Managing Quality in Health and Social Care - Assignment Example

 Table of Contents Table of Contents 2 1.0Introduction 4 2.0 The Quality of Healthcare and Social Care Services 4 2.1 Stakeholders Perspective Regarding the Quality of Health and Social Care 4 2.2 The Role of External Agencies in Setting Standards of Health and Social Care 5 2.3 The Impact of Poor Service Quality on Health and Social Care Stakeholders 7 3.0 Strategies Incorporated For Improving the Quality of Health and Social Care Services 8 3.1 Standard Used for Measuring the Quality of Health and Social Care Services 8 3.2 Evaluation of Different Approaches for Implementing Quality Service 9 3.3 Potential Barriers to Delivery Quality Health and Social Care Services 10 4.0 Evaluation of the Systems, Policies and Procedures in Health and Social Care Services 11 4.1 Evaluate the Effectiveness of Systems, Policies and Procedures Used In a Health and Social Care Setting In Achieving Quality in the Service(s) Offered 11 4.2 Other Factors That Influence the Achievement of Quality in the Health and Social Care Service 13 4.3 Recommendation Regarding Health and Social Care Service for improving the Quality 13 5.0 Methodologies for Evaluating Health and Social Care Service Quality 15 5.1 Evaluate Methods for Evaluating Health and Social Care Service Quality With Regard to External and Internal Perspectives 15 5.2 The Impact That Involving Users of Services in the Evaluation Process Has On Service Quality 16 6.0 Conclusion 18 7.0 References 19 8.0 Bibliography 21 1.0 Introduction During the contemporary era, the importance of maintaining the quality of health care and social care aspects has become a serious concern for healthcare settings. In this regard, several countries have developed policies and procedures of health care services with the aim of enhancing the quality of medical science and social care. At the same time, medical institutes have tried to enhance the standard of medical services by hiring skilled doctors and nurses along with technical experts. Moreover, medical organisations have incorporative technological approaches and advanced instruments for enhancing the quality of the medical services with the intention of fulfilling the need and expectation of the patients. Respectively, based on the case study based on The Royal United Hospital Bath NHS Trust has been identified to be performing operations in an efficient manner, irrespective of which the company faced certain issues in terms of lack of innovation and inadequate number of competent staff members. 2.0 The Quality of Healthcare and Social Care Services 2.1 Stakeholders Perspective Regarding the Quality of Health and Social Care Quality is one of the foremost important aspects in case of health and social care services. The standard as well as quality of the health and social care services vary amid different countries. In this regard, quality of health and social care services are depending on the principles of a country. Moreover, national legislation or constitutional framework of a country is highly involved with the quality of health and social care services. The three important stakeholders of RUH Bath NHS include CQC team, nurses and patients. CQC team has been identified to be conducting survey in RUH Bath NHS Trust with the aim of ascertaining patients’ experiences and core services provided. The overall health and social care standard is an important consideration for ensuring that the operations of RUH Bath NHS Trust are conducted in accordance with the needs and requirements of the stakeholders for better sustainable performance. In addition, the development and implementation of health and social care related services in RUH Bath NHS Trust that include patient safety, managing risks and medical management among others for fulfilling the expectations as well as perceptions of the stakeholders (Persad & et. al., 2009; Schweppenstedde & et. al., 2004). In this context, according to the case study, The Royal United Hospital Bath NHS Trust is involved in ‘Chief Quality Care’ (CQC) inspections for monitoring the quality of service with the aim of ensuring the judgment, care, welfare, safeguarding and assessing aspects of the patients. The organisation has been performing operations in a transparent as well as open manner, so that the stakeholders have adequate information relating to the challenges along with funds invested for the development of the same. In this respect, the organisation has been identified to be performing operations on the basis of needs of the stakeholders (Park, 2014; Persad & et. al., 2009). 