shared Governance programs offerings and lastly, center for Frontline Nursing Leaders. The reason why transforming leadership would enhance the work quality of the nurses is that by developing transformational leaders, the hospital would be capable of implementing as well as creating the environment that meets the needs of the patients. Furthermore, this would allow numerous learning opportunities for the leaders and the leadership teams so that they can learn together and obtain the tools that are needed to meet the required objectives (NQIP, 2010). The term quality improvement refers to the systemic and data guided activities that aim at immediate improvement in the health care delivery. The PDSA model; the Plan Do Study Act has been widely made use of by the Institute for Healthcare Improvement for the rapid improvement. The important reason for implementing this particular model is because it allows the results and change to be assessed through the frequent and small PDSAs instead of the slow and big ones (Sackett et.al, 2000). This model for the improvement that is developed by the Associates in Process Improvement may seem to be a simple model but it is a powerful tool that is used for quality improvement. The model mainly comprises of two parts. Firstly, three basic and fundamental questions must be addressed in any order and secondly, the PDSA cycle that aims at testing as well as implementing the changes in the real work environments and settings. The three questions that are asked include; how will we know that a change is an improvement? What are we trying to accomplish? And lastly, what changes can we make that will lead to improvement? (Barbiarz, 2009) Apart from these, the efficiency of the work of the nurses is being increased across the globe by making use of the Toyota production system also termed as the Lean methodology. As a result of using this methodology, the not only the nurses but also the managers and the physicians will increase their quality of work. The factors that take part in the proper implementation of the Toyota Production System in the hospitals are eliminating the unnecessary daily activities that are linked with the overcomplicated processes and rework (Hughes, 2013). According to a research conducted on the “Nurses view of quality improvement education’, a total of 38.6 percent of the nurses from a total of 159 nurses in total were clear on the view that they were either poor or very poor in terms of their preparation regarding the knowledge about the quality improvement. The perception and preparation that these nurses possessed for the quality improvement was not steady but showed variation in terms of the specified topic. The A.D graduates possessed a low level of preparation regarding the quality improvement when placed in comparison of the B.S graduates who had a higher degree of preparation. The results of the research showed that the nurses are of the view that they fail to consider the importance of the help that they attain form the training from their employers and managers. As a result, this is indicative of the fact that the efforts of the employers to train the nurses are not sufficient and needs more research and assistance (Kovner et.al, 2010). Out of the total number of nurses, only 23 percent claimed that they did find the training program to be helpful in their work. Albeit there exist a strong focus and attention on the quality improvement within the hospitals, a wide proportion of the nurses fail to understand the link that subsists between the quality improvement education and the successful implementation of this in their work in the hospitals. There needs to be solid explanation that provides justification to the results attained. This shows that the nurses continue to shift their attention on providing the patients with care for whom they are responsible and fail to see themselves as possessing the accountability for enhancing the delivery system for care at the unit or at other specific higher levels. These nurses tend to remain unaware of the fact that if they do see themselves as providing care for all levels, their ability to provide a high quality care will be improved (Kovner et.al, 2010). As easy it may seem, implementing the quality improvement changes in the hospitals is subjected to numerous limitations and challenges. All these challenges are in relation with the involvement of the nurses in terms of quality improvement. These challenges include: 1. The confrontation of the traditional nursing education which is most of the time unsuccessful in preparing the nurses for their quality and efficiency oriented work in recent times within the modern day hospital settings. 2. The task of allowing the nurses to engage themselves at all the levels within the hospital. These levels start from the bedside till the management level. 3. The demands that are coming into light with increasing intensity and the need to face these demands properly in order to take part in more and duplicative activities concerning quality improvement 4. To deal with the levels of organizational burden and load which is linked with the QI activities 5. The challenge of possessing enough and sufficient nursing staff at times like today when the resources present at hand are limited and scarce (Debra.A et.al, 2008). As a result of presenting a clear range of the functions performed by the nurses, the quality and efficiency of the nurses can be increased. In order to do this, the professional development as well as the talent management that is occurring at the level of the collaborative team should be facilitated. Adding further, the nurses must be allowed to imply their focus on the resources that are present in the clinical care and to be expressive regarding what the nurses are able to do against the perception of what should do. The establishment of applicable education, clear accountabilities and responsibilities for all the team members should be provided. The team members include not only the support service but also the nurses (NQIP, 2010). There is also a need for the culture of mutual respect and recognition in the hospitals. This principle proposes that bridging gaps and barriers must be created by professional cultural and generational differences. It also recommends that cultivating authentic and sincere relationships that are grounded in trust and respect tend to give confidence to a sense of equity and plays a vital role in the shared appreciation of nursing and support service jobs. It also recommends that rewarding and recognizing all the members of the team for their impact on the patient