The Impact of Competition on Management Quality in Public Hospitals

The provided content consists of research studies and articles on healthcare quality, service delivery, and strategic analysis. The studies explore various aspects such as the impact of electronic service quality, patient activation, cost reduction strategies, and remote monitoring on healthcare outcomes. Additionally, the content includes references to standards and guidelines for healthcare professionals, including National Occupational Standards, Standards and Indicators, and the fundamental standards.

MANAGING QUALITY

TABLE OF CONTENTS
INTRODUCTION ..........................................................................................................................3
TASK 1 ...........................................................................................................................................3
1.1 Explaining perspectives of stakeholders regarding quality...................................................3
1.2 Analyzing the role of external agencies in in setting standards for quality .........................4
1.3 Assessment of impact of poor service quality on stakeholders ...........................................5
TASK 2 ...........................................................................................................................................6
2.1 Explanation of standards for measuring quality that exist in residential care facilities ........6
2.2 Evaluation of different approaches for implementing quality systems ................................7
2.3 Analyzing potential barriers to delivery of quality care........................................................8
TASK 3 ...........................................................................................................................................9
3.1 Evaluating the effectiveness of systems, policies and procedures .......................................9
3.2 Analyzing other factor which influence achievement of quality ........................................10
3.3 Suggesting ways quality could be improved .....................................................................10
CONCLUSION .............................................................................................................................11
REFERENCES .............................................................................................................................12
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INTRODUCTION
Managing quality in health care is concerned with improving effectiveness of treatments
and increasing patient satisfaction with the service. It involves implementation of various
qualitative and quantitative approaches, policies and strategies which aim at improving
efficiency as well as safety of processes and systems of service delivery (Büyüközkan and Çifçi,
2012). There is an increased attention on quality management in health care sector owing to the
rising concern of hospital acquired infections. The present report is based on managing quality at
Groveland park care home. The organization has recently faced frequent outbreaks of
Methycillin Resistant Staphylococcus Aureus infections. This has led to an increase in the rate of
hospital admission because a large number of clients share eating and living accommodation.
Therefore, it is extremely important to tackle these infections. In the present report, different
perspectives of quality have been analysed in relation to health and social care. Systems, policies
and procedures in the context of health and social care have been evaluated. Moreover,
understanding has been developed regarding strategies fort achieving quality in health and social
care.
TASK 1
1.1 Explaining perspectives of stakeholders regarding quality
The stakeholders in health and social care can have different perspectives regarding
quality. A health care organization like Groveland park can have different stakeholders such as
statutory, third sector, private and informal. These have been explained below: Statutory- Among these stakeholders come the strategic health authorities, primary care
trusts, social service departments etc. (Yoder-Wise, 2014). Third sector- These stakeholders are the focus groups, action groups and charities which
are associated with Groveland Park care home. Private- Practitioners and private providers of health care services will be the private
stakeholders of the residential home (Bloom and et.al., 2015).
 Informal- Informal stakeholders of Groveland park will comprise of service users, their
relatives and carers.
These stakeholders have the following perspectives regarding quality in health and social care:
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 Professional perspective- Professional perspective is concerned with the implementation
of various quality management frameworks at the residential home. Stakeholders have
views that the residential home should have proper quality management frameworks such
as SERVQUAL (Landolina and et.al., 2012). Social perspective- Social perspective comprises of the expectations and perception that
service users have. The service users of Groveland park are elderly people. Some of them
even suffer from dementia. Service users expect to obtain an environment which is harm
free. They expect the residential home to provide them hygienic place for living and
eating. Also, they have expectation of efficient and effective systems and processes of
service delivery.
 Personal perspective- Stakeholders of Groveland park also have personal perspectives
regarding quality in health and social care. They have a sense of responsibility for quality
control and quality assurance (Tricco and et.al., 2012). They expect the residential home
to follow a medical setting or a program for quality assurance.
1.2 Analyzing the role of external agencies in in setting standards for quality
There are various external agencies which play a significant role in setting standards for
quality in health and social care in organizations like Groveland park. These external agencies
comprise of NICE, CQC, Health service commissioners etc. Their role has been analysed below:
NICE
This agency provides quality standards in the form of concise sets of prioritized
statements . These play a significant role in maintaining quality in health car organizations. This
is because these standards are designed for driving measurable quality improvements within
specific areas of health care (Standards and Indicators, 2015). NICE helps in setting standards at
organizations like Groveland Park by enabling health care practitioners to make decisions
regarding care on the basis of THE latest evidence and THE best practice.
CQC or Care Quality Commission
CQC plays an important role in setting standards at Groveland park. CQC inspects the
health and social care organizations for practicing fundamental standards of care. These
fundamental standards cover the areas such as premises and equipment, food and drink, good
governance, staffing, patient safety etc. (The fundamental standards, 2015). In order to achieve
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the fundamental standards set by CQC, organizations like Groveland Park have to set quality
standards pertaining to clean environment, food, drink, equipment etc.
Health service commissioners
This is an independent body which receives complains about health service providers. It
works with the objective of resolving complaint about health service providers so that their
quality of health services can be improved (Thota and et.al., 2012). Actions taken by health
service commission office plays an important role in setting quality standards at Groveland park.
1.3 Assessment of impact of poor service quality on stakeholders
The impact of poor service quality om stakeholders of Groveland Park can be assessed.
As per the given case, the organization is encountering outbreak of infectious diseases linked
with Methicillin-Resistant Staphylococcus Aureus (MRSA). There are a large number of clients