2.2 The Role of External Agencies in Setting Standards of Health and Social Care Several countries around the world, uses external approaches with the aim of improving the quality of healthcare and social care services. In this regard, it is also witnessed that several countries have used external agencies for the review of healthcare and social care related services. Moreover, many countries have used inspection and auditing procedure by monitoring and regulatory approach with the aim of quality improvement (Walshe & et. al., 2001). On the other hand, Schweppenstedde & et. al. (2014) claimed that governing authority of several countries introduce few measures for quality improvement, whereas some actions have been incorporated by the government of the countries for the improvement of quality care. In this context, Walshe & et. al. (2001) argued that several financial and non-financial actions have been introduced by the health care organisations for the purpose of external review relating to health as well as safety related issues (Schweppenstedde & et. al., 2004; Walshe & et. al., 2001). As per the case study, the external agencies including CQC and Emergency Care Intensive Support Team (ECIST) among others have been engaged with RUH Bath NHS Trust for developing service and care provisions. It has been identified that CQC has played a crucial role for promoting leadership and culture of health and social care services by maintaining the quality and performance. At the same time, it is also recognised that external agency has tried to build trust and transparency among the stakeholders with the intention of improving the services of medical science. Moreover, CQC has established a strong relationship standard with the patients for improving the patients care performance. On the other hand, ECIST has tried to build strong engagement with the valuable staff for providing higher quality healthcare services, which can enhance the leadership opportunity for the organisation. In this regard, ECIST would be facilitated in developing standard relating to admission as well as discharge of patients (Park, 2014). 2.3 The Impact of Poor Service Quality on Health and Social Care Stakeholders In order to identify the impact of poor medical services, it is witnessed according to observation of Walshe & et. al. (2001) that lack of health and social care lead high mortality rate among the patients. At the same time, Park (2014) argued that due to poor health and social care services, numerous numbers of complaints have been observed against the quality of medical science, which influenced the services rendered by nurses. In this regard, several infections and diseases have created large number of serious incidents or problems in the medical science segment, which have hampered the growth of medical institutes as well as medical organisations in a diversified manner, which in turn affected the patients in having appropriate care and treatment services. Thus, several problems have infused due to poor nursing operations. Moreover, it has raised critical difficulties for the patients, which have discouraged the overall growth of health care and social care industry around the world. Additionally, poor health service quality has instigated challenges for the patients as well as stakeholders. In addition, the community services and General Practitioners failed in integrating their services effectively. In this regard, it is identified from the stated case study that RUH Bath NHS Trust has been focused on having an appropriate evaluation of improving services for better treatment and care services (Park, 2014; Walshe & et. al., 2001). 3.0 Strategies Incorporated For Improving the Quality of Health and Social Care Services 3.1 Standard Used for Measuring the Quality of Health and Social Care Services Health care quality has been maintained on the basis of certain standards of CQC, NICE and NMC for measuring quality. It has been identified that CQC has adopted quality and safety standards in relation to screening, diagnosis and treatment procedures. The NICE quality standard is national guidance based on which clinical practice is improved and accordingly, healthcare provisions are improved. In addition, NMC standard is to provide ethics, conduct and performance based on which the nurses are required to conduct their operations in accordance with the needs of patients (Park, 2014). Education and training based approach has been generally used for enhancing the quality of health care. On the other hand, process measures have been used for enhancing the service quality of health care in terms of administrative aspect. In this regard, the objective was to reduce the medical gap, which is usually observed due to the poor technical performance for inappropriate physical attributes and medical instruments (Sorenson & Mossialos, 2007). Simultaneously, outcomes of RUH Bath NHS Trust have concentrated on the long term problems such as functional as well as psychosocial attributes of health and social care. By implementing these standards, RUH Bath NHS Trust has tried to ensure the improvement of health care and social quality. Additionally, these standards have improved the treatment environment for the patients (Sorenson and Mossialos, 2007). In this regard, RUH Bath NHS Trust as recognised from the case study has used CQC, NICE and NMC standards for inspecting the operations of the organisation and quality of services. In this respect, the inspecting team has been conducting operations on the basis of certain standards that include privacy as well as dignity (Park, 2014). 