Determinants of Health and Quality Improvement

The provided assignment content discusses the determinants of health, quality improvement in healthcare, and the importance of effective patient care. It features a range of journal articles and online resources that explore various aspects of healthcare, including organizational culture, electronic medical records, and chronic disease management. The content also touches on the impact of social media on healthcare and the need for high-quality care, particularly for older adults.

Managing Quality in Health
and Social Care
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Table of Contents
Introduction..........................................................................................................................................4
Task 1....................................................................................................................................................4
a) Quality of services from the point of view of stakeholders.........................................................4
b) Outlining key areas through model of quality.............................................................................4
c) Relationship between quality of the clinic and principles of care for people with breast cancer5
d) Role of hospital and department of health in setting of waiting time standards.........................6
Task 2....................................................................................................................................................6
a) Range of standards for measuring quality of performance of the clinic......................................6
b) Approaches to implement quality systems in the clinic..............................................................7
c) Values of established quality systems..........................................................................................7
d) Impact of quality of the clinic on patients, staff and others........................................................7
e) Potential barriers to delivery of quality.......................................................................................8
Task 3....................................................................................................................................................9
a) Effectiveness of systems, policies, procedures in achieving quality in services.........................9
b) Factors that influence achievement of quality.............................................................................9
c) Recommendations for actions to affect improvements in the quality.........................................9
Task 4..................................................................................................................................................10
a) Alternative methods for evalutaing service quality...................................................................10
b) Benefits of consulting service users..........................................................................................10
Conclusion..........................................................................................................................................10
References...........................................................................................................................................11
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INTRODUCTION
Quality is one of the most important and vital aspects that management of any organization,
is operating and needs to follow as they are directly related to operating effectively in the market
and also to meet their goals and objectives (Shortell and et. al, 2011). This aspect becomes all the
more important for companies in the health and social care industry. The present report discusses
about perspectives of some stakeholders in relation to quality in the firm. Furthermore, it also
consists of role of hospital and the department of health in health care setting in terms of waiting
time standards.
TASK 1
a)
There are many stakeholders that a health and social care organization needs to satisfy to a
greatest extent. Stakeholders are customers, i.e. the patients, government, regulatory bodies, etc. In
terms of quality their viewpoint and perception is of great importance, even if they may differ from
one another (Wade, 2009). Herein, it may not be wrong to say that perception of patients towards
quality of care and services in the hospital is of great significance. At the out-patient clinic in NHS
hospital, it was observed that patients are not satisfied to a great level, as they have to wait for a
long period of time to meet the doctor. Clinic's policy is to treat a patient within 15 minutes of the
time given to them, only if they arrive at hospital on time. But on many occasions they have to wait
for more than 25 minutes to meet the doctor. Therefore, in this context, it may not be wrong to say
that patients' view on quality is that they are given the right treatment and according to the
appointment given to them(Review of Cancer WaitingTimes Standards, 2011). Similarly,
stakeholders such as employees also have a very important view point for quality in health care
services. If employees of the care home are not trained properly, then their performance would not
be very effective, due to which quality of the clininc would decline considerbly. Therefore, it may
not be wrong to say that staff at the care home would want that they proviide the best health care
services to the patients, but for the same, they will also expect regular training and development
session from management at the organization.
On the other hand, stakeholders like government and regulatory bodies which may include
the likes of General Medical Council (GMC), Care Quality Commission (CQC), etc. have a very
different perspective on the same. Their expectation is that the health and social care organizations
operating in the country follow all rules and regulations which are developed by them. There are
many rules such as Equality Act, 2010; Disability Discrimination Act, 1995; etc. Similarly, bodies
such as Care Quality Commission, expect that all the quality related standards and principles
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prepared are followed by health care organizations such as clinics, hospitals, etc.
b)
(Source: Davies, Nutley and Mannion, 2011)
There are many models of quality that can be considered by management of the clinic in
order to perform better to achieve organizational goals and objectives. One such model is the
Nordic Model developed by Gronroos (Hawn, 2009). It consists of three major areas that need a lot
of attention in order to effectively operate and also maintain certain quality standards at the
workplace. Technical Quality; Functional Quality and Image have a direct impact on both the
expected services and perceived service quality. The technical quality aspect of the model discusses
about the tasks that have to be carried out to develop and maintain quality standards in the
organization. The given hospital lacks in this area of quality as there is a lack of any set technical
procedures for getting access to reports of previous investigations in a timely manner.
