Quality and Quality Improvement in Health and Social Care - Term Paper Example

Quality and Quality Improvement in Health and Social Care Name Institution Date Introduction Quality and quality improvements in health and social care are of great concern across the world. The international organizations, governments as well as stakeholders in the healthcare sector are increasingly putting in place measures to improve quality of health and social care. The ultimate goal of quality improvement in health and social care is to ensure that the patients are satisfied. High quality care services have positive impacts on the patients as it enhances their recovery. A number of approaches and frameworks have been devised for the purposes of ensuring that the required improvements are achieved. Quality improvements are important in ensuring that high standards are used when dealing with the patients (Batalden, et al, 2016). International quality standards have been developed in order to aid in the improvement process. Theoretical approaches are in place for ensuring that the organizations are able to implement their plans. Most of the theoretical approaches are increasingly focusing on the needs of the patients. This is attributed to the increased need for consulting the patients during the treatments process. The patients have a right to know about the treatments as well as the process that they are being subjected to. Quality improvements ensure that the rights of the patients are respected at all times (Batalden, et al, 2016).The need for different stakeholders to work together is an important aspects related to the quality improvement. The processes are however prone to some challenges and hence the need for evaluation. The paper thus discusses the theoretical approaches to quality and quality improvements in health and social care. Discussion Shared involvement Shared involvement is a concept that ensures that the patients as well as their family members are part of the process. The shared involvement framework enables the patients, family members and the healthcare professionals to work together interdependently for co-creating and co-delivering care (Sabadosa & Batalden, 2014). The patient and the family members in this framework rely on the healthcare professionals for the provision of timely and quality services. In order to improve on the quality of healthcare service delivery, the patients have to be well informed. This is achieved by providing them with adequate information about their conditions. The availability of information on the part of the patient gives rise to mental and emotional readiness to engage. The quality of care can be greatly improved when the patients are ready to provide more information and engage freely with the healthcare professionals (Dent & Pahor, 2015). This concept ensures that the rights of the patients are upheld at all times during the treatment and provision of care. The framework of shared involvement enables the patient to understand why the medical professionals are taking certain steps or actions during the process. This gives room for the patients to engage the professionals and raise any concern. The engagement between the patients and the healthcare professionals ensures that the challenges can be reframed into opportunities so as to improve on the quality of the services. The experience of the patients is improved when they feel that the healthcare personnel are concerned about their conditions are keen on offering the best quality of care. The family members play a crucial role in the framework. Some of the conditions or diseases facing the patients are genetic. The involvement of the family members in such situations is therefore useful in ensuring that high quality services are provided. An example of one such condition includes cystic fibrosis which may affect the children in the family (Sabadosa & Batalden, 2014). The healthcare professionals can obtain more information about the condition from the family members. This enhances the treatment process with the experience of the family members who have been affected being shared with the healthcare personnel. The family members are responsible for caring for the patients in most of the situations. Providing them with more information about the activities that they should carry out is vital in improving the quality of care. Provision of information to the family members ensures that they observe correct procedures and processes when dealing with the patients. The information is also vital in ensuring that the family members are able to better understand the condition of the patient. This improves on the interaction with the patient and demystifies any myth surrounding the conditions. Shared involvement and provision of information to the family members greatly improves on the quality of care when dealing with mental health patients (Dent & Pahor, 2015). Shared involvement encourages the participation of different stakeholders in improving on the quality of care. Listening and learning from the stakeholders is also promoted by shared involvement and hence improving on the quality of care. Coproduction Coproduction is an approach mainly used in the public sector for the purposes of improving on the quality of services delivered to the clients. It involves the citizens, communities and the healthcare professionals. Expertise of the different groups is pooled together in order to ensure the delivery of more effective and sustainable services (Batalden, et al, 2016). It ensures that the citizens as well as the citizens as well as the patients have rights