3.2 Evaluation of Different Approaches for Implementing Quality Service In order to improve the quality of the health care service in RUH Bath NHS Trust as identified from the case study, it is essential to concentrate on the appropriateness of medical treatment through quality control and Total Quality Management (TQM). In this regard, quality control approach focuses on nursing practice. Moreover, overall environment of the medical institute needed to be developed for enhancing the quality of health care and social care services (Park, 2014). According to the viewpoint of Sorenson & Mossialos (2007), medical organisations are needed to establish a positive engagement with the staff for enhancing the quality of medical treatment (Sorenson and Mossialos, 2007). Simultaneously, with regard to TQM, incorporating technology is highly essential, which can improve the overall performance of the health care and social care services. For instance, application of computer system is highly essential through which tendency of the disease can be identified quickly. On the other hand, computer based approach also assists to keep record of the patients, which can enhance the overall effectiveness of the health care and social care services (Park, 2014). In this regard, the report of World Health Organisation (2006) claimed that healthcare organisations should take decisions considering few factors such through analysing the situation and considering the objective of the treatment. Apart from this, by implementing health care related to TQM, the accountability of the medical providers can be enhanced, which will assist in developing the quality of the health care and social care services. Thus, it can be claimed that for implementing TQM and quality control, the three approaches used to implement the quality systems are clinical audit, national guidelines, and leadership and culture. Leadership and culture has been an important approach based on which an effective working environment has been developed. Clinical audit has facilitated in having an effective estimate about the performance of RUH Bath NHS Trust, so that appropriate measures are undertaken for better effectiveness. National guideline has been an effective approach with the assistance of which the organisation is able to conduct operation on the basis of ethical as well as performance consideration (Park, 2014; Sorenson and Mossialos, 2007; World Health Organisation, 2006). In this regard, RUH Bath NHS Trust implementing TQM based on the above-mentioned approaches will be able to improve safety as well as quality aspects for better service provisions. The organisation with the implementation of TQM has planned to adopt innovation in service level (Park, 2014). 3.3 Potential Barriers to Delivery Quality Health and Social Care Services From the case study, the internal barriers of RUH Bath NHS Trust include patient record and equipment. The internal barriers are faced for lack of technological development owing to which the record keeping service of the organisation was ineffective and inappropriate management of service equipment. According to the viewpoint of Jacobs & et. al. (2011), low income based countries are facing several difficulties in case of maintaining the quality of health care and social care services. In this regard, it is identified that geographical access, adequacy and availability has raised numerous challenges, which hampered the quality of health care services. Lack of innovation and competent staff members have initiated challenges for the developing and underdeveloped countries (Peters & et. al., 2008). Treatment cost is also one of the potential barriers of quality health services. On the other hand, availability of drug, treatment equipment and medical staff such as doctors and nurses are the one of the potential barriers of the health care services, which usually initiates challenges in terms of wages and incompetent staff. At the same time, discrepancy can be observed due to the unstable quality and prices of the medical drug. Simultaneously, efficiency of the medical staff, technological intervention, cost and prices of the health care services are the potential barriers of quality health and social care services (Jacobs & et. al., 2011; Peters & et. al., 2008; Ensor & Cooper, 2004). The external barriers of the organisation are social policy and legislation. The organisation has been identified to be ineffective in adopting effective social policies due to lack of social care agencies. In this respect, the company has been effective in providing different communal services for the development of the community as a whole. Additionally, the organisation is recognised to be ineffective in adopting appropriate legislation in terms of healthcare policy and CQC standard. Subsequently, the company faced challenges in performing operations effectively (Jacobs & et. al., 2011; Peters & et. al., 2008; Ensor & Cooper, 2004). 4.0 Evaluation of the Systems, Policies and Procedures in Health and Social Care Services 4.1 Evaluate the Effectiveness of Systems, Policies and Procedures Used In a Health and Social Care Setting In Achieving Quality in the Service(s) Offered Based on the case study, RUH Bath NHS Trust, in order to ensure the effectiveness of system, policies and procedures of health care frameworks, it is essential to enhance the quality of medical institutes along with nursing approaches. It has been identified from the case that waiting times for patients is long owing to which it has been ineffective in conducting operations successfully in terms of assistance and medical aid. Contextually, the organisation has adopted plans for reducing waiting times by providing care services on the basis of need or urgency. In addition, the organisation is identified to develop an emergency surgical ambulatory clinic based on which the organisation is able to provide care services to patients with urgency (Park, 2014). In this regard, quality of