Quality Improvement Plan for the US Healthcare System - Essay Example

? Quality Improvement Dawn M Lawrence HCS/588 May 15, Debra Brindley RN, BSN, MSM, LHRM, CENP, CPHQ Introduction Quality Improvement is a formalapproach to the analysis of performance and systematic efforts to enhance the process. In management, the organization’s leadership adopts measures to improve patient safety and overall quality. According to Berwick, the central idea of modern quality is “Every system is perfectly designed to achieve exactly the results that it achieves”. Performance is a characteristic of any given system that persistently show the same results unless the system is changed. Reports about quality of U.S healthcare system highlight the quality to be beneath the level of expectations (Ramsom et al, 2008). Goals The Organization Has To Meet The motive of Quality Improvement Plan (QIP) is to commend support to health care associations in their attempts accomplish improvement in the health care facilities. Ontario Government in June 2010, approved the Excellent Care of All Act (ECFAA), a legislation to promote a civilization of relentless eminence development emphasizing the requirements of patients as the priority. Under such act, emphasis is laid for- a) commitment to provide elevated quality of health facilities; b) generating a constructive patient know-how to be familiar with the procedure; c) making certain that the procedure is approachable and answerable to the community and meet the expectations of the people; d) grasping its managerial group responsible for its attainment; e) identify the importance of clarity to pursue the procedure (Our Performance- Quality Improvement Plan). Departments, Programs & Activities To attain the projected health quality, active participation of clinicians is vital prerequisite for the quality improvement. Health professionals possess varied hierarchies and networks with least communication concerning quality of care. Clinicians with clear understanding about the quality of health care facilities as well as try to improve what is lacking are likely to be the winners. In health care sector, patient is the customer and seeks best health care and concern. Growing awareness for health care in the community also enhances the expectations of the people for high quality health care facilities. It is highly significant to design QIP keeping four constraints in consideration encompassing- safety, efficacy, accessibility and the patient focused plan. Quality Improvement Plans gyrates around these four principles as patient focuses plants is the main highlight of QIP. For the successful implementation of the QIP, it is essential for the health care providers to recognize the working of the plan. An appropriate understanding aids in enhancing the quality of patient's care and concern. QIP is a collective effort and involves contribution of all the staff members for its success encompassing effective implementation of the appropriate processes. Responsible individuals are required to take ownership of the developed QIP processes. The process is analyzed by means of focus on data and identification of problem(s) as well as by measuring performance. The amendments made in the QIP must be tested and the data procured must be analyzed to ensure that the basis of improvement is changes, progress in quality improvement involves the procedure and success attained encompass two parameters what is done and how it is being done (Quality Improvement Plan Guidance Document). The legislation necessitates that all health care associations must set up a quality board to keep an account on excellence associated matters; build up an annual QIP and make it available to the community, connect administrative payment to the attainment of objectives embarked in the excellence enhancement grounding, perform employee's assessments, build up a patient pronouncement of standards ensuing community consultation to deal with and enhance the patient's understanding. Thus, the annual QIP should encompass yearly performance enhancement objectives together with the justification for those targets; information concerning the manner in and extent to which, executive compensation is linked to the achievement of those targets. The complete assessment of the hospital or the health care organization is essential for drafting the Quality Improvement Plan, there after the methods are devised for the improvement in required areas (Quality Improvement Plan Guidance Document). Performance Data & Tools To Be Collected/ Displayed Quality of health facilities constantly need improvement, measurement of this improvement enables one to define hospital performance. The chief methods adopted to measure the performance of the hospital to assess the quality improvement encompass- inspection, public satisfaction surveys, third party assessment encompassing ISO standards and statistical indicators, peer review or by accreditation programs, supported by clinicians for self-analysis and to enhance improvement. Accreditation programmes focus more on the areas to be improved and not on the failures. Efficacy of this description is procured with the help of variables encompassing the