Quality Management in Medical Radiation Sciences - Essay Example

Quality management in medical radiation sciences Name Institution Date Quality management in medical radiation sciences Introduction In the context of health care, quality may refer to the extent to which products or services produce the desired outcome. The services provided by the health facilities have raised increasing concern as to whether they are of intended quality. More concern is however directed to establishment of proper guidelines that are aimed at improving the quality of search services. Quality improvement involves those efforts aimed at achieving better health outcomes through analysis and improvement of the service delivery processes (The Victorian quality council 2008). The framework for managing the quality of health services in NSW identifies six dimensions of quality which are of great concern when developing a quality improvement framework (NSW health department 2005). These include: Safety Consumers must be safe while they get health care services, while the environment in which the services are provided must also be safe. Risks must also be minimized during provision of services. Effectiveness The services offered must produce the expected benefit. Effectiveness describes the extent to which the services achieve the intended outcome. Appropriateness This is concerned with the use of evidence to do the right thing, at the right time, to the right person. Services provided must be selected depending on the likelihood that the service will give the most desired outcome. Consumer participation Consumers must be incorporated in the health care delivery, planning, evaluation and monitoring in a dynamic and responsive manner. This will enhance acceptability of the services. Access Consumers should be able to access the services. Efficiency Services must be provided in a manner that achieves value for money. The aim should be to minimize the cost of inputs as well as allocation of resources to services of greatest benefit to the consumers. In order to manage and improve health care, it is very essential to be able to measure the quality of services provided. By measurement of quality, it is possible to make comparisons so as to establish current performance as well as set targets for the future (NSW health department 2005). Judging by the complex nature of the health service organizations, effecting changes aimed at improving quality of health care can be very complex (The Victorian quality council 2008). Developing such improvement programs therefore requires an understanding of the processes involved in the service delivery, the factors that affect delivery and how those factors can be influenced to achieve the improvements. In such complex systems, decisions must be supported by solid evidence as opposed to information from isolated occurrences, politics or assumptions (The Victorian quality council 2008). In this line of argument, quality improvement can be both proactive and reactive. Why Employ Quality Management A review of health care quality in Australia raised the need for managers and clinicians to pay attention to the quality of care being delivered to consumers. Cases of errors in medicine have been on the rise with the potential harm in nuclear medical services. There has been massive development of technology in the health care and given the complexities involved, health organizations have identified their own set of problems as concerns appropriateness, safety and access to these services (NSW health department 2005). This may be assumed to be a result of the fact that there may be lack of control in the overall performance and regulation. The system may not have sufficiently refined control indicators to highlight the time when changes are needed. As many would put it, technology has determined what we do without adequately evaluating the benefits. According to reports by the New South Wales Environment Protection Authority, fifty-seven cases of maladministrations were reported in New South Wales over a five year period out of the 666179 nuclear medicine procedures recorded for the same period (Yenson T. et al, 2005). The report says that most of the maladministrations were a result of incorrect radiopharmaceutical dispensing although those involving diagnostic radiopharmaceutical did not result in immediate adverse effects. Another review in the Australian Health Care Study in 1992 on quality reported that 16% of admissions were associated with an iatrogenic adverse effect. Almost half of the adverse effects however were preventable since most of them were a result of human error (Yenson T. et al, 2005). These incidences express the need of a quality management program in the health facilities to improve the nuclear medicine services. In the case provided, there is evidence of maladministrations with an increase in tissued injections of radiopharmaceuticals. This has lead to reinjection of radiopharmaceutical or rebooking of the procedure. Such occurrences do not only increase costs for the hospital and the consumers but expose patients to the risks associated with nuclear medications. It must be in the interest of the hospital management to minimize these occurrences and develop a more efficient system with guaranteed success. In the effort to minimize such occurrences, the hospital could adopt a properly organized quality management program that could go a long way to help it achieve its performance goals. Developing a quality management program The development of a comprehensive quality management system should aim at minimization or complete eradication of problems experienced in modern health care centers like the avoidable errors, overuse of services, underutilization of services, lack of evidence and even communication problems. While these are put into consideration, the six dimensions of quality health care systems should be addressed (NSW health department 2005). A quality management program should be undertaken following the steps explained below: Choosing the right tool For the purposes of managing the project to solve the given scenario, the best tool would be a flow chart. It will be of great help if the proper tool was selected for any project or study. Different tools will give different approaches to the project and so the best choice should be the one that will satisfactorily address the needs of the project. The best way to select a tool would be using the tools matrix (NSW health department 2002). Developing an effective team While developing a program for quality management, it is important that all the individuals understand that each ones performance will be determined by the overall performance of the whole team. They must therefore be team players who work together, with clearly defined roles and an understanding that the team’s work must be given a priority. The team must however display competence be it at the organization level, the multidisciplinary care team, or at the individual level (NSW health department 2005). Collecting data about the process This is a very important contribution to problem identification and resolution. If this is not done in the right way, then it becomes difficult to effect the other quality improvement tools (NSW health department 2002). NSW health department (2005) describes this step as information management. The information management involves improving the availability and quality of information that relate to staff, as well as the public. Availability of enough information is a great step towards determination of performance (NSW health department 2005). Availability of data enables decision making that is supported by solid evidence (The Victorian quality council 2008). In this scenario, accurate data was to be collected relating to number of victims of the maladministration as well as the effects and remedies employed to help the victims. For the case presented, all the data relating to the incidences of tissued injections in the hospital would have to be sourced. Further information related to the case in terms of ways of minimizing such occurences, and other historical information of the subject would have to be sourced. Such information would be obtained from hospital’s record books or radio medicine websites and journals. Diagnosing the problem The diagnosis involves collection of evidence, determination of the cause and organization and prioritization of the information. If adequate information is available, then the data will help to push improvement by showing the problems and also pull improvement by depicting opportunities (The Victorian quality council 2008). This stage will enable establishment of the nature and cause of the problem and identification of the points that may require improvements. This step would thus involve determination of the extent of the damage in the scenario and investigation of the number of victims in order to fully understand the extent of the problem. Evidence would be sourced from the record books and any other available material. The team would also need to find the root cause and analyze the procedures undertaken in administration of the treatment. Analyzing the problem This involves examination of qualitative and quantitative data on the project that was collected in the diagnosis stage of the project. Important during analysis are the cause and effect diagrams, pareto chart, affinity diagram and various graphs of current data. For our scenario, this step would involve a critical examination of the recorded data for purposes of determination of the proper course of action. The cases for the tissued injections are analyzed and the costs for reinjection and rebooking evaluated and tabled. At this stage, the team must review standards governing nuclear medicine and compare with the practice in the hospital. This will help them come up with proper recommendations for the new way of action in order to minimize such cases. Reviewing progress This is very important in the development of the project and should be done regularly in the course of the project. This process can however be built into the meeting process. This step will not only ensure that the project achieves its goals within the agreed time lines but it will ensure that all members are at par and are satisfied with the team’s operations. A simple checklist could be used to track the progress of the project if all the steps for the project are properly outlined in it. Selling your achievements After the development of the project, it is only reasonable that the message be communicated to the relevant parties. The way in which findings will be reported will greatly determine the way in which that information will be used to effect the proposed changes (NSW health department 2005). Although this is the last step, it is very important since here the evidences and obtained from the whole project. In our scenario, this step would involve presentation of the findings to the hospitals management. This could be done through a power point presentation with findings clearly outlined. One of the major proposals for the scenario would be the introduction of the bar code system that minimizes amount of manual human manipulation that has always been a source of error (Hakala et al 2012) as well as the adherence of guidelines for incidence management that will advice on the most effective ways of responding to incidences that occur in the health systems which include openness about failures, emphasis on learning, obligation to act, accountability, justice care, appropriate prioritization of action and teamwork (Quality and safety NSW health depart. 2005). Auditing It is however important to carry out quality audits and assessments in nuclear medicine departments. The audit and quality management as a whole need to be patient oriented, systematic and outcome based. The management processes must also respect the diversity of the nuclear medicine services and the multidisciplinary contributions (International atomic energy agency 2008). A complete quality improvement cycle is shown below: Adopted from The Victorian quality council (2008). Conclusion Healthcare has experienced several challenges as far as quality is concerned. Cases of errors and maladministrations have been witnessed, creating much doubt in the integrity and competence of such services. While hospitals strive to improve their performance, the role of quality management cannot be underestimated. A properly developed quality management procedure will cause major improvements in the service delivery and enhance accountability and service delivery to consumers. References NSW health department (2002). Easy Guide to Clinical Practice Improvement. A guide for healthcare professionals. Gladesville NSW: Better Health Care. The Victorian quality council (2008). A guide to using data for health care quality improvement. Rural and Regional Health and Aged Care Services Division, Melbourne: Victorian Government of Human Services. NSW health department (2005). Quality of Health Services in New South Wales - a framework for managing - issued 1999. NSW: Department of health. Yenson, T. et al, (2005). Radiopharmaceutical maladministrations in New South Wales. Nuclear Medicine Communications, 26:1037–1041. International atomic energy agency (2008).Quality management audits in nuclear medicine practices. Vienna: Sales and Promotion, Publishing Section International Atomic Energy Agency. Beach, T. A. et al (2012). Ensuring safe and quality medication use in nuclear medicine: a collaborative team achieves compliance with medication management standards. J Nucl Med Technol, vol. 40, no. 1, pp. 1-10. Quality and safety NSW health depart. (2005). Incident Management Policy. North Sydney N.S.W., NSW Health Dept. Hakala J. L., Hung J. C. & Mosman E. A. (2012). Minimizing Human Error in Radiopharmaceutical Preparation and Administration via a Bar Code–Enhanced Nuclear Pharmacy Management System. J of Nuclear Medicine Technology; 40:1–4. Read More