health care services of RUH Bath NHS Trust would be improved by increasing the medical accuracy of medical practice. In this case, it is highly essential to establish quality improvement strategies with the intention of improving the quality of the clinical care. Apart from this, by setting targets and incorporating comparative performance approach health care and social care quality can be achieved. Simultaneously, by concentrating on the innovation approach, quality of medical services of RUH Bath NHS Trust can be improved (Sorenson & Mossialos, 2007). With the aim of improving the quality and effectiveness of system, policies and procedures, RUH Bath NHS Trust should focus on the medical errors with the intention of reducing medical errors or mistakes. At the same time, it is also essential to gather the feedback of the clients and stakeholders for improving the overall quality of the medical service. Simultaneously, by concentrating on the time as well as task management, the expected quality can be achieved in case of health care system. In this context, it can be claimed that RUH Bath NHS trust should emphasise its health and social care services for enhancing the quality and effectiveness more significantly (Park, 2014; Sorenson & Mossialos, 2007; Walshe & et. al., 2001). 4.2 Other Factors That Influence the Achievement of Quality in the Health and Social Care Service From the case study, it has been recognised that there are certain other factors that have influenced the achievement of quality in case of RUH Bath NHS Trust, it is revealed that regulatory involvement relating to law and governance has been ineffectively adopted, which led to inappropriate management of the care services offered. Simultaneously, Schweppenstedde & et. al., (2014), argued that type of service i.e. as an NHS trust, the organisation ensured quality enhancement by concentrating on medical review process. At the same time, it is also essential for the medical staff to concentrate on the long-term care with the intention of enhancing the quality of clinical care. Moreover, it is highly essential to focus on fund distribution for enhancing the opportunity of increasing the quality. Improvements of health care services are not only relied on policies or system, rather it is also essential to concentrate on the workforce for attaining growth in case of health and social care services. In this context, it can claimed that RUH Bath NHS trust should concentrate on these above mentioned factors, which can influence the quality in terms of health and social care services for users of service expectations (RUH Bath NHS Trust, 2014; Schweppenstedde & et. al., 2014; Francis & Netten, 2004). 4.3 Recommendation Regarding Health and Social Care Service for improving the Quality It has been identified that RUH Bath NHS Trust has been facing certain challenges in terms of patient record, waiting times and emergency equipment. RUH Bath NHS trust should focus on few factors for improving the quality of health care services. In this regard, Schweppenstedde & et. al., (2014) claimed that RUH Bath NHS trust need to incorporate evident based practice approach for enhancing the overall quality of health care and medical services. At the same time, it is also highly essential to concentrate on the audit and evaluation procedure for enhancing the quality of services. Apart from this, RUH Bath NHS trust should promote research culture with aim of enhancing the quality of clinical as well as medication department. Simultaneously, the organisation should encourage researchers for increasing the appropriateness of the medial research and record keeping. Besides, RUH Bath NHS trust should create awareness for its own medical services along with that it is also highly essential for the medical staff to create an environment for the working protocols to minimise waiting times. The organisation is also needed to adopt innovation, so that effective emergency equipment should be accomplished as well as managed through regular review (Park, 2014; Schweppenstedde & et. al., 2014; Francis & Netten, 2004). 5.0 Methodologies for Evaluating Health and Social Care Service Quality 5.1 Evaluate Methods for Evaluating Health and Social Care Service Quality With Regard to External and Internal Perspectives It is highly essential to evaluate the effectiveness of health and social care service quality with the aim of improving overall performance of healthcare organisations. Moreover, by incorporating different approaches that include survey, questionnaire and complaint procedures, it would be possible to identify the service level of RUH Bath NHS trust. In order to execute the evaluation process for identifying quality of the health care services, it is essential to prepare a questionnaire through which it can be possible to gather the feedback of the patients along with the staff members and stakeholders of RUH Bath NHS trust. This would give a fair and honest idea or opinion about the services quality of RUH Bath NHS trust in terms of its clinical care. On contract, the patients or staff members may be reluctant to answer the questionnaire. Based on the case study, conducting a qualitative survey based on audit reports and company reports would ascertain in having suitable information about the performance and quality standards. In a qualitative survey, the results lack reliability to a certain extent due to lack of in-depth analysis (Park, 2014; Malley & Fernández, 2012). In this regard, the best method to be adopted by the organisation is questionnaire and survey, as these two methods would ensure in having appropriate understanding about the quality and care services offered. 