and responsibilities as equal partners. The question of what kind of service the patient want to live as well as their eligibility for certain services has to be considered in the coproduction framework. In order to improve on the quality of service offered, the service users as well as their communities are involved in defining the need or problem and designing the solution. The delivery and evaluation of the service can be carried out independently or with the involvement of the experts in order to improve on the quality. Shared decision making process as well as information is an important aspect of coproduction (Spencer, et al, 2013). This plays an important aspect that encourages participation, mutual respect as well as the knowledge and skills of each of the participant. People powered health is a program that was developed in England as a model of coproduction. This has played an essential role in reducing the overall health cost as well as the hospital stay for the patients. The benefits of coproduction in improving the health care services are evident in social as well as monetary value. Coproduction improves on the performance of the practitioners and hence contributing to quality care services. This is achieved by motivating the practitioners leading to improved performance. As a result of coproduction, the practitioners are empowered which makes it easy for them to make a difference in the lives of the others. Flexibility as well as shared learning is encouraged through coproduction and hence improving on the capacity and capability of the healthcare organization (Batalden, et al, 2016). This has played a vital role in ensuring that the healthcare organizations are able to deliver quality services. Coproduction ensures that the service recipients are empowered, valued and listened to. The feeling created among the recipients improves on their levels of confidence in the organization and the healthcare personnel. The National Health Service (NHS) in Wales used the approach to improve on the quality of services delivered to the patients (Spencer, et al, 2013). This was achieved through a methodology known as Improving Quality Together (IQT). This has played an important role in enabling the staff members to improve on their skills and gain accreditation on the aspects of quality. As part of the coproduction process, the doing component commonly known as Plan, Do, Study, Act (PDSA) Cycle is usually utilized (Spencer, et al, 2013). In order to successfully implement the coproduction process a number of steps have to be followed. This include identification and building of the initial team, defining and sharing assets, co-creating the vision in order to develop will, co-designing the solution so as to build ideas, co-delivering for the purposes of building execution and co-evaluating in order to measure the impact of change. Patient centeredness and involvement Patient involvement is an important aspect that in quality improvement in health and social care. This is an important approach that is increasingly becoming in important in Europe. This is attributed to the New Public Management (NPM) reforms in Europe. Patient involvement is an approach to quality that is aimed at enhancing the empowerment process. Empowering the patient enables them to participate in every step of their treatment (Kavcic, et al, 2015). Choice is one of the pillars of patient involvement. This ensures that the patient is considered as a consumer. When the patients are considered as consumers, the doctors have to design clinical services that guarantee high quality practice. The patients as consumers also have access to good information which facilitates informed choices. Patient involvement also ensures that they are treated as participants in the healthcare provision. This is achieved through various practices that enable the direct participation of the patients in the treatment and care services. An example being the self-management plans for diabetes patients. As participants, the patients are usually provided with simplified medical terms in order to fully understand the activities taking place. The healthcare personnel however work closely with the patients to ensure efficient self management. During the design of care pathways, the patients have to work directly with the doctors (Sabadosa & Batalden, 2014). The doctors as well as the other healthcare personnel ensure that the patient is aware of all the activities in the pathway. This is considering that they will be directly involved in the implementation process. In Europe patient involvement considers the aspect of voice as a means to improve on the quality. Voice considers the patients as a citizen in the care process. It is the responsibility of the doctors to work with citizens in order to deliver quality services to the local people. This means that the doctors have to educate the patients during the process as a means of quality improvement (Dent & Pahor, 2015). The process has to build confidence in order to ensure that they are listened to. The patients as citizens may also attend various forums in order to obtain more information from the professionals. The quality of services offered to the patients is improved as a result of patient involvement. European countries such as Slovenia is actively implementing measures aimed at promoting patient involvement as a means to improve on quality. The adjustments being put in place aims at ensuring that the country is able to improve on the quality of healthcare services offered to the individual patients. A lot of focus is being placed on the needs