Quality Improvement in Health Care: Concepts Analyzed - Term Paper Example

 Quality Improvement in Health Care: Concepts Analyzed Introduction Ordinary people are bestowed with a single life, thus, they highly depend on health services when well-being manifests otherwise. Consequently, American citizens have high expectation regarding delivery of health services, as they must be “safe, effective...equitable, and efficient” (Lynn et al., 2007, p. 666). To meet them, experts suggest several tool parameters, “continuous quality improvement (CQI),” to enhance how services are provided. This is an organizational strategy between top management and clinical participants in establishing methodological processes and effective mechanisms that support high quality performance by all institutional staff during delivery of overall health services (Mclaughlin & Kaluzny, 2004). The encompassing definition shows the import of attaining provisions in quality health and services through competent CQI, although several aspects may account for its difficulty to thrive in hospital organizations. Foundation in Quality Improvement Quality improvement in clinical setting possesses complex nature. A valid study indicates its success lies on the elements surrounding such concept (see Figure 1 in Appendix A). In the illustration, a variety of influences affect the execution of quality improvement in clinical settings: “culture, implementation approach, perceived impact...clinical conditions, and bed size” (Shortell et al., 1995, p. 380). Each factor can alter the degree of health service delivery, giving them the critical role, and the necessary dynamics that can be assessed for significant evaluation of existing resistance. Despite the basic proponents in quality improvement, different perspectives emerge, depending on how improvement tool should be carried out for relevant participants. Kovner, Knickman, and Jonas (2008) identified four primary stakeholders directly involved in CQI: “providers, patients, payers, and policymakers” (p. 415). The health care team plays provider role, where they focus technical aspect of care, including application of medical knowledge and skills, and ethical standards in clinical service. They cater to patients, another stakeholder, who view quality care on the psychological side. For patients, quality improvement depends on expressed level of sincere attention and respectful care from health providers. Actual payers of treatments aspire to have technical and touch aspect of health services. Practical efficiency and emotional efficacy of clinical interventions must collaborate to bring excellent services that health team are supposed to provide. Lastly, policy makers seek to place regulatory measures to ensure that both clinical practice and professional attitudes are within institutional and societal boundaries (Kovner et al., 2008). All of them view quality improvement in different lights, but they all agree that improvements are closely needed. As presented earlier, health care providers and their patients profess different perceptions on quality improvement. Their belief clash impedes the full application of CQI. Health teams are integral in maintaining benchmarks dictated in quality improvement methods. They are the source with which clinical progress initially originates. Nonetheless, quality parameters cannot proceed without the cooperation of patients. Their full consent is crucial, since they will directly benefit from employed improvements. They are informed of potential risks and given opportunities to refuse (Lynn et al., 2007). With more patients declining, the probability of determining the efficacy of CQI is relevantly diminished. In this case, the collaboration of both providers and patients should be established before any steps towards attaining quality improvement are performed. Practical Appraisal on Quality Improvement The filtration of quality improvement in health industry is past overdue, as it strives to keep up with other economic industries (Mclaughlin & Kaluzny, 2004). This area is not solely involved in making profits, as lives are at stake. Irreparable health conditions may occur; in worst cases, deaths result. In quality improvement, ethical principles of doing good and doing no harm are ensured, safeguarding patients’ safety. Aside from these, continuous feature in improvement procedures assumes that appropriate clinical mechanisms must be employed in cost-efficient manner (Counte & Meurer, 2001). On internal level, clinicians are given opportunities for active involvement in administrative and leadership department. Their suggestions regarding clinical conduct and services are highly necessary for successful health operations (Weiner, Shortell, & Alexander, 1997). By this, direct association between clinicians and non-clinical employees are strengthened for better quality care collaboration. Quality improvement is an experiential learning regarding professional values and practice. On the clinicians’ side, full participation is rendered to deliver efficient and appropriate treatment interventions, with the inclusion of other responsibilities in scheduling work shifts, dispensing medications, and documenting clinical interventions (Lynn et al., 2007). Aside from basic medical obligations, three aspect of clinical discrepancies are expounded--underuse (more benefit versus less risk), overuse (less benefit versus more risks), and misuse (mismanagement of appropriate services) (Chassin, 1997). These forms exhibit faulty judgment by clinicians in executing professionals’ duties, hence, the need for quality improvement. To prevent and contain clinical damages, accrediting and regulatory bodies are established, from National Committee on Quality Assurance, Joint Commission on Accreditation of Health Care Organizations, and Institutional Review Boards, as well as specific clinical associations that evaluate educational and skilled competence of clinicians and allied health practitioners (Iglehart, 1996). They perform the task of assessing whether institutions and affiliated practitioners are following standardized practice dictate by state laws. In carrying such tasks, these organizations require cooperation of resource stakeholders, including “U.S. Health Resource and Services Administration, Institute for Health Care Improvement, National Health Service, and Veterans Health Administration’s Quality Enhancement Research Initiative” (Mittman, 2004, p. 897). They are influential organizations with capacities to persuade interested parties and associations on funding and supporting the practical cause of CQI. By doing so, initiation and sustenance in procedural and experiential application of CQI can proceed until its efficacy is evidently exhibited and integrated in hospital systems. Conclusion All in all, continuous quality improvement is a systematic and problem-based solution to combat growing pressures for better health provisions. Not only does it tackle the root problems in clinical practice, it also considers management approach in the different organizational structures. Such method clarifies involvement of non-clinical personnel in improvement system, proving its applicable dynamism in any institutional areas. Most importantly, as CQI seeks to significantly address conflicts in medical practice and management, this is guided by accrediting and regulating bodies, appraising both the institution as a whole and competency of practitioners it houses. In doing so, not only is CQI in the process of establishing its evidence-based qualifications on medical field, it proves that the method holds positive potentials in bringing what it aspires--delivering effective quality health improvements in a patient-cored concept. References Chassin, M.R. (1997). Assessing strategies for quality improvement. Health Affairs, 16 (3), 152-161. Counte, M.A., & Meurer, S. (2001). Issues in the assessment of continuous quality improvement implementation in health care organizations. International Journal for Quality in Health Care, 13 (3), 197-207. Iglehart, J.K. (1996). The national committee for quality assurance. The New England Journal of Medicine, 335 (13), 995-999. Kovner, A.R., Knickman, J., & Jonas, S. eds. (2008). Health care delivery in the United States. 9th ed. New York, NY: Springer Publishing House. Lynn, J.L., Bally, M.A., Bottrel, M., Jennings, B., Levine, R.J., Davidoff, F.,...James, B. (2007). The ethics of using quality improvement methods in health care. Annals of Internal Medicine, 146 (9), 666-679. Mclaughlin, C.P., & Kaluzny, A.D. (2004). Continuous quality improvement in health care (2nd ed). Canada: Jones and Barlett Publishers. Mittman, B.S. (2004). Creating the evidence base for quality improvement collaboratives. Annals of Internal Medicine, 140 (11), 897-901. Shortell, S.M., O’Brien, J.L., Carman, J.M., Foster, R.W., Hughes, E.F., Boerstler, H., & O’Connor, E.J. (1995). Assessing the impact of continuous quality improvement/ total quality management: Concept versus implementation. Health Services Research, 30 (2), 377-401. Weiner, B.J., Shortell, S.M., & Alexander, J. (1997). Promoting clinical involvement in hospital quality improvement efforts: The effects of top management, board, and physician leadership. Health Service Research, 32 (4), 491-510. Appendix A Figure 1. Framework on Factors in Implementing Quality Improvement (Shortell et al., 1995) Read More