5.2 The Impact That Involving Users of Services in the Evaluation Process Has On Service Quality From the case study, it can be claimed that with the assistance of evaluation process, it would be possible to determine the quality and the effectiveness of RUH Bath NHS trust in terms of health and medical care services. Apart from this, the evaluation process would also help to determine the appropriate execution and implementation of the clinical care on the basis of evident based approach. In this regard, the organisation with the involvement of service users in the evaluation process is facilitated with the opportunity of having an in-depth understanding about service quality offered. In addition, the involvement of service users is recognised to be ineffective for the risk of obtaining bias feedback. In the evaluation process, the service users are able to offer appropriate information in relation to the services provided. On the other hand, evaluation will also be liable for consultation and empowerment. Evaluation based on service users will be less time consuming, but the findings generated may lack validity (Park, 2014; Schweppenstedde & et. al., 2014. With the assistance of appropriate evaluation process execution, it would be possible to identify the efforts of RUH Bath NHS trust to improve the quality of the health care in terms of reducing health risk and diseases among the population. Moreover, it would also define the procedure based on which RUH Bath NHS trust has benefitted the patients through the quality of the health and social care services. Apart from this, it can be also claimed that with the assistance of evaluation process, it would be possible to identifying the aid and quality of RUH Bath NHS trust along with its target area where the medical organisation has concentrated its utmost effort for enhancing the quality of clinical services. 6.0 Conclusion Based on the above discussion, it can be comprehended that the primary aims of enhancing the quality of health and social care services to protect the life of people and to ensure safety and security for patients. Moreover, it is identified that medical organisations need to adopt certain measures to improve the quality of health and social care services. In this regard, it can be identified from the case study that RUH Bath NHS trust has faced certain challenges owing to which the performance of the company was affected largely. Thus, it can be recommended that the company needs to use internal and external analysing measures for having effective information about medical needs of patients for enhancing the quality of health and social care services. 7.0 References Ensor, T. & Cooper. S., 2004. Overcoming Barriers to Health Service Access: Influencing the Demand Side. Health Policy Planning, Vol. 19, pp. 69–79. Jacobs, B. & et. al., 2011. Addressing Access Barriers to Health Services: An Analytical Framework for Selecting Appropriate Interventions in Low-Income Asian Countries. Health Policy and Planning, Vol. 27, pp. 288-300. Francis, J. & Netten, A. 2004. Raising the Quality of Home Care: A Study of Service Users' Views. Social Policy and Administration, Vol. 38, pp. 290-305. Malley, J. & Fernández, J., 2012. Measuring Quality in Social Care Services: Theory and Practice. London School of Economics and Political Science, pp. 1-26. Park, C., 2014. Royal United Hospital Bath NHS Trust. Care Quality Commission, pp. 1-63. Persad, G. & et. al., 2009. Principles for Allocation of Scarce Medical Interventions. Lancet, Vol. 373, Iss. 9661, pp. 423–431. Peters, D. H. & et. al., 2008. Poverty and Access to Health Care in Developing Countries. Annals of the New York Academy of Sciences, Vol. 1136, pp. 161–171. Schweppenstedde, D. & et. al., 2014. Regulating Quality and Safety of Health and Social Care. International Experiences, pp. 1-184. Sorenson, C. & Mossialos, E., 2007. Measuring Quality and Standards of Long-Term Care for Older People. The London School of Economics and Political Science, pp. 1-20. Walshe, K. & et. al., 2001. The External Review of quality Improvement in Heath Care Organizations: A Qualitative Study. International Journal for Quality in health Care, Vol. 13, Iss. 5, pp. 367-374. World Health Organisation, 2006. A Process for Making Strategic Choices in Health Systems. Quality of Care, pp. 1-40. 8.0 Bibliography Berg, K. & et. al., 2002. Identification and Evaluation of Existing Nursing Home Quality Indicators. Health Care Finance Review, Vol. 23, Iss. 4, pp. 19-36. Ekman, B., 2005. Community-based Health Insurance in Low-income Countries: A Systematic Review of the Evidence. Health Policy and Planning, Vol. 19, pp. 249–70. Härter, M. & et. al., 2006. Improving Quality of Care for Depression: The German Action Programme for the Implementation of Evidence-Based Guidelines. International Journal of Quality Health Care, Vol. 18, Iss. 2, pp. 113-19. Mukamel, D. B. & Mushlin, A. I., 2001. The Impact of Quality Report Cards on Choice of Physicians, Hospitals, and HMOs: A Midcourse Evaluation. Joint Commission Journal on Quality Improvement, Vol. 27, Iss. 1, pp. 20–27. Read More