of the patient and this has played a vital role in identifying the quality gaps as well as areas of dissatisfaction (Sabadosa & Batalden, 2014). Involving the patient in the process has contributed to improve relationship between the healthcare personnel and the patients. The presence of a good relationship ensures that the patients can openly address issues affecting them with the confidence that they will be addressed. The focus on the patient as well as their involvement has also increased the levels of satisfaction. Driver, facilitators and barriers of quality in health and social care The political changes in Europe and other countries is one of the main drivers of quality and quality improvements in health and social care. Policy making through the participation of the members of public in debates has encouraged the political class to pass laws aimed at improving on the quality of health and social care. This includes the European Charter on Patients Rights 2002 and Patients Rights Act 2008 in Slovenia (Kavcic, et al, 2015). The presence of laws and regulations play a vital role in driving the quality. Compliance with the law is mandatory and the healthcare organizations have to put in place appropriate measures. A number of studies as well as research indicate that the quality is an important aspect that influences the quality of services offered to the patients. As a result of this, most of the facilities and organizations are putting in place quality improvement measures. The safety of the patients is of major concern in the current world. The quest to improve on the safety of the patients and reduce fatalities is a major driver of quality improvement in health and social care (Sabadosa & Batalden, 2014). The need to effectively deal with the increasing burden of chronic diseases as well as health needs by the elderly has force the stakeholders in the sector to device new approaches. The new approach developed has greatly contributed to improved quality of health and social care services. The support for quality by various stakeholders is also considered as one of the main facilitators to process. Despite the availability of several approaches to quality improvements, a number of barriers are still in place. The presence of barriers negatively influence attaining quality improvement goals and objectives. In European countries such as Slovenia, some of the aspects of quality improvement such as user involvement have not been firmly embedded into the healthcare system (Kavcic, et al, 2015). This creates a challenge in improving on the quality of health and social care services. Some resistance from the healthcare personnel who are used to the old methods is evident in some of the facilities and these impacts negatively on quality. Lack of adequate resources is one of the barriers to quality health and social care services. Some of the quality improvement measures require huge financial resources and hence impacting negatively on the implementation process. Human resources such as healthcare personnel are also needed in order to improve on the quality of health and social care. The resource constrain is being faced by most of the organizations who do not intend to pass the costs down to the consumers. As a result of this, a number of quality improvement measures cannot be implemented. The implementation of the measures also requires some follow up as well as continuous improvements (Spencer, et al, 2013). This requires resources that may not be available and hence impacting negatively on the process. Resources are also required for the purposes of motivating the healthcare personnel and this may not be available in most cases leading to the problem. When providing the social care services in some of the facilities such as the mental health, a number of barriers are in place. In most cases, the personnel are faced with a challenge of caring for the patients and containing them for the purposes of control. This is a major barrier to quality improvement as the personnel cannot effectively implement the required changes. The organizational structure based on containment creates difficulties in putting in pace quality improvement measures and hence affecting the quality improvement process (Paula & Huw, 2004). In some of the instances, the healthcare personnel are faced with resistance from the patients as well as their caregivers. This is a major barrier that affects the decision making process. User involvement is greatly hindered by the resistance from the patients. This barrier in most cases is attributed to lack of adequate information by the patients and their family members. A resistance healthcare culture is a major barrier to quality improvement in health and social care services (Paula & Huw, 2004). When the pressure increases, the healthcare personnel usually revert to the old ways of doing things. This is considering that some of the quality improvement activities are time consuming. The professional knows best mind set is still common in the field of health and social care services. This is a major problem to quality improvement as the professionals are reluctant to engage in some of the activities. Diversity among the patients is also a barrier as not all of them have the desire and capacity to be active participants. Quality measurement In order to determine the impacts of the quality improvement activities in the health and social care services, measurements have to be made. The measurements are useful in the process of determining the effectiveness of the quality activities as well as their impacts in the patients. Measurement