experience must always take place for better performance by them (NQIP, 2010). Adding further, another tool that be utilized is the evidence based practice in nursing. When the nurses have proper evidence based practice, they are able to provide a high quality patient care that is based solely on knowledge as well as research rather than being based on traditions and advice of colleagues (EBPN, 2006). By using the evidence based practice tool, the hospital will receive tremendous success. Firstly, it would result in a better patient outcome, will contribute to the science of nursing, with the integration of EBP and nursing, high quality patient care results and the achievement of ANCC magnet recognition program is also made possible, it would also aim at enhancing the confidence of the nurses in the decision making process and lastly, it would keep the nursing practice relevant and up to date. The models that are used to implement the EBP in nursing include first and foremost the Disciplined Clinical Inquiry (DCI) model which is considered as the most appropriate model for this tool. It presents a pathway that integrates the organizational performance and the individual performance of the nurses with the evidence based health care. This mode, comprising of five phases, aims mainly to implant the EBP into the nursing culture. The second model is the Academic Center for Evidence Based Practice model (ACE). This model provides knowledge about the relationship between the stages of the knowledge transformation. The third model is the Iowa Model of Evidence Based Practice. This model works by first selecting the topic and them retrieving the evidence using the evidence based practice and then implement the changes (Spector, 2011). Furthermore, by redesigning the care in order to optimize the professional knowledge and expertise of the nurses is another tool that can be made us of. This will not only develop the care system and documentation but also will lead the nation in developing the evidence required for the nursing practice. Also, the care systems will tend to provide support to the workflow of the nurses so as to optimize the patient and nurse interaction at any time it may occur. Through this, the legitimizing and recognizing of the evolution of the knowledge in the rapidly alternating environment will also occur. This would be done by conducting a literature review based on the highly reliable systems and the personalized health care. By collaborating with the CCI a methodology can be developed that will determine the key drivers required for the highly reliable personalized health care. In order to redesign the nursing care as well as the securing of appropriate resources, the organizational synergy will be assessed and secured through this method. Lastly, an analysis of the patient care along with the experience in the 2-3 patient care area needs to be analyzed (Cooper et.al, 2009). Adding further, an open and continuous communication must exist between the nursing staff. There is need for the development of a patient centered and patient focused language that can be made use of by not only the nursing staff but also by the support services groups. For this, there needs to be an implementation of mechanisms that aim at measuring the interdepartmental feedback and satisfaction that can be measured. Further, a communication plan must be developed that distributes the decisions and key messages to all the levels. It is important to note that the manner of communication needs to be in a manner that is linguistically and culturally appropriate (Pawson, 2006). To build a culture and system of safety that aims at supporting, encouraging the nurses is also required. This spreads the teamwork and vitality in all the respective areas of nursing. The core principles designs to all the processes and work must be applied. These include reduce reliance on memory, standardize, simplify and proactively plan for demand. Lastly, the universal protocol processes that enhance the communication and minimize the occurrence of error must be utilized (Kathleen et.al, 2013) Conclusion A study done in Korea concerning the service quality and the gap perceived by the patients provides information regarding the need for improving the efficiency and quality of work performed by the nurses (Taehan, 2004). Thus, by making use of the numerous tools and methods those have been highlighted in the essay, the efficiency of the work done by the nurses in the hospital can be enhanced and amplified. References ANA, (2009), Health Care Reform: Improving Quality of Care, ©2009 American Nurses Association Barbiarz.J, (2009), Improving patient satisfaction through employee satisfaction: focus on nursing satisfaction with support services, Hospital management and development: patient care. Cooper, S. R., Betts, V. Trotter, B. K., & Gentry, J. (2009). Evidence based practice and health policy: A match or a mismatch? In Malloch, K., & Porter-O’Grady, T. (Eds.), Introduction to evidence-based practice in nursing and health care. Sudbury, MA: Jones and Bartlett Publishers. Debra.A, et.al, (2008), The Role of Nurses in Hospital Quality Improvement, HSC, funded in part by The Robert Wood Johnson Foundation, is affiliated with Mathematica Policy Research, EBPN, (2006), Evidence-Based Practice in Nursing A GUIDE TO SUCCESSFUL IMPLEMENTATION, ©2006 HCPro, Inc Hughes.R, (2013), Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Chapter 44Tools and Strategies for Quality Improvement and Patient Safety, onda G. Hughes, Ph.D., M.H.S., R.N., senior health scientist administrator, Agency for Healthcare Research and Quality. Kathleen.R, et.al, (2013), The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas, Volume 18 2013 Kovner.C, et.al, (2010), New Nurses’ Views of Quality Improvement Education, The Joint Commission Journal on Quality and Patient Safety Health Professions Education, January 2010 Volume 36 Number 1, Copyright 2010 Joint Commission on Accreditation of Healthcare Organizations Morton, Judy C.; Brekhus, Jodi; Reynolds, Megan; and Dykes, Anna Kay (2014) "Improving the patient experience through nurse leader rounds," Patient Experience Journal: Vol. 1: Iss. 2, Article 10. Available at: http://pxjournal.org/journal/vol1/iss2/10 NQIP, (2010), Nursing Quality and Performance Improvement Plan, http://www.mc.vanderbilt.edu/documents/Magnet%20Website/files/Nursing%20Quality%20Plan.pdf Pawson, R. (2006). Evidence-based policy: A realist perspective. London, England: Sage Publishers Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). 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