Empirical Investigation and Quality Improvement

The assignment requires an empirical investigation of the relationship between role stressors, emotional exhaustion, and turnover intention in the airline industry. It also involves a quality improvement aspect, with references to various studies and papers that have explored different domains of healthcare quality. The assignment seems to be focused on analyzing and improving quality in various contexts, including hospitals, healthcare services, and patient care.

Evaluating Quality in Health
and Social Care

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
(1) Discuss theoretical perspectives on quality or evaluation of services in HSC.................1
(2) Outline plan of stages in the evaluation of quality services in HSC.................................3
(3) Outline the methods used for supporting choice in terms of strengths and weaknesses. .5
(4) Discuss hopes of various stakeholders for the evaluation in HSC...................................8
(5) Outline methods used to evaluate success of project in HSC...........................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................12

INTRODUCTION
Healthcare is required to deliver services of high quality so that service users are
benefited by them and they can get healthy within stipulated time which is tried hardly by
healthcare. The enclosed report deals with evaluation of service quality at BRI (Bristol Royal
Infirmary)hospital so that it may improve upon its services in effectual manner (Al Issa and
Macian-Juan, 2014. ). The BRI is required to fulfil demands of patients so that they may treated
within the stipulated time. There are various methods which allow healthcare to be more
effective in improving the quality of its services.
(1) Discuss theoretical perspectives on quality or evaluation of services in HSC
The different perspectives on evaluating HSC are as follows:
1. Functionalist Approach-
This approach states that good and effective medical care is essential for healthcare for
society's ability to function effectively. Poor medical care during pregnancy, birth and child care
create a dysfunctional society as a result healthcare should be function effectively to achieve
customer satisfaction so that they may be cured as early as possible. Poor medical care is
dysfunction for society as people who are ill face difficulty in becoming healthy without
functioning health services and this makes them less productive.
From the perspective of this theory, BRI hospital should be able to function according to
the needs of service user so that they may get treated within stipulated time. This theory states
that sick people should not be perceived as having caused their own health problem. Secondly,
patients are expected to have their illness confirmed by doctors and to follow instructions of
them in order to improve their condition and hopefully recover.
Thirdly, physicians also have a role to perform. They have to diagnose patient's illnessess
effectively and after that ensure that appropriate treatment is provided. This is so that illness is
properly diagnosed and also patients have to state accurately problems related to their health
(Ding and et.al , 2014.). Thus, a hierarchical structure is followed between doctors and service
user in HSC. It is envuisaged that doctors give advice and instructions to patients which improve
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their health and, in many cases, can cure any diseases they may have. The BRI hospital provides
quality services to patients so that they may live healthy.
2. Conflict theory-
This theory is about inequality in healthcare institution's delivery of services. Conflict
theory evaluates the efforts of doctors over decades to control the practice of medicine and to
define various problems in society. This theory has evolved as alternative medicine has been
increasingly popular among patients. Doctors feel that these alternative medicines in the market
are inadequate or even dangerous to people's health. It also been evaluated quality on eating
disorders receive help from physician or any other healthcare professional (Eom and et.al, 2014).
Conflict theory set out to highlight ideological aspects inherent in traditional thoughts. It
assumes that behaviour of people is well understood in terms of tensions between groups over
power and allocation of resources including access to services and political representation.
According to this theory, most people who are rich would get better treatment than those who are
not so fortunate. People who are less fortunate are more prone to become sick (Rao and Clarke,
2017). BRI hospital must provide equality in services to wealthy as well as less fortunate people
so that all of classes of patients may be treated equally and receive the same opportunities for
treatment and diagnosis.
Conflict theory focuses on inequality that is faced by society in healthcare on basis of
providing quality services to the members of that society Conflict theory describes inequality
that is faced by patients which come for their treatment in healthcare to become healthier. BRI
hospital should provide quality of services so that no patients will not face any difficulty in
getting quality treatment according to their personal finances or ability to pay.
3. TQM (Total Quality Management)-
The BRI hospital should follow the principles of TQM. These are based on customer
focus, team work and continuous quality improvement. HSC should be customer focus which
means that it should fulfil the needs of patients who are admitted in hospital. Team work means
that staff should coordinate with each other to provide quality of services to service users. It
should make continuous quality improvement so that service user can be receive maximum
benefit from the services they receive and a maximum number of patients can be treated as
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quickly and cost-effectively as possible. TQM model should b e adopted by HSC so that it may
deliver a continually high quality of services to patients.