has been identified as a critical aspect in testing and implementation of changes (Moullin, 2004). It is also through measurement that knowledge is brought into daily practice. The quality measures can be carried out at different levels using a number of tools. The local clinical teams usually utilize measurement for benchmarking as well as day to day monitoring. The healthcare organizations in most cases utilize quality accounts for the purposes of reporting on quality to the local communities that they operate in. This therefore enables the members of the community to understand the progress being made in terms of improving on quality. Commissioning for Quality and Innovation (CQUIN) is a scheme that is used by the commissioners to measure the quality aspects (Moullin, 2004). National Quality Board is involved in the measurement of quality at the national level in comparison with the other countries. The measures are thus important in ensuring that the quality improvements measures are beneficial to the patients. The rate of improvements is usually determined by the small tests of significant changes. This encourages learning as well as completion of another cycle of quality improvement measures. Performance management has been introduced in the healthcare system as part of the measurement means. Performance management is however commonly used as a means of measuring the quality issues in relation to the performance of the staff members. It mainly incorporates the aspects of information, management, measurement and action. A well designed performance management system is vital in ensuring that the needs of the patients are met. During the process of measuring the quality aspects, feedback has to be obtained. This is useful in determining the response of the patients as well as the other stakeholders involved in the process. A balanced set of metrics can also be used for informing quality assurance and improvement (Boaden, Harvey, Moxham & Proudlove, 2008). This plays an important role in terms of providing a ground for effective quality management and governance. In order to ensure that the measurement is successful, all the staff members have to be involved. A combination of outcome as well as process measure is also useful during the process. The cost of measuring performance has to be has o be considered in order to ensure efficiency. A clear system that translates feedback into strategy for action is vital during the measurement process. In the healthcare sector, there are three commonly used types of measures. This includes outcome measures, process measures and balancing measures (Boaden, Harvey, Moxham & Proudlove, 2008). The measurement processes in most cases require the involvement of experts. This is considering that an evaluation and review of data is required on a continuous basis. All the stakeholders have to be informed of the measurement process and its objectives. This is for the purposes of ensuring that they are fully prepared for the process. Conclusion In conclusion, it is evident that quality and quality improvement in health and social care service is in ensuring that the needs of the patients are fully addressed. The quality of care services offered to the patients is becoming of great importance due to the burden of chronic diseases across the world. A number of theoretical frameworks have been developed for the purposes of addressing the quality issues. Shared involvement is one of the theoretical frameworks that are utilized in the sector. Shared involvement focuses on the patient as well as their family members and health professionals. Coproduction is an important framework that promotes interdependerbility among the stakeholders. The coproduction is increasingly becoming popular in Europe as well as different parts of the world as it encourages best practices. Countries like Slovenia are increasingly putting a lot of focus on the patients. It is evident that quality improvement faces some challenges as a result of barrier. Its success is however attributed by the presence of drivers. Measurement of the quality improvement measures is increasingly becoming important in the healthcare sector. It is evident that the impacts of the quality improvement activities can be obtained through measurement. References Batalden, M., et al. (2016). Coproduction of healthcare service. BMJ Qual Saf, 1–9. Boaden, R., Harvey, G., Moxham, C., & Proudlove, N. (2008). Quality Improvement Theory and Practice in Health Care. London: NHS Institute for Improvement. Dent, M., & Pahor, M. (2015). Patient involvement in Europe- a comparative framework. Journal of Health Organization and Management, 29(5), 2015 546-555. Kavcic, M. et al. (2015). User involvement in Slovenian healthcare. Journal of Health Organization and Management, 29 (5), 595-610. Moullin, M. (2004), “8 Essential Features of Performance Management Evaluating a health service taskforce”. International Journal of Health Care Quality Assurance, 17(3). Moullin, M. (2004), “Evaluating a health service taskforce”. International Journal of Health Care Quality Assurance, 17(5). Paula, H., & Huw, T. O. (2004). Service design, culture and performance: Collusion and co- production in health care Human Relations, 57(11), 1407-1426. Sabadosa, K. A., & Batalden, P. B. (2014). The interdependent roles of patients, families and professionals in cystic fibrosis: a system for the coproduction of healthcare and its improvement. BMJ Qual Saf, 23, i90–i94. Spencer, M., et al. (2013). Co-producing services – Co-creating health. 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