who are susceptible to infection as they share eating and living accommodation. Impact of poor
service quality on stakeholders can be assessed in the following manner:
 Personal impact- Poor quality standards at Groveland park will have personal impact
on service users. Their needs related to hygiene, patient safety etc. will not be met. In
the given case, the service users share eating and living accommodation. Therefore
their basic needs have been impacted by poor standards of quality. This will lead to
low self esteem (James and Savitz, 2011). They will also feel devalued in the absence
of proper care. Moreover, poor quality standards have led to the spread of infectious
diseases at the residential home which have become the major source of illness leading
to increased hospital admission.
 Social impact- Poor quality standards will also have social impact on the service users
in relation to health and social care. This is evident in the given case in which the
service users are severely impacted by health and safety issues related to spread o
infection (Kongstvedt, 2012). There are elderly people in the care home. An infectious
disease related to MRSA is spreading within the organization thus threatening the
health and safety of service users.
 Professional impact- Poor quality standards at Groveland Park can also lead to
professional impact which comprises of disciplinary action, prosecution, fines and
even closure of the setting.
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TASK 2
2.1 Explanation of standards for measuring quality that exist in residential care facilities
There are various standards for measuring quality in residential care facilities like
Groveland park. These have been explained below: NHS performance framework- This framework acts as a standard and informs the
organizations about the criteria for assessing their performance. It provides information
to the strategic health authorities about the appropriate time when they should interfere
to deal with poor quality standards. The NHS performance framework is based on five
principles namely transparent, consistent, proactive, proportionate and focused on
recovery (The NHS Performance Framework: Implementation guidance, 2011). With the
help of these principles, this framework measures quality in residential care facilities like
Groveland Park. National occupational standards (NOS)- These standards provide description of the
skills, understanding and knowledge that is required for undertaking a particular task in
the area of health and social care (National Occupational Standards, 2015). These help
in measuring quality in residential care settings by focusing on the skills and competence
that a person needs to work effectively in residential homes. Key activities undertaken
within the occupation are covered in this standard. Hence, national occupational
st6andards can be used as tools for helping organizations like Groveland park to improve
their performance. Standards of Proficiency for Social Workers- These standards set out safe and effective
practice in the profession (Standards of proficiency - Social workers in England, 2015).
They are considered as threshold standards that are necessary for the protection of
service users of residential home. These standards of proficiency are required to be met
by Groveland Park and its staff. With the Standards of Proficiency, the residential care
facility can measure the quality of service by determining the knowledge and capabilities
of social worker and comparing them against the standards.
 Skills for care- This is a employer led workforce development body which addresses the
area of social care in England (Song and et.al., 2012). It helps in measuring quality in
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residential services by working with the organization and ensuring that their staff has the
right set of skills and values for delivering high quality care.
2.2 Evaluation of different approaches for implementing quality systems
There are different approaches for implementing quality systems at Groveland park.
These approaches can be divided into three categories such as personal, social and professional.
The approaches can be discussed under these categories.
Personal
At personal level, the following approaches for implementing quality systems can be evaluated: Reflective practice- This approach is a method by which own experiences can be studied
for improving the work (Lorenzi and Riley, 2013). It can be evaluated that this approach
can prove to be very useful for the staff at Groveland park as it will help in learning. The
act o reflection will also assist in increasing confidence. However, it will not make the
individual learn skills. Target setting- Target setting is a useful approach for implementing quality systems.
Targets can be set at Groveland Park based on which quality systems can be
implemented easily. However,merely setting the targets will not lead to improvement in
quality within the residential care setting.
Social
At social level, the following approaches can be evaluated for implementing quality systems:
 Sharing best practice- This approach is concerned with internally sharing best practices.
It can be evaluated that this approach is helpful at improving performance by replicating
success throughout the organization (Evans and Lindsay, 2012). It will make the staff
identify and share best practice with others in the residential care setting. Mentoring and coaching- This is another approach which can be used for implementing
quality systems within Groveland Park. Mentors can be appointed who can be assigned
the task of coaching and mentoring new staff within the care home. This will help in
communicating importance of quality culture and will make the staff follow quality
practices (Büyüközkan, Çifçi and Güleryüz, 2011).
Professional
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At professional level within the organization, the following approaches for implementing quality
systems have been evaluated: Needs analysis- This is the process with the help of which needs of a defined population
can be identified and evaluated. This approach will be helpful in describing the problems
faced by staff at the residential home and thus possible solutions can be generated. By
solving the problems, quality systems can be effectively implemented without any
resistance (Hibbard and Greene, 2013).
 Providing adequate resources- Quality systems can also be implemented by adopting the
approach of providing adequate resources to the staff. For example, in the given case, the
residential home is suffering from the issue of spread of infectious disease as the
residents share eating and living accommodation. Hence, by providing resources such as
separate and isolated eating and residing spaces, quality systems can be implemented
(Song and et.al., 2011).
2.3 Analyzing potential barriers to delivery of quality care
There are various barriers to delivery of quality health and social care services in the case study
organization. These have been analysed below: Resistance to change- For delivery of quality health and social care services, some
working practices and systems have to be changed at Groveland park. Also, some new
systems have to be introduced for dealing with the spread of diseases. This would require
specific changes at the workplace (Glasby, 2003). The staff of the organization may resist
to change. This will act as a barrier to delivery of quality care at Groveland park. Interpersonal relationships- Unhealthy interpersonal relationships at the residential care
setting can also act as a barrier to delivering quality care. These may make the situations
stressful and hinder the new systems for quality care. Communication- For effective delivery of care, communication is important. If
communication of appropriate information is not done on the right time, it may hinder the
delivery of quality care at the residential setting.
 Organizational culture- In health care organization, organizational culture plays a vital
role