INTRODUCTION Falls in hospital refers to an unplanned descent to the floor with or without injury to the patient. It consists that fact that a fall may results into lacerations or internal bleeding, leads to increase in health care utilisation and fractures. However, falls are responsible for creating severe injuries sometimes die that physicians and other care professionals should take care of quality as wellassafetyofpeopleinhealthcareorganisations.Thepresentreportisbasedon Comprehensive Care Standard which provide care facilities to needy people in order to make them well being. It has main concept of focussing on quality of medical services and safety of sick individuals admitted in the hospital for their welfare. This assignment will focus on nominated approach to address quality & safety issue along with its rationale. It will also includes the facilitators and barriers selected strategy and implementation of the same. TASK Nominated Approach or intervention that addressed the quality and safety issue The approach of addressing the quality & safety issue is Six sigma which is effective to improve patient outcomes. The set of management techniques as well as tools that are designed for improvisation within business activities by eliminating probability of errors and reduction within variability of processes is defined as six sigma. This involves measurement, improvisation as well as validation of activities. Basically, it is associated with link among different defects which occur per million opportunities along with standard deviation which takes place within specification of process. With respect to Comprehensive Care Standard, six sigma will aim at methodology through which satisfaction of customers along with profitability can be intensified by streamlining operations, improvisation within quality along with elimination of defects. The stages involved within six sigma are elaborated below with respect toComprehensive Care Standard: ï‚·Define:In this step step, team of hospital is liable for developing the problem statement like what the main issues is. It is necessary to have a clear as well as concise description which team has to address. This must also involve information related with Critical to Customer Quality. The fall of patients has became a measure problem within along with this scope has to be described along with resources involved here. A plan should be formulated by management of Comprehensive Care Standard which will be containing 1
information related with what has to be done, when it will be started and who is liable for doing it. Along with this, high level process map is developed which will be involving suppliers, input, processes, outputs as well as customers who will be benefited by this. ï‚·Measure:In this, the team is liable for assembling entire picture of state of the process as well as baseline for measuring the falls will be established by making use of existent system. Detailed process maps for high risk areas will be required to find the area which needs maximum acknowledgement. It will reveal inefficiencies related with processes for identification of data. Along with this, data collection plan will be developed by Comprehensive Care Standard for defining methods as well as processes involved within collectionofdata.Controlchartwillactasanimpellingtoolforoutlyingthe measurements. ï‚·Analyse:The emphasis is on identification of causal factors which will identify root causes related with problems. Comprehensive Care Standard can make use of frequency plots or scatter plots for analysis of data that is being collected. For this, team can make use of Fishbone diagrams for having a brainstorming sessions. In this, the root causes relatedwithfallswillbedeterminedalongwithcountermeasuresthatcanbe implemented. ï‚·Improve:The team of Comprehensive Care Standard has determined the root causes related with the problem. This stage will focus on identification, implementation as well as validation of corrective actions for resolving issues related with falls as well as improvise the performance. The team is liable for identification of relevant process improvisation through which efficiency , quality as well as safety can be intensified. In addition to this team must also analyse the failure modes with respect to solutions that has been formulated so that in case if any kind of problem occurs while implementation ofthesolution.Nextcomesvalidationofimprovisationswhichispriorfor implementation through the usage of statistical methods. ï‚·Control:The aim of this phase involves support as well as maintaining gains that are realized within improve phase. Appropriate actions needs to be taken for assuring that process is not regressed back within previous states. For this certain actions have to be taken by team of Comprehensive Care Standard like update process documentation, training of associates with respect to new plans along with implementation of statistical 2
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process control. In addition to this, Comprehensive Care Standard also needs to formulate monitoring plan and celebrate the success of accomplishment of goal which involves reducing falls within the hospital. The rationale of approach/intervention to address the problem The selected approach of Six sigma can be described as an effective method that provide support to improve business procedures with the help of using statistical analysis. It is very much efficient to boost up quality and safety of patient in Comprehensive care Standard. However, it can be considered as high disciplinedand data driven methodology along with approach which make sure removal of defective aspects in any manner. Moreover, the six sigma is important because it is helpful for care organisations in certain ways including mapping or flowcharting, eliminating of variation & waste, reduced defects and room for continuous improvement. In addition to this, these aspects are helpful to improve clinical methods and approaches which facilitate to reduce safety issues and provide better quality services to patients through removing incidents related falls. Facilitators and barriers to the implementation of strategy The Six sigma is very effective for reducing incidents of falls in hospitals which is an important problem to be solved in term of improving quality and safety. It can be implemented with the help of analysing facilitators and barriers which are given below: 3
Facilitators of Six Sigma ï‚·It is a patient driven method which facilitate to attain maximum client satisfaction and reducing the defects with innovative technique for improving outcomes. ï‚·This intervention leads to rise in patient outcomes along with reducing efforts of clinical staff. ï‚·Six sigma has a aim of targeting the clinical procedures and concentrate on the procedure improvement rather than final outcome. ï‚·It can be considered as a prosthetic methodology which focus on preventing defect like falls etc. which is helpful to improve quality and safety for patients. ï‚·It is known as an attentive regarding clinical procedures and training which provide support to capitalised every effective aspects along with eliminating defective factors quickly. Barriers of Six Sigma ï‚·Suitability of six sigma has been argued in front of Six sigma critics because quality standards are according to every specific tasks in hospitals which consumes additional duration of time that create problem some times. ï‚·It is responsible for promoting the outsourcing of improving projects which results into lack of accountability which is not suitable for patient privacy. ï‚·This method provides an emphasis on the rigidity of the procedure that basically contradicts the innovation and kills creativity. ï‚·The approach six sigma needs skilled work force for implementation and dedication of staff & control is difficult to accomplish it its not applied on regular basis. ï‚·There are lots of real time barriers at the time of converting theoretical concepts into practical applications that requires to be solved. Way of implementing the approach or intervention into practice The six sigma is effective approach to boost up quality and safety in healthcare organisation that facilitates to increase patient outcomes. It consist to remove various kinds of defectsandapplyingfavourableaspectsintermsofimprovingclinicaloutcomesin Comprehensive Care Standard for reducing the problems of falls. However, it has been analysed that effective implementation is efficient to gain maximum outcomes in respect removing defects and increase quality as well safety of people. Meanwhile, the appropriate way consist to follow 4
several steps in correct sequences for implementing this intervention successfully which are mentioned here. Initially, it is necessary to create a burning platform Put resources in place - Teach the methodology - Prioritise Activities - Establish ownership - Take the right measurements - Govern the program - Recognise contributions - CONCLUSION 5
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References Books & Journals Garrard, L. and et. al, 2016. Reliability and validity of the NDNQI® injury falls measure. Western journal of nursing research,38(1), pp.111-128. Mahida, N. and Boswell, T., 2016. Non-slip socks: a potential reservoir for transmitting multidrug-resistantorganismsinhospitals?.JournalofHospitalInfection,94(3), pp.273-275. Quigley, P. A. and et. al, 2016. Reducing falls and fall-related injuries in medical-surgical units: one-year multihospital falls collaborative.Journal of nursing care quality,31(2), pp.139-145. Zhao, Y. L. and Kim, H., 2015. Older adult inpatient falls in acute care hospitals: intrinsic, extrinsic, and environmental factors.Journal of gerontological nursing,41(7), pp.29- 43. 6