On the other hand, functional aspect consists of how the pre-determined tasks and duties have to be
carried out, so that the quality standards could be developed and maintained in the clinic (Munn-
Giddings and Winter, 2013). The clinic is further lacking in this aspect of quality which has led to
an increase in waiting time by 25 minutes despite arriving on time as pr scheduled appointment.
This shows a serious lack in functional standards that are followed within the clinic.
The final element of this model is that of the image. A good and positive image can be prepared by
effective functioning of the above two aspects related to quality. In this sense, it may not be wrong
to say that the clinic is lacking in terms of not being able to develop a positive image as the two
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Illustration 1: The Nordiac Model

functions are not being performed properly. Thus in turn has led to hampering of service quality and
expected service that is being provided by the employees. .
c)
Breast cancer is a disease which is very dangerous to the human life and a life threatening
illness as well, because of which quality related aspects are very important. In this sense, it may not
be wrong to say that for such kind of individuals, quality oriented care is very important for their
effective treatment. It means that there is a very crucial relation between quality of services which is
provided at the clinic and principles of care provided to people suffering from breast cancer
(Ludwick and Doucette, 2009). During the case study, it was observed that many a time records of
the patients were not available to the doctors and nurses, because of which they could not provide
effective healthcare services to patients. This happened as the records of patients were kept in
Central library rather than in the clinic itself. These definitely puts an impact on the principles of
care used to care for patients.
In such cases, they had to contact the receptionist and ask for a patient's records or the Medical
Records Department for the same. But the department many times could not provide such records
on time and in an effective manner. Due to this reason, patients of breast cancer had to face time lag
with respect to their screening and diagnosis (Baggott, 2013).
d)
In any hospital and health care organization, a very crucial role is played by time that
patients have to spend while waiting to meet with a doctor (Druss and et. al, 2009). For breast
cancer patients, waiting time sometimes can be every critical, as their life depends upon the amount
of time that they would spend waiting. In this context, the hospital itself as well as the department
of health in the country, has a very crucial role to play. Waiting time targets formulated by
Department of Health is of 15 minutes (Your rights in the NHS, 2015). This standard has been kept
by the clinic but is not being adhered properly. The issues are arising due to absence of previous
reports of patients that are kept in central library.
This is majorly because of reason that these bodies and organizations are the ones who are
required to interact with the patients directly and understand the problem(s) or suffering they are
going through. The two organizations have to collaborate and join forces with one another to devise
some methods through which waiting time in the hospital can be reduced. In this sense both
hospitals and department of health need to work closely with one another so that waiting time for
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the patients can be reduced and they can be provided fast and effective treatment for their illness
(Curtis, 2012). In a general scenario, the waiting time targets of the hospital are affected by lack of
proper funds and resources to handle a huge inflow of patients.
TASK 2
a)
For management as well as doctors and nurses, it is imperative that they take certain steps to
measure and constantly evaluate performance of the clinic in terms of quality. There are a range of
methods and techniques that can be used by the authorities to measure quality of performance of the
clinic. According to the problems and issues faced by the clinic, there are a variety of standards that
can be used by management of the organization and thus make attempts to improve the same (Greß
and et. al, 2009). One of the most important standards that can be taken into consideration is that of
the waiting time. For health and social care firms, it is imperative that the waiting time is kept to a
minimum as they are the major indicator of performance of the organisation. In case of the cited
healthcare firm it was observed that waiting time as per the company policies was 15 minutes but
in reality the patients had to wait for more than 25 minutes on an average. Other than this, database
management and record keeping as well as retrieval can also be considered as another standard for
measuring quality of performance of the clinic (Evans, Barer and Marmor, 2014). Many times in the
case, it was seen that past medical records of the patients were not available with the doctors who
caused a delay in diagnosing the problem(s) and also in delivery of health care services.