national culture, purpose and application criterion (HEN). Methodology and Processes QIP aims to assist organizations keeping the legislative prerequisite under ECFAA into consideration. This is imperative to certify fulfilment with the section 8(5) of ECFAA. For the successful plan it is essential that overview of hospital's QIP must be performed and focus of the existing QIP must be considered together with the coalition, jeopardy, mitigation and challenges. This must be analyzed critically to execute improvement in the QIP (Quality Improvement Plan Guidance Document). Improvement objectives and proposals- this is also known as Model for Improvement as it involves, Aim- what is desired to be achieved; Measure- the way to understand that the alteration is an improvement; Change- what alterations and amendments must be made to bring reformations (Quality Improvement Plan Guidance Document). Link to performance-based compensation to the executives- it is essential to motivate the executives for the success of QIP. Essentially all the legislative requirements must be fulfilled in developing QIP (Quality Improvement Plan Guidance Document). Standard To Compare Performance Reports about the hospital quality assessment must be compared with the standard and therefore report must be submitted to the authority. For instance OHQC is one such body that monitors the QIP in various health care sections (Quality Improvement Plan Guidance Document). Authority Structure Of Plan Implementation Empirical practice and health care discrepancies are imperative in medical practice and is must for consideration in QIP. However, better quality is directly proportional to the care provided in the hospital or health care organization. Thus, every health care organization is required to procure the feedback and constantly work to improve the quality of care offered to the patients as it directly implicates the mission and vision of the health care organization. Constant monitoring not only aids in quality improvement as well as provide an assessment to the organization to accomplish their set aims and objectives (Quality Improvement Plan Guidance Document). Roles and Responsibilities for QIP The present epoch witnesses clearness and answerability in all aspects including health as awareness about rights and duties is on rise. In healthcare system, individuals frame different outlook towards quality of health care being provided and approval of ECFAA enables health care organizations to monitor and report to people. QIP is designed in co-ordination with the Ministry Of Health And Long-Term Care, Local Health Integration Networks, The People- who are the stakeholders as they have diverse requirements, Hospital Board, Hospital Quality Committee, Chief Executive Officer or Hospital Administrator and the physicians as they perceive quality in terms of technical performance, diagnosis, apposite therapy to get a good outcome (Berwick, 2002; Quality Improvement Plan Guidance Document). Role of Insurance & Other Cost Effective Parameters The insurance companies and cost- effectiveness of the care also becomes the determining factor for the QIP. As QIP is patient focused it becomes vital to consider this parameter as health care cost determines the patient ratio in any health care organization. QIP should have provision to keep the costs down and have processes that allow their employees to return to work quickly. The manager’s primary goal is concerned with hospital function and delivery of services. The patient’s impression about the quality is the highly imperative as it involves concern, empathy as well as dexterity of communication of assistance in the hospital as this is enduring hunch on the patient's mind about the quality of health care being provided by the health, which is further added by the efficacy as well as cost-effectiveness of the facility being provided (Quality Improvement Plan Guidance Document). Who The Performance Activity Outcomes Are Communicated To By adopting various initiatives health care could become more affordable; these initiatives involve establishing health insurance exchanges; fostering innovations to promote quality and reduce cost; administrative simplification. The Agency for Healthcare Research (AHRQ), a federal agency under Human and Health Services works to advance the quality, effectiveness and safety and aids in providing benchmarking and standards database. The work is distributed to enhance the quality. The Centers for Medicare and Medicaid services work with the providers to ensure quality, well-organized facility and cost-effective care for the old, disabled, and low income. The Center for disease Control and Prevention (CDC) examines and manages infectious diseases and helps to prevent the spread of diseases. The Joint Commission is an accrediting agency, which is voluntary, reimbursement by Medicare/Medicaid/insurance often enforced accreditation. Accrediting agencies set standards and provide thorough inspections of facilities Educating The Staff Quality management and consistency are needed in healthcare. For formulating QIP, various areas need to be monitored encompassing safety by minimizing harm caused due to poor care, care