Quality Improvement Framework and Indicators - Research Paper Example

Quality Improvement Framework and Indicators Quality improvement is an approach used by organizations, particularly healthcare, to improve the quality of their products and services. Quality Improvement Foundational Framework involves tools that an organization would use to improve quality. A multitude of quality improvement frameworks have been devised. These frameworks include European Foundation for Quality Management (EFQM), Chronic Care   Model   (CCM), and others. According to Massoud, four principles of quality improvement are particularly important. These include: focus on the client, understanding of service systems along with key processes, team work, and focus on the use of data. In the healthcare industry particularly, services should be devised to satiate the needs of clients. An important measure of quality improvement is the extent to which customers’ needs are fulfilled. In order to bring improvements in healthcare quality, it is also important to fathom key processes first. In every healthcare organization, work is accomplished by different people working in teams. Therefore teamwork is a pre-requisite of quality improvement in healthcare organizations. In order to evaluate the effectiveness of improved systems, it is imperative to analyze data before and after the implementation of those changes (Massoud, n.d.). Quality improvement frameworks in healthcare are based on various key dimensions. One of these key dimensions is effectiveness. As far as quality improvement in healthcare is concerned, effectiveness is described as the degree to which healthcare processes are achieving desired outcomes. Another dimension is safety which describes the degree to which healthcare processes keep away from adverse outcomes of healthcare processes and practices. Responsiveness, in other words patient-centeredness, is another dimension. Patient-centeredness is the degree to which a healthcare organization gives importance to its patients. A good way to assess this is to evaluate patients’ experience in terms of their healthcare. Accessibility is also a dimension which describes the degree to ease to which healthcare services are provided. Equity is related to healthcare financing, health status, and outcomes. Equity measures the degree to which a healthcare organization provides healthcare services to its people. The optimum use of healthcare resources available to a healthcare organization is considered efficiency. Efficiency can further be classified into ‘micro efficiency’ and ‘macro efficiency’. In some frameworks, macro-efficiency is often replaced with sustainability. It involves the overall healthcare spending at the right level. On the other side, macro efficiency refers to the realization of resources. According to a conceptual framework for healthcare quality indicators (HCQI), healthcare performance dimensions include quality, access, cost, equity, and efficiency. According to the framework presented by Edward Kelly and Jeremy Hurst, the core quality improvement dimensions include Effectiveness, safety and responsiveness/patient centeredness. These dimensions can significantly increase the desired outcomes (Kelly & Hurst, 2006). According to Donabedian, indicators can be classified into structure and process. Structure indicators of healthcare indicators include qualification of doctors and facilities available at the healthcare organization. Process indicators include proper delivery of appropriate healthcare to the organization. Areas which should be monitored for Quality In order for an organization to successfully implement a quality improvement framework, it is important to adopt an apt methodology. First of all, it is imperative to identify components which need to be improved. In healthcare organizations, some of the common problems which need to be addressed include inaccessibility of drugs and medicines, unavailability of staff, poor management of laboratory, and waiting time. The next step is to analyze all these problems. It is important to clarify various processes and systems through flowcharts. A review of previous data can also assist in evaluating problems. If previous data is not sufficient or adequate to analyze all important issues, it is necessary to gather additional relevant data. The third step is development. It involves proposals, assumptions, and hypotheses about the required changes which can possibly result in quality improvement. At this point all suggestions are in the form of hypotheses. It is important to testify them before proper implementation. The next step involves testing a hypothesis. Although the scientific method of hypothesis testing involves planning, testing, and evaluating the results but the process has been adapted by quality management. The adapted method involves four steps: plan, do, act, and study (PDSA) (Massoud, n.d.). Quality Improvement in Healthcare The need of quality improvement in healthcare is obvious. There is a need of continuous quality improvement in healthcare. Quality improvement in healthcare allows for continuous developments to meet various challenges. The purpose of quality improvement programs in healthcare organizations is to provide patients with the best healthcare. It is also necessary to improve the overall standard of a country’s healthcare. Perspectives of Stakeholders Stakeholders have diverse perspectives on healthcare quality improvement because their perspectives and influenced by their past experiences and expectations. Different healthcare stake holders perceive quality improvement differently because their definition of quality improvement and healthcare differs from others. (Campbell, 2000) Role of Clinicians and Patients in Quality Improvement The healthcare industry does not only consist of doctors. It involves nursing staff, patients, clinicians, and other stakeholders. They all work in teams to run a healthcare organization. Since different people in a healthcare organization work together to fulfill various functions so it is necessary to involve all stakeholders in the overall improvement. It will help them better understand these changes which will ultimately result in proper implementation. This approach will also people develop a sense of ownership of the improved processes (Massoud, n.d.). Regulatory Organizations in QI The AQA is a collaboration of the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), America’s Health Insurance Plans (AHIP), and the Agency for Healthcare Research and Quality (AHRQ).These regulatory organizations have joined their hands to improve healthcare quality and value in all settings. The strategies of quality improvement taken by AQA involve the implementation of performance measures at the physician and group level. Its strategies also involve data collection, and reporting of meaningful information to customers and other stakeholders. The ABP is another regulatory organization that focuses on quality improvement in healthcare. The sole objective of this organization is to promote excellence in healthcare particularly for children and adolescents. The (IHI) is a non-profit organization with the purpose of improving the healthcare system of the world. All these regulatory authorities and organizations can significantly egg on quality improvement. These organizations can improve patient care, accelerate growth in the healthcare industry, and innovate and recommend state-of-the-art equipment for modern healthcare (American Academy of Pediatrics). References Massoud, F.M. (n.d). Advances in Quality Improvement: Principles and Framework. Reproline Online. Retrieved from www.reproline.jhu.edu/ Kelly, H. Hurst, Jeremy (2006). Health Care Quality Indicators Project Conceptual Framework Paper. DELSA/HEA/WD/HWP(3). Donabedian A (2003). An Introduction to Quality Assurance in Health Care. Quality Improvement Organizations. Oxford: Oxford University Press; Retrieved from www.aap.org Campbel,M,S. (2000). Defining Quality of Care. Social Science & Medicine (51).pp 1611-1625 Read More