Continuous Quality Improvement - Research Paper Example

Outline 1. Introduction 2. Transformation in healthcare 2.1. Changing roles of Continuous Quality Improvement 2.1.1. Professional model and transformational model 2.1.2. Distinguished characteristics of Continuous Quality Improvement in transformational model 2.2. Managed care in organization and in healthcare provision 2.3. Physician participation 2.4. Definition of safety and adverse events 2.5. Failure Mode and Effects Analysis 3. Healthcare Information technology 3.1. History of adoption of information system in healthcare 3.2. Traditional Quality Assurance and Continuous Quality Improvement 3.3. Data to Decision Cycle and how it works 3.4. Management issues, concepts and technologies 4. Conclusion Continuous Quality Improvement 1. Introduction. Continuous Quality Improvement is a term used to denote the ongoing efforts of incorporating planning and structure to implement constant improvement in the healthcare service. The quality of care experiences growth as the day’s increases from the efforts of the employees. In many healthcare organizations Continuous Quality Improvement is illustrated in the strategic plan, committee of leaders in the organization, human resource training, and methods of identifying opportunities for improvement, implementation teams, and regular engagement in analysis together with evaluation. Accordingly, policies enable human resource to participate and cause growth. New techniques are used in the Continuous Quality Improvement process. This assignment will discuss the transformation in healthcare made by Continuous Quality Improvement process. It will also discuss healthcare information technology. 2. Transformation in healthcare. The quest for Continuous Quality Improvement has influenced the approach of the medical health services provision. Consequently, the role of Continuous Quality Improvement changes either to new methods of transformation and knowledge acquisition in the organization. 2.1. Changing roles of Continuous Quality Improvement. Continuous Quality Improvement improves on the existing traditional methods of quality assurance to improve the organization and its systems. There is a professional model which contrasts with the transformational model. 2.1.1. Professional model and transformational model. There is difference between professional model used for health services and transformation model. Sollecito and Johnson (2011, p. 424) notes that, the professional model emphasizes ion the organization and its system. The organization is considered supreme. The professional model advocated for individual responsibility in the service delivery. The leaders were professionals and a preserve of the few. There was a lot of autonomy and authority was bestowed upon the administration. Similarly, the professionals had the authority over the customer. Plans were to be followed strictly and goals to be accomplished according to the instructions of the institution. Quality assurance was embraced. The transformational model focuses on cultivating the existing organization and changing the perspective so that the improvement is seen as a continuous process. Transformational model recognizes the participation of all stakeholders to include the professional, the management the health workers and both internal and external clients. Many aspects of the service delivery are considered subject to improvement. The improvements are made continually using scientific methods. The transformational model ensured the responsibility is shared between the individuals, the leaders and the healthcare employees. Employees were trained to become leaders and engaged leadership skills at all levels. The value of the outcome was emphasized to encourage participation and excellent performance. Decision making is shared to include the healthcare worker’s and the patient’s opinion. Unlike in professional model where performance is retrospective, performance in transformational model is enhanced on appraisal. Continuous improvement is encouraged as planning is made flexible. 2.1.2. Distinguished characteristics of Continuous Quality Improvement in transformational model. Transformational model emphasize on service that will impress and surpass the anticipation of the patient. The success of work is considered accomplished if the needs of the patients have been addressed satisfactorily or exceedingly. Patients are not the problem; the problem is in the process of delivering the healthcare services. Variation is intended and misappropriation can cause negative outcomes. Therefore, variation of services is implemented only if necessary. Persistence in continuous improvement will cause gradual change that is desired while using the scientific method. Healthcare facilities that adapting transformational model incorporates the process in everyday activities by training employees and letting them use the skills every day. Healthcare professional engage in efforts to cut down on cost and reflect it so as to become competitive. While paying attention to remain competitive the healthcare facility adheres to all the requirements stipulated by the regulatory bodies. Therefore, the healthcare organization begins a process of improving service by understanding the external environment and managing the external environment. A comprehensive and informative training is offered to the healthcare professionals so that they are able to analyze, evaluate and contribute to the enhancement of the transformation process. The healthcare organization become accustomed to recognizing patient’s preferences and uses the same measures to rank their performance on quality. The opinion of the patient and physician matters when it comes to determining the quality of the services. A Continuous improvement strategic plan of incorporating changes is recommended and given priority for Continuous Quality Improvement. Best practices are preferred and favored when making change for quality progress. Moreover, responsibility is shared between the organizational leaders, the healthcare workers and as an individual. Planning is continuous as the need for change emerges. The organization becomes focused on the future (McLaughlin et al, 2011, p. 46). 