must engage patient and family as partners, efficient communication as well as co-ordination must be promoted, prevention and care must be promoted to reduce mortality caused due to cardiovascular disease, promoting healthy living, making quality care available at an affordable cost for patient families and employers by means of fresh health care delivery systems. When quality is measured in terms of structure, the focus is on the relatively static behaviors of individuals involved in the care. Appropriate methods and guidelines must be provided to the staff of the health care organization encompassing clinicians, nursing staff and administration (National Strategy for Quality Improvement in Health Care). The Need For Improvement Estimates report that health care system in America is poorly organized and this is the biggest reason why millions of inhabitants not succeed in obtaining effective health care. Moreover, the health care system fails in utilizing most of its resources. Health care expenses are mounting due to the escalating population, enhanced longevity and requirement of novel services, techniques and remedies. However, medical errors subsequently require supplementary health care and duplication of services thereby further augmenting the expenses and cost of the health care facility. Poorly designed care procedures may delay the effective care which in some cases my deprive some of the patients from appropriate health care while on the other hand there is overuse of many services where the peril from the services outweighs the gains. Reformation in health care quality becomes necessary for the enhanced managerial and therapeutic processes (National Strategy for Quality Improvement in Health Care). Besides being the leader in innovations and development of novel therapeutic approaches, in diagnosing, managing, curing, preventing the illness together with educating and training the medical staff and nurses, the facilities fail in benefitting large sector of population. One of the biggest reason that emerged is fragmentation and disorganization of health care facilities in the United States and every time the patient or the family members have to recite the story to the fresh medical professional they come across. Poor organization and loss of records leads to duplication and repetition of tests and this adds to the augmentation of health care costs. Therefore, the need to formulate the patient centered strategy became imperative, which is now pinned to QIP and strategies. The motive is to ensure appropriate care at the exact moment and in the precise setting consistently (National Strategy for Quality Improvement in Health Care). Making Quality Care More Affordable The motive of QIP is to minimize the cost of health care facility and to enhance the quality of the health care being provided thus making the care and quality patient focused. It is imperative to understand that the health care spending is augmenting at the faster pace as compared to the economical growth. With the high rate of recession and inflation rate, health care is becoming a burden on families. People could witness that increase in their paychecks is proportional to the payment of health care facilities. QIP therefore aims at providing quality care with minimum cost on the patient's pocket (National Strategy for Quality Improvement in Health Care). Conclusion The quality lies in the eyes of beholder, variations persist in health care facilities. Uninsured patients directly influence the cost of healthcare and constrains of the organizations to focus on cutting costs. It becomes imperative for the health care organizations to focus on cutting costs keeping the quality of health care facility for the patient as the priority. Constant monitor in the quality is critical for preserving suitable verifications and balances as organizations attempt to deliver sound healthcare at an affordable cost. QIP promotes patient focused quality health care to meet the requirements of patient, family and communities who pay to procure care and health. QIP fosters a delivery system that assists medical professionals and health care providers associated with health care organizations, with the motive to render reduced administrative burden and collaboration to enhance care. QIP is a strategy to measure enhancement in care procedures and in general physical condition of inhabitants of United States. References Berwick, D. M. (2002). A User's Manual for the IOM's ' Quality Chasm' Report. Health Affairs, 1(2), 80-90. HEN- How can hospital performance be measured and monitored? (n.d.) Retrieved from www.euro.who.int/document/e82975.pdf. National Strategy for Quality Improvement in Health Care. (n.d.) Retrieved from www.healthcare.gov/law/.../nationalqualitystrategy032011.pdf Our Performance- Quality Improvement Plan. (n.d.) Retrieved from http://www.southlakeregional.org/ourperformance.qualityimprovementplan.html. Quality Improvement Plan Guidance Document. (n.d.) Retrieved from www.health.gov.on.ca/en/ms/ecfa/pro/.../qualityimprov/qip_guide.pd... Ramsom, E. R., Joshi, M. S., & Nash, D. B. (2008). The Healthcare Quality Book (2nd ed.). Chicago, IL: Health Administration Press. Read More