4. Donabedian Model (1969)-
This model is a conceptual model and information is drawn from three activities i.e
structure, process and outcome. Structure includes factors such as physical facilities and
equipments that measures care quality. Process is the segregation of all actions such as diagnosis
and treatment. Outcome, on the other hand, resolves results into effective and positive changes in
health of the patients that results from quality treatment. The Donabedian model helps to make
structure of HSC in adequate manner. This model is helpful to healthcare to evaluate its
performance.
5. Quality control-
Quality is the main concern of hospital so that it may successfully treat the patients so
that their get healthy as soon as possible. Quality are the activities and techniques that are
operated in order to achieve and maintain the level of quality within healthcare.
6. Quality assurance-
It means that meeting quality standards so that organisation may be get it on right time to
treat patients and avoiding wastage of efforts.
(2) Outline plan of stages in the evaluation of quality services in HSC
The plan for evaluating quality services is as follows:
1. Prioritise indicators of performance-
Healthcare should effectively prioritise performance indicators to fullest possible extent
as those will provide useful information which can be used to figure out any deficiency in
providing high quality of services to service users (Khawandanah and et.al , 2015.) The BRI
hospital should therefore use performance indicators so that it can identify any area where it is
falling short of the expected quality and use this information to improve the effectiveness of the
services it gives to patients.
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2. Collect appropriate data-
After analysing performance indicators, data regarding that should be collected and
provided to the management team. They will then be able to evaluate how effectively the
healthcare is fulfilling needs of service users. It also gives them clarity in providing efficient
services to them.
3. Identify opportunities-
Various opportunities to strive to improve quality of services provided to patients need to
be analysed. This will give management the chance to improve upon services and systems which
are required to provide quality support to patients so that they may be treated. Opportunities
therefore need to be exploited so that BRI hospital may flourish in its functioning to provide a
good quality of services to service users. It can exploit opportunities like providing assistance to
patients through its website, and providing services information through maintaining applications
with the help of modern technology (Whitmore and et.al, 2014).
4. Implement feedback-
The feedback from patients who have already availed themselves of high quality services
can be much valuable for BRI hospital. It can evaluate its performance and can improve upon it
so that if any deviations are observed by patients, they can be resolved in effective way. As a
result, feedback from patients can be used by the hospital to implement improvements, and the
hospital can use patient feedback to meausure and evaluate the quality of services provided.
5. Measure effectiveness-
It is required by HSC to constantly look for improving its performance so that service
user may get enhanced services. The effective quality should be instantly measured by healthcare
so that it may improve upon weak areas and get implemented required measures to provide good
quality services to patients. Thus, BRI hospital will be able to evaluate its plan to provide
effective services to users of it in the manner which will achieve its objectives and goals in
effectual manner.
6. Re evaluation-
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The BRI hospital should constantly re-evaluate its performance so that further
improvements can be initiated to provide higher quality services to patients. Re evaluating
existing services is needed so that it can efficiently produce effective results (Cho, Choi and Lee,
2014). Customers will be benefited by quality of services and as a result healthcare can achieve
its objectives in the best possible way. Re evaluation helps institution to get deeper insight to
services improvement. If it has neglected or overlooked any quality standards, then through re
evaluating services evaluation can provide an indication as to which services can be improved so
that. Thus, patients will be satisfied with services provided by institution and as a result,
outcomes of those being treated will improve and institutions will be able to achieve their targets
more effectively.
Social factors-
This factor includes bed blocking in which old people are not discharged because there
are no available beds in healthcare. For this, structure is to be followed such as staff should be
trained in BRI so that they may take care of needs and wants of old and by applying this,
healthcare can achieve its social goals.
Organisation factors-
This factor can be achieved when staff interrelate and coordinate their work with each
other so that organisation culture may be attained in organisation. Although, it is difficult but it
can be initiated in organisation. They are all following the same policies, procedures and sharing
the same mission and values and this provides consistency of service throughout the
organisation, although, this can sometimes be difficult to achieve.
Political factors and legislation-
BRI hospital has to adhere by various rules and regulations so that it may provide quality
care service's to patients and use taxpayers’ money effectively.Safeguarding the rights and
consistency of services should be main concern of it. It has to abide by regulations so that
patients safety and care is successfully achieved. The various legislations setting out the
standards by which it has to do this are Care Act 2014, Mental Capacity Act 2005 and many
more which safeguard the interests of service users in HSC.