b)
It is a well-known fact that quality systems are very important and integral to working of
healthcare organizations, largely because of reason that they are related to efficiency and
effectiveness of care that may be delivered to the patients. It also affects the image of the healthcare
firm in front of different stakeholders. There are many approaches that can be considered by
management of the clinic to develop and implement highly effective quality systems at the
workplace (Singer and et. al, 2011). One of them is Benchmarking. It can be defined as the process
used for comparing the business performance metrics to best practices from other companies. The
clinic can surely make use of benchmarking as a tool. This can be done as the waiting time
standards being followed in clinic can be compared with other hospitals. If such standards are met
and maintained at the workplace, then it can be said that management of the clinic has been able to
make operations of concerned organization efficiently and effectively.
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c)
Developing, maintaining and managing quality related aspects of working of firms in the
health and social care industry is a very crucial and critical role played by different kinds of quality
systems and approaches. These are developed by different healthcare bodies such as hospitals and
governing organizations like Care Quality Commission (CQC), etc. These kinds of established
quality systems are of great importance for the healthcare organisation as it can enable the given
breast screening clinic to operate in an efficient and effective manner (Puchalski and et. al, 2008).
There are many standards which are developed by different bodies and organizations to assist the
clinic for operating effectively and it also attempt to improve their own performance. One such
system is that of the ISO (International Organization for Standardization). It is world's leading body
in terms of quality certifications which is provided to firms and enterprises, regardless of the
industry that they may be working in. Certifications issued by ISO have now become a symbol for
effectiveness and efficiency in operations of health and social care organizations and also provide
appropriate care to patients. These standards and quality certificates become all the more important
when it comes to treating people with breast cancer as for them quality is of great importance
(Berwick, Godfrey and Roessner, 2010).
d)
For health and social care firms, it is imperative that they develop and maintain certain
quality levels at the workplace as they have a direct impact over delivery of care services to the
patients as well as on tasks and duties which is performed by care workers in the organization.
During this case, it was noted that performance of clinic in terms of quality has not been very
effective due to which it is not able to provide useful care to the patients and treat them for their
health issues such as breast cancer. Waiting time standards were not maintained by the clinic staff
properly (McGlynn and et. al, 2013). In order to adhere with the stipulated waiting time the need is
to bring improvement in record keeping system.
If these aspects would have been paid ample amount of attention by authorities, then the patients
could have been treated effectively. Similarly, use of different quality systems and approaches also
would affect the staff members in a positive manner. This is because they would get an opportunity
to treat the patients and also provide them with such a kind of care which will help in resolving their
health related issues easily and effectively (Hasson, 2010). Furthermore, compliance of different
quality systems would help in building a positive and strong image among stakeholders, but with
the present clinic, this was not the case. Since its management had not paid attention to different
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quality related aspects such as waiting time standards and record keeping as well as its retrieval
because it had negatively affected stakeholders like government, regulatory bodies, etc.
e)
Providing and maintaining certain quality levels and standards in working styles of health
and social care industry is not a very easy task as there are a plenty of barriers and problems that the
authorities have to face and overcome. In this context, one of the major issues to deliver quality can
be seen in terms of providing regular training and development to the employees (Malley, 2010). In
the case study, it was observed that doctors and nurses did not have any easy access to records of
patients and many times even after requesting the same from Medical Records Department they
could not obtain the same. moreover it can prove to be time consuming and expensive affair for the
organization (Kaplan and et. al, 2010). Organization's management would have to identify and use
the latest tools and techniques with a view to reduce waiting time that patients have to spend in the
clinic and also to manage as well as retrieve their medical record easily and effectively. But again,
using this method can be a very expensive option for the clinic.
TASK 3
a)
While analysing the case, it was observed that concerned clinic of NHS was not working in
an efficient and effective manner as a large variety of aspect related to quality were not paid ample
of attention (Joosten, Bongers and Janssen, 2009). Waiting time standards were not followed by the
organisation as the patients had to wait for more than the specified time limit which was 15 minutes.