2.2. Managed care in organization and in healthcare provision. Managed care has transformed organizations services and healthcare provision. The overall standards of dealing with patients have been changed. Healthcare workers receive training that changes how they handle the patients and improve quality of work. The relationship between quality and cost of healthcare has been reviewed over and over making necessary improvements that will allow many patients access healthcare. Efficiency in the service delivery has been improved causing patients to gain confidence when attending healthcare facility. Evidence based care that is adapted improves the body of knowledge and contribute to decision making. Preventable hospitalization has been made possible for healthcare costs to be lowered and increase competition (Harris, 2005, p. 181). 2.3. Physician participation. Kahan and Goodstadt (1999, p. 89) mentions that, physicians are well placed and can participate in the change process of the organization. They can change and transforming the organization by sharing ideas, participate in developing the thoughts, give incentives, identify opportunities and become resourceful in facilitating change. When given the chance to learn they can grasp and practice what is taught and be willing to train others. The management can develop prospects for the physicians to avail their contribution in the planning process. The managers can ensure participation from the physicians it is advisable to allow them practice leadership in transforming the organization. They can suggest how to save on cost and maintain high quality care. They are able to set and follow clinical care objectives and championing prevention of diseases. The management can facilitate their training and integrate them in the adaptive as well as technical changes as they happen. 2.4. Definition of safety and adverse events. Patient safety is of uttermost importance. Safety means being free from harm or damage as an individual. An adverse event occurs when a medical error causes negative effects on the patient by causing harm or negative outcomes. Adverse events should be avoided by the medical professionals. The outcomes are serious and can be reported because they can cause permanent disability and sometimes death. Medical errors from the physicians impact on safety and quality of healthcare. Measures for preventing errors should be in place at all times. There are institutionalized measures for detecting and measuring the adverse events that might emerge from medical errors. Near misses are situations where a medical error could have possibly caused adverse event but the outcome did not harm the patient. Near misses act as a warning and constant reminder to the physician. To avoid adverse events the healthcare facilities together with the professionals identify the common causes of the medical errors. They come up with interventions, preferably standardized procedure. The healthcare professional begins adapting a culture of ensuring safety at all times. A specific checklist is designed to check implementation of preventive measures. The healthcare professional engages in continuous learning on safety. 2.5. Failure Mode and Effects Analysis. Failure Mode Effects Analysis is an organized way of assessing failure in a process to prevent adverse events. This is achieved by controlling, eliminating or accepting the cause of failure. Then each failure is given a control measure. The Employing the Failure Mode Effects Analysis can help healthcare professionals discovers how undesirable situation happen and how compromised safety of a patient can occur. 3. Healthcare Information technology. Healthcare like other sectors has introduced information system in the management. The information technology has improved services and changed the sectors perspective on service delivery. 3.1. History of adoption of information system in healthcare. According to McLaughlin and Kaluzny (2006, p. 268), history of information technology in healthcare had began even before the year 1980 when other sectors such as automobile were beginning to incorporate information technology in their management. Hospital in Kentucky and Nashville proceeded even before the commission for accreditation had incorporated the requirement. The emphasis was on work context, understanding of the working process, customer centered approach, leadership and continuous training. Organizations began networking and engaged in new activities such as joint ventures, diversification of services, new acquisitions and made partnership with other organizations. The organization began hiring professionals with appropriate skills who could fit in the prescribed programs and ended up laying of underutilized employees. The type of care offered was then varied which cause the caused the cost of operations to go high. Competitive prices for the healthcare were adopted to encourage patients to preferred healthcare provision from certain facilities. The challenges emerging from the strategies that were organization centered cause change to be inevitable. There was need to adapt an industrial structure that would accommodate a large number of customers and improve on efficiency. Delays in transformation to fit in information technology were hampered by the unpredictable cause and effect situation in the healthcare