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(3) Outline the methods used for supporting choice in terms of strengths and weaknesses
The strengths and weaknesses of supporting system in HSC are as follows:
1. Observation-
By using observation method, healthcare will improve upon its quality of services. The
observation method involves experienced people or management observing other staff carrying
out their normal work processes and activities. Observation method is helpful as when
researchers observes and record events, it is not necessary to rely on willingness of respondents
to report accurately (Westerberg and Tafvelin, 2014). This method is quite useful to carry out
quality of services in healthcare as it provides data which is can be used to improve services in
healthcare.
Strengths-
Observation method is quite useful method to evaluate quality of services in healthcare.
By implementing it in institution, it will be able to gain and collect information which is required
for the purpose of improving services by that institution. Also, it is very useful method to study
human behaviour. Data collected is very accurate as it done by observing which is often carried
out by senior and experienced staff. By using good and modern technology, observation can be
done in effective manner. Observation's main strength is that it provides in depth analysis of
certain work processes and, as a result, problems can be identified and specifically targeted
resulting in quick improvements.
Weaknesses-
Main weakness of observation method is that it cannot address past problems identified
only current work practices. It cannot study past problems which is major drawback. It cannot
study opinions of others. Observation can study attitudes of behaviour. Consequently, complete
information cannot be obtained so this becomes a hindrance in improving service quality in
healthcare.
2. Customer survey-
This survey is important for management to evaluate and improve the hospital services to
patients. Customer survey is vital method by which demands and needs of customers can be
identified by management and improvement can be done in effective manner (Turnpenny and
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Beadle‐Brown, 2015). It serves as primary tool to healthcare as it provides information about
customer's desires in effectual manner.
Strengths-
Customers survey provides up to date feedback by which management can easily identify
areas where services can be improved. Patients’ demands and needs can be carefully analysed
with the help of customer surveys. They provide benchmark results that constantly allow
companies to compare data over time and benchmark survey data with that of previous years to
determine if any changes are required to service provision as a result.
Weaknesses-
Surveys rely on individual patients’ perspectives which may be biased and they may have
unrealistic expectations. Some changes they require may not be achievable within existing
budgets or may be at odds with government policy, eg the provision of mixed wards. Sometimes
too many surveys make patients lazy to respond it. These serve as incomplete information to
healthcare and it cannot implement it as information is incomplete.
3. 360 degree appraisal-
It should be operated by management so that it can be successfully utilised to make sure
that healthcare is working effectively. It is an important type of feedback which flows from the
top to the bottom and vice versa. It is vital feedback which is used by management so that clarity
and transparency can be achieved. It also helps in improving service quality in healthcare (Lin
and et.al., 2014).
Strengths-
The 360 degree appraisal method is used to provide feedback from all angles, that
is from peer groups to managers, and from managers to subordinates. It is highly beneficial for
organisations and can help them accomplish their set targets. The BRI hospital uses this method
so that each department can work efficiently for the betterment of organisation. It also improves
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the morale of employees as they feel that their opinions are being listened to and that they can
influence the systems and processes within their organisation. This will improve healthcare
service quality and patients will be satisfied by higher quality services. As communication comes
from a variety of sources, it will contain different opinions and perspectives which is very vital
to healthcare to improve upon service quality.
Weaknesses-
There is a chance of altered or edited feedback which can provide incomplete or
misleading information to management and, as a result, feedback loses its integrity (Newbigging
and et.al, 2015). Aim of feedback should be constructive and not personal but some employees
may feel unable to give honest feedback for fear it would affect their future working
relationships with the people about whom they gave the negative feedback, which are often their
superiors. If the feedback obtained from this method is only one-way or is incomplete, there will
be no change in behaviour and feedback will be of limited use to institution. If constant feedback
is given or received about a particular employee's weaknesses, then it is likely that he or she will
build up a negative and resentful attitude towards a feedback culture.
(4) Discuss hopes of various stakeholders for the evaluation in HSC
1. Manager's hope-
Manager evaluates the services quality on the basis of staff which have been hired for
providing services to patients. The BRI hospital tries to hire efficient, qualified staff which carry
out their responsibilities in effective manner depending upon their abilities and skills. Managers
constantly hope to achieve patient satisfaction so that it may be rated highly by the local
population it serves, the staff who work within it, clinical commissioning groups and inspecting
bodies such as the Care Quality Commission.. Management should review their staff
performance continually so that if any improvements are identified, then these should be quickly
implemented. Ensuring the highest quality of staff also reduces the frequency of these staff
making mistakes which, in turn, increases patient satisfaction reduces the expense of dealing
with complaints and carrying out investigations and ultimately the payment of damages to
patients and their families where mistakes have been made.