It eventually resulted in building a bad image among the stakeholders thereby resulting in many
complaints from patients end. Therefore, it may not be wrong to say that policies and procedures
used by the clinic were not very effective and useful. Moreover, systems related to patient record
keeping and retrieval of such records was also not very effective. This was as the records were not
readily available thereby leading to time lag.
b)
Achieving certain quality standards is a very tough task mainly because of reason that it
involves attention to be paid on lot many aspects of organizational workings (Creek and Lougher,
2011). There are many factors which have an influence over achievement of quality at the
workplace. One of them is training and development of doctors and nurses. For the clinic, in order
to attain quality standards, it is imperative to provide regular training sessions to staff members.
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Proper training sessions is likely to improve the existing skills possessed by the staff members. For
example, training in the area of communication can help the staff members to communicate with the
patients in a better manner. They can thus be informed about delay in waiting times.
This is mainly because of the reason that it is directly related to their performance and also
the way they provide care and other such services to the patients. Other than this, not adhering with
the technologies also affects achievement of quality at the workplace. The clinic must inculcate
latest technologies into their working but implementing it in organization that can prove to be a very
time consuming and expensive task.
c)
There are a large variety of factors and forces that have affected quality of performance of
the clinic. It includes waiting time standards; record management, etc. (Moraga, Calero and Piattini,
2006). Therefore, it may not be wrong to say that the management of clinic must pay attention to
these aspects. Resolving these would help in improving quality of the hospital by significant
margins. For the same, authorities must take into consideration ways through which waiting time
can be reduced. Many times, it has been observed that as patients have to wait for a long time
period they could not be provided with effective healthcare services which ultimately adversely
affected their health and well-being. Furthermore, the management must also pay attention to their
database management and retrieval techniques (Aveyard, 2014). This way doctors can be provided
with patient records which will reduce the chances of delay in serving them.
TASK 4
a)
There are many stakeholders whose needs and wants have to be not only identified by
management of the clinic but also fulfiled to a great extent. Therefore, it may not be wrong to say
that the organization's one of the major responsibilities is to find ways to satisfy demands in terms
of quality of the various stakeholders (Lehnert and et. al, 2011). One method through which such a
task can be carried out is to develop communication systems and approaches. This way, different
stakeholders can be contacted and informed about operations of the clinic; and then make attempts
to interact with them. This will help the authorities in achieving certain quality standards and
maintaining such levels within the organisation. By developing effective communication systems
for the organization, management of the clininc would be able to interact with different stakeholders
in a much efficient and effective manner. It can be supported through fact that it would give these
business associates a platform to express their views and opinions or issues they may be facing.
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Furthermore, new and improved communication systems, if implemented at workplace, would give
management an opportunity to interact with stakeholders such as care users, employees, etc. and
understand their needs and demands. This way, external stakeholder standards can be met with ease
and comfort. For instance, external stakeholders of the organization may demand that high quality
services are delivered, so that expectations of care users and other such stakeholders are
accomplished to the greatest extent possible.
b)
Delivering different kinds of services to their users and also maintaining specific quality
levels is not an easy task. In this context, taking feedbacks from the patients that come for screening
for breast cancer can prove to be a good and effective option for management of the clinic
(Campbell and et. al, 2009). It will benefit the clinic as feedbacks can aid in generating a lot of
information about the need of patients that come to the clinic for screening. This is most likely to
assist towards drawing effective strategies that may help in the process of fulfilment of such
demands with great ease and comfort.
CONCLUSION
Quality has a very important role to play in the process of delivering effective care to the
patients. During the report, it was observed that it is very important for the management of the
clinic to satisfy the stakeholders. Furthermore, approaches of benchmarking and total quality
management can be of great use for the concerned organization. In the report, it was also observed
that technological resources are major barriers that the clinic would have to face and try to
overcome because they can prove to be very expensive for the organization, and thus affect the
organization's existence in the market.
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REFERENCES
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