sector. Technology required decentralization structure and many organizations had centralized structure and were hesitant. Setting up technology in an organization cost was high and was subject to changes in the future. After information technology was introduced, the cost of healthcare became very high. Thereafter, researchers engage in evidence based research followed by quality healthcare with subsidized cost (Sollecito and Johnson 2011, p. 276) 3.2. Traditional Quality Assurance and Continuous Quality Improvement. The traditional quality assurance approach uses centralized. Quality of work was seen as a goal of the organization. There were common values, mission and vision of the organization meant to improve collective services and organization. Work was seen as part of a whole and as a process where employees were required to adapt. The patient was seen as the financier of the bills and the community as the recipient of the healthy people. Related organizations networked so that they could share expertise and generate opportunities. On the other hand Continuous Quality Improvement embraces decentralization of data, information and knowledge. The employees are taught to work using available information to make decisions. Leadership skills are taught to enable the employees increase productivity and efficiency when giving services. Communication and conflict management skills are part of the training to enable them make informed decisions. The employees have performance appraisals that are concurrent into their every day work, which facilitates the continuous quality improvement process. There is flexibility in the plan where depending on circumstances the decisions can be made in the best interest if improving quality. Improvement of the healthcare is managed by suggesting and acting on issues that can be developed. 3.3. Data to Decision Cycle and how it works. Data to decision cycle is a way of obtaining highly valued decisions. The process entails generating data. The data can be obtained from the information system or from the field. After collecting the data, it is combined and analyzed using scientific method. After the analysis information is created to inform the decision maker. The decision is made based on the results of the analysis. The process is repeated again to make another cycle. Time used in the decision making is valuable. The value of the decision can be related to the impact of the decision to be made. 3.4. Management issues, concepts and technologies. Information management is challenged by the great need for continuous learning and the continuous generation of data. Therefore the healthcare facilities should partner with the education institutes and regulatory bodies to develop learning objectives and curriculum. Policies should be in place to strengthen the acquisition of knowledge. Healthcare information system is increasing becoming a tool for information management for the healthcare data and knowledge. The healthcare professionals have come up with designs of information systems specifically designed for healthcare use. Additionally they identify present and future needs of the information system by creating policies. The use of information technology includes storage, use, collection and transfer of the information. The professionals work closely with other professionals to obtain support in the management of information system. Example of the information system is Electronic Health Record. The knowledge of information technology management has increased. The information can be used to generate data or decision making. The continuous quality improvement encourages use of scientific methods which facilitates the development of data that can be used for research. The research will generate findings that can inform decision making. 4. Conclusion. Continuous Quality Improvement has increased efficiency in the healthcare system. There is professional model which has individualized responsibility, has autonomy and has strict plans. Contrary transformational model has shared responsibility, decision making is devolved and plans are flexible. Continuous Quality Improvement is emphasized in the management of healthcare by educating the employees. Physicians are encouraged to participate in the information management healthcare by giving views, identifying opportunities and implementing change. Safety is emphasized to avoid adverse events. Failure Mode Effects Analysis is used to minimize the chances of engaging in a medical error that could result in adverse effects. Information technology in healthcare care was adapted when other organizations began using information management. However, the adaption took long because of the cost involved and uncertainties. After adoption it replaced the Traditional Quality Assurance which was centrally structured. Continuous Quality Improvement replaced Traditional Quality Assurance since it was enabled by information technology to facilitate decentralized decision making. Decision making can be supported by analyzing data. Reference List Harris, M. G. (2005). Managing Health Services: Concepts And Practice. Elsevier Australia. Kahan, B. and Goodstadt, M. (1999). Continuous quality improvement and health promotion: can CQI lead to better outcomes? Health Promotion International 14 (1), 83-91. McLaughlin, C. P. and Kaluzny, A. D. (2006). Continuous Quality Improvement: Theory Implementaion, and applications. Sudbury, MA: Jones & Bartlett Learning Publishers. McLaughlin, C., Johnson, J., and Sollecito, W. (2011). Implementing Continuous Quality Improvement in Health Care. Sudbury, MA: Jones & Bartlett Publishers. Sollecito, W. A., and Johnson, J. K. (2011). Mclaughlin And Kaluzny's Continuous Quality Improvement In Health Care. Sudbury, MA: Jones & Bartlett Learning. Read More