Implementing Quality Improvement Initiatives in Clinical Settings

Running head: CHANGE MANAGEMENT
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INTRODUCTION
Quality improvement is about making healthcare safe, effective, patient-centred,
timely, efficient and equitable (Health Foudation). According to the Health Foundation,
there is a complelling case for applying organisational quality improvement approaches to
healthcare. We think that all staff have a role to play in ensuring the healthcare services
continue to improve. The documented literature highlighted that in a clinical setting, the
high rate of morbidity observed due to inadequate nourishment received by the patients.
Tucker et al. (2012) suggested that 20 to 50 percent of hospitalized adults are
malnourished in United Kingdome. The significant number of health professional failed to
provide additional attention to the patients who are malnourished and require additional
nourishment (‘Qiu et al. 2015). Hence in the clinical setting, it is required to improve quality
of care to the patients by implementing MUST score tool for identifying need along with
screening and creating a colour code for the patients who need extra attention, that is,
feeding, encouraging during mealtimes and throughout the day. It will provide nurses an
opportunity to enhance their practice of providing quality care to the malnourished patients
and become aware of their practice (Cotogni et al. 2017). Moreover, the improving quality
of care empowers patients, boost their self-esteem, increase the possibility of faster
healing and improve patient satisfaction (Berezowska, Passchi and Bleiker 2019). Hence,
this quality improvement initiative is required in the clinical setting for reducing the global
burden of disease and a high morbidity rate. In order to implement the changes, Kotter's
change model can be the best suitable model of change. The model recognizes the need
for incorporating opinion of staffs and other stakeholders. Hence it is the best suitable
model for implementing changes.
Background
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Nourishment is fundamental and is as crucial as medications and different sorts of
treatment. It is every individual nurse’s duty to keep up with patient wellbeing by creating
powerful, proof- based practice and initiative at all dimensions. Good nutrition, hydration
and pleasant eating times can significantly improve more older individuals' wellbeing and
prosperity. It is inadmissible that in certain wards in different hospitals there is an inability
to offer help at eating times for the individuals who need it and an absence of good-
quality, alluring and nutritious sustenance – this establishes an absence of regard for
patients' dignity (Department of Health and Nutrition Summit Stakeholder Group, 2007).
Nutrition is a basic piece of patient consideration that is regularly dismissed or ignored.
Age concern (2006) contended that it is a 'national outrage' that six out of ten more older
individuals are in danger of becoming malnourished, or their circumstance breaking down,
in medical clinic. Patients who are malnourished remain in hospital longer, are more times
bound to develop complications during medical procedures, and have a higher death rate
than the individuals who are well nourished (Age Concern, 2006). A noteworthy extent of
patients admitted to hospital are in danger of ailing health. Keeping up the nourishing
condition of patients who are in hospital is a crucial part to be considered. In any case, the
Audit Commission (2001) referred to studies exhibiting that up to 40% of grown-up
patients are either admitted to hospital with hunger, or become malnourished during their
stay.
Malnutrition can be characterized as a condition of sustenance where a lack, abundance
or awkwardness of vitality, protein or different supplements, including minerals and
nutrients, causes quantifiable unfavourable impacts on an individual's body work and
clinical result (Royal College of Physicians, 2002).
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About 5% of the UK population are believed to be underweight, and it is evaluated that
roughly two million individuals are malnourished at any one time. Lack of healthy
sustenance can, and does, influence everybody (Gregory et al, 1990) yet the most
vulnerable incorporate those with long-term conditions, older individuals, those who have
been just discharged from hospital, and the individuals who are poor or socially
segregated. Ailing health is both a reason and result of infection – it inclines individuals to,
and postpones healing from, disease.
Age concern (2006) contended that it is a 'national outrage' that six out of ten more
established individuals are in danger of becoming malnourished, or their circumstance
breaking down, in medical clinic. Patients who are malnourished remain in hospital longer,
are more times bound to develop complications during medical procedure, and have a
higher death rate than the individuals who are well nourished (Age Concern, 2006).
The Council of Europe's (2003) Resolution ResAP(2003)3 on Food and Nutritional Care in
Hospitals distributed 10 key qualities of good dietary consideration in clinics. Two of these
identify with the MUST scoring tool that all patients are screened on admission to
recognize ailing health or those in danger of it. All patients are re-screened week after
week and that all patients have a consideration plan, which recognizes their wholesome
consideration needs and how they are to be met. In addition to this tool, I would create
colour-coded paper to make it easy to recognise a patient who needs extra attention that
is, feeding, encouraging during mealtimes and throughout the day.
In this case, two best change management can be chosen for implementing
change such as Lewin's change management and Kotter’ change management. Kurt
Lewin's change model based on three models of change such as unfreeze, change and
freeze which provide a high-level approach to change in the organization. It gives a
manager and framework for implementing a change effort which always very sensitive and
accepted by employees associated with the organization (Cameron and Green 2015).
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