Patient surveys and feedback provide information to managers so that they can
implement effective working and functioning. Improvement in services is made by managers so
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that patients can be provided with the highest quality of services. The BRI uses customer
feedback so that, if any complaints are set out by patients, then these can be resolved by it in
effective manner which eventually maximises the satisfaction of service users.
2. Users-
Service users provide valuable feedback to managers. They constantly provide
information to managers who must be implement their recommendations so that customers can
be given quality treatment within the reach of every patient. Patients hope that healthcarewill
provide services to them at a low cost with enhanced quality. This makes patients extremely
satisfied with services at low prices (Held and Dills, 2013).
It provides cost effective benefit to patients and, as such, customers can attain quality
services and hospitals can accomplish their objectives and goals. With the use of modern
equipment, some illnesses can be cured at very fast pace and treatments can be carried out within
the stipulated time. This provides patients with effective results and they get treated within
timely manner. Patients hope also for good medicines that can help them to recover quickly from
disease. These medicines are useful to users as they improve quickly.
3. Employees-
These stakeholders are important part of healthcare. Employees hope that management
should be able to provide efficient and good training for their overall development so that they
can become more efficient in carrying out their tasks. As professionals, they are required to carry
out a minimum amount of continuous professional development each year to keep their training
and knowledge up to date. The Management of BRI provides training to their employees so that
they can be more productive in delivering services to patients. This is required because staff need
to be made familiar with modern equipment and changing techniques as well as changes to best
practice.
They need to be trained so that they may effectively use this training delivering services
to users in effective manner. Also, salaries should also adequately reflect their skills, education,
capabilities and responsibilities. This is a vital parameter as if salary is not commensurate, then
the employee will not provide effective services to patients and may ultimately leave the health
service, and this can result in the necessity to pay higher wages to agency staff. As a result,
healthcare needs to satisfy demands of employees to increase their efficiency (Yang and Xiao,
2017).
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(5) Outline methods used to evaluate success of project in HSC
The successful evaluation of quality of services in healthcare are as follows:
1. 360 degree appraisal method-
BRI hospital should use 360 degree appraisal method as it will provide useful insight to
it. The flow of information is started with peer groups and reaches to managers and then tom
subordinates. This is useful technique by which healthcare can established and implement
shortcomings so that improvement can be made. This defines success for healthcare institution
(Cronin Jr and Taylor, 2011).
2. Observation method-
This is quite useful for management as it provides accurate and timely information
regarding work processes, systems, the interaction between different departments, the allocation
of resources and the capability of staff. It is useful as it evaluates human behaviour which is an
important element for HSC. The data collected through observation is quite reliable and accurate
and provides good information to managers to enable them to manage the quality of services so
that it may be able to provide these to patients. By using modern technology, observations can be
carried out in effective way by managers. Also, an advantage for the observation method is that it
provides the scope for in depth analysis about the study which then serves as useful tool to
management of healthcare. They are able to carry out its working in effective manner.
3. Customer survey-
This is another useful method for managers as it provides them information which is
required so that no wastage of valuable resources is being made by it. When customers answer
about their demands, needs and wants, it provides a clear idea to the organisation as to what it
has to implement and how to meet those demands to satisfy patients in the manner which will
provide them more growth (Six domain of Healthcare Quality, 2016). This method is useful as it
deals with satisfaction of customers and how it can be achieved by institutions in the way which
will enhance its image in front of patients.
CONCLUSION
Hereby it can be concluded that healthcare should be efficient in providing services to
patients. The services must be of top quality so that it can satisfy demands and needs of service
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users. BRI hospital must be able to satisfy all its patients so that they may get treated within
stipulated time. This will provide healthcare good image in front of patients. For effective quality
in HSC, healthcare needs to plan out its performance indicators in the manner which will provide
it effective returns. There are various methods in healthcare to provide effective information so
that improvement can be made in the overall structure of it. The various methods used are
observation, customer survey and 360 degree appraisal which helps to provide information to
healthcare so that it can improve its service quality.
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