Quality in Health System-Free-Samples for Students-Myassignment

Questions: 1.Define quality in Health Care and Explain the key elements of total Quality Management and Continuous Quality Improvement in the Health Care Context. 2.Patient Safety is Considered to be the Cornerstone of High-Quality Health Care. What is meant by the two terms Safety in Healthcare and Patient Safety? 3.In 2012 the Australian Commission on Safety and Quality in Healthcare implemented National Safety and Quality Health Service (NSQHS) Standards. 4.How does clinical governance differ from clinical leadership in the Context of Quality and safety in health care Provision? 5.What is the role of Clinical Leaders when ensuring Quality Improvement in the Clinical settings? Answers: 1.Quality in Health system with TQM and CQI elements The term Quality means the degree/ grade of excellence. According to Institute of- Medicine, health care quality is defined as the grade/ degree to which the health-related services that are rendered to persons and communities maximizes the chance of getting desired health-related outcomes as well as consistent with prevailing health care professional knowledge (AHRQ, 2012). Quality in health organization involves practicing health care interventions appropriately based on the pre-established procedural standards, with an objective of satisfying the patients as well as maximizing health outcomes without creating health- related risks and/or unnecessary expenditure. The elements of quality include providing safe, effective, patient- centered, timely, efficient and equitable care (AHRQ, 2017). There are various approaches of quality management in which total quality management (TQM) that is called as continuous quality improvement (CQI) in a health system, indulges itself in analyzing the health- related issues, planning corrective actions, implementing these actions in needed areas and evaluating the effectiveness of these action (NCCHC, 2017). TQM helps to constantly improve the work performance at all the levels of system in each and every departmental (functional) area of a health organization utilizing man, money and material resources. AIHW (2017) has stated that Australia peaks high internationally in quality improvement and remains as one of the top performer in OECD countries. CQI aims to minimize the capital and waste of poorer quality-care. The elements of TQM and CQI are as follows: a). the customer/patients focus, whose health-needs are paramount in quality determination. Customer satisfaction, analyzing ownership with services by customer/patient opinion surveys, minimizing errors, avoiding reasons for dissatisfaction, maintaining societal relationships, following business ethics, maintaining safe environment, sharing quality- standards in organization are needed (McLaughlin, 2012). b). Strategic planning with leadership to promote customers expectations, newer diagnostic techniques, advanced developments, evolving customer-care system and societal expectations. c). Continuous improvement with learning: regular planning, implementation and evolution. d). Empowerment with team-work. e) Improving process management. f). Team-building and group-integration tools. g) Quality Assurance and Control. 2.Client safety maintenance of safe healthcare The entire health system revolves around the patients by keeping them as their cornerstone. All the health professionals and organizations work for the welfare of the patients and hence they should be the core of quality performance. Their safety represents the quality of health organization and the safety of health organization also means the same. Safety is one of the quality dimensions which involve preventing harm to the clients that could be either temporary or permanent (Douglas, 2012). The health organizations should provide a safe environment to the patients by keeping them free from injuries due to accidents or preventable traumas that occurs in health organization (AHRQ, 2012). Safety means protecting the clients from harm/ injuries and Quality means maintaining appropriateness and effectiveness and hence safety and quality in health systems means People + Systems i.e. providing appropriate and effective care to clients without causing harm. TheAustralian- National health performance committeehas stated about maintaining safety in health organization by linking it with preventing and/or reducing harm that actually or potentially occurs in an organization or in an internal (hospital) environment to an acceptable limit. It was estimated that nearly 12% of the adverse events occurs every year in Australia in which 50% of them are avoidable and at-least 1 in 300 has chance of getting injury as compared to only 1 in 1 million aircraft traveller. Nearly 0.04% (1,782) Australian patients encounter death or serious harm and 0.149% of patients encounter temporary or less harm every year. They commonly encounter harm due to drug error, patient falls, and hospital acquired infection and suicide. Approximately 500,000 Australians become sick due to hospital admissions and turn back for further treatment (Dunlevy, 2013). Hence, maintaining safety in an organization is crucial to protect patients from harm and thereby to improve quali ty. 3.NSQHS standards- Quality In 2012, Australia- Commission on safety with quality in health care has proposed NSQHS standards to assist health organizations to render safe as well as high quality- care (Fig: 1). These standards were framed after an elaborate public, healthcare professionals and stakeholder collaboration. Protecting people from harm and improving quality of the health- services provided were the two aims of these standards. They form the basis for the accreditation process as it helps in determining how and with what a health- organizations performance will be evaluated. The health-service organizations can compare these standards with its performances and can use in internal quality-assurance and/or in external- accreditation process (NSQHS, 2012). Figure: 1 shows NSQHS standards of Australia (NSQHS, 2012) The NSQHS standards are explained as: 1). Adequate governance to maintain reliability in health care setting which portrays quality framework of a health setting to provide safer treatment. 2). Proper partnering with consumers/patients that encompasses strategic plans to create a patient-centered health system by including patients/consumers in developing and designing quality- care. 3). Prevention and control of hospital associated infections by evidence based strategies (Duguid, 2011). 4). Drug safety which includes strategic plans to ensure whether the clinicians are competent to safely prescribe, dispense or administer medicines to the consumers. 5). Consumer identification along with appropriate procedure- matching that comprises the strategic plans to clearly identify and appropriately match the consumers with appropriate managing strategies. 6). Clinical handing over which includes the strategic plans to maintain adequate clinical-related communication while handing over the p atients to other professionals. 7). Blood with blood products which encompasses the strategic plans to improve safe, effective as well as appropriate transfusion of blood and its products. 8). Prevention treatment of pressure sores which includes strategic plans to prevent the development of pressure sores and also to manage pressure sores by applying evidence based practices 9). Adequate recognition with response to critical conditions in the emergency department 10) Prevention of patient falls and harm which comprises the strategic plans to reduce incidence of patient fall (NSQHS, 2012). 4.Clinical governance and leadership Clinical governance and leadership are the integral components of modern health care system. Both minimizes the chances of medical errors and hence contributes to quality health care delivery. The health care organizers as top- level managerial members, Doctors and Nursing staffs implements clinical governance to share health responsibility and clinical accountability in enhancing quality in health care with constant effort on promoting health, minimizing harm and fostering a environment of excellence in consumer care. On the other hand, clinical leadership flows from leaders (head of department) to low- level management. The clinicians form the core of clinical leadership who is responsible for making baseline decisions about quality- care (Daly, 2014). Clinical governance system sets, monitors as well as promotes the performance of organization and also communicates the importance of patient/consumers experience along with importance of quality to the employees of organization. Cli nicians and other members of workplace use the governance systems whereas the clinical leadership system implements the quality goals that are set by the clinical governance system and also monitors for the achievement of these goals. They act as a bridge between the employees and the clinical governance system and act as communicators, directors, trainers and teachers of quality improvement process. Clinical governance involves appropriate frame-work with processes to promote quality improvement constantly in an organization by involving clinical leaders and staffs whereas in regard to clinical leadership, clinical leaders should influence other staffs and direct them based on the organizations vision and objectives. The clinical governance is responsible for improving productivity, placing orders and controlling the health-organization to achieve quality goals and the clinical leaders are responsible for establishing a common purpose with direction and develop interpersonal relationship with employees to achieve organizations objectives by acting as role models (Fealy, 2011). For quality improvement, efficient clinical governance develops and implements health practices which could reduce errors while clinical leadership involves in health-system performance, maintaining integrity in health system and achieving objectives (MacPhee, 2013). 5.Clinical leaders in Quality Improvement The clinical leaders form the key persons in the quality improvement of a health-care process. The presence or absence of efficient clinical leaders in a health setting may create a stark consequence on the health outcomes and quality. Delivering health care services safely with compassionate and quality depends on the efficiency of the clinical leaders who are at the front-line. The Garling Report has suggested that the Nurse Unit managers should be trained to be efficient clinical leaders by reviewing and re-designing their positions. As per Francis report (2013), all the ward managers should be capable of being efficient clinical leaders in health setting (Daly, 2014). Therefore, the clinical leaders should strive to enhance health- care performances and improve quality in health care by collaborating with clinicians and consumers in this reform process (McNamara, 2011). Clinical leaders role is not predefined but emerges from hospital setting after gaining expertise and their method of developing and facilitating sound interrelationships with health team. The clinical leaders should be efficient in promoting innovations with changes through quality improvement which could be achieved by understanding, influencing, and motivating persons by establishing effective interpersonal relationship so as to exchange and learn practice from others (McNamara, 2011). They should make the health team to understand about organizational process which could in-turn enable quality-based changes. The physician leaders must bring the physician perspective, implement initiatives and communicates importance of quality to others and the nursing leaders must bring nursing perspective, practice to their full extent, gain higher degrees, full collaborators with clinicians and other health professionals and should make effective work-force planning with policy- developing to improve quality in health setting (IOM, 2011, AHRQ, 2017). The clinical leaders should make creative and innovative changes in health care, be efficient communicator in consumer- staff environment, be courageous to handle situations, solve quality issues and provide consumer-based care to promote quality. References AHRQ. (2012). Agency for Healthcare Research and Quality: U.S. Department of Health Human Services. Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/understand/index.html AHRQ. (2017). Leadership Role in Improving Safety: U.S. Department of Health Human Services. Retrieved from https://psnet.ahrq.gov/primers/primer/32/organizational-leadership-and-its-role-in-improving-safetyAIHW. (2017). Safety and quality of health care: Australian Institute of Health and Welfare- Australian Government. Retrieved from https://www.aihw.gov.au/safety-and-quality-of-health-care/Daly, J et al. (2014). The importance of clinical leadership in the hospital setting: Journal of Healthcare Leadership. 6: 75-83. Retrieved from https://doi.org/10.2147/JHL.S46161 Douglas, C. (2012). Potter and Perrys Fundamentals of Nursing- Australian version. Missouri: Elsevier Duguid, M Cruickshank, M. (2011). Antimicrobial Stewardship in Australian Hospitals. Sydney: ACSHQC Dunlevy, S. (2013). Why are hospitals are making us sick?: News Corp Australia Network. Retrieved from https://www.news.com.au/national/why-are-hospitals-are-making-us-sick/news-story/372d84c34ba6f9c2a06718990217062b Fealy, G et al. (2011). Barriers to clinical leadership development: findings from a national survey:J Clin Nurs. 20:20232032. Francis, R. (2013). Report of the Mid Staffordshire NHS Trust Public Inquiry-Executive Summary. London, UK: The Stationary Office. Retrieved from https://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf IOM-Institute of Medicine, (2011). Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing:The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press. MacPhee, M et al. (2013). Global health care leadership development: trends to consider:J Healthcare Leadership: 2129. McLaughlin, C.P. (2012). Implementing Continuous Quality Improvement in Health Care: A Global Casebook. Sudbury, MA: Jones and Bartlett learning McNamara, M et al. (2011). Boundary matters: clinical leadership and the distinctive disciplinary contribution of nursing to multidisciplinary care:J Clin Nurs. 20 (2324):35023512. NCCHC. (2017). Continuous quality improvement: National Commission on correctional Health care. https://www.ncchc.org/spotlight-on-the-standards-24-1 NSQHS. (2012). National Safety and Quality Health Service Standards: Australians Commission on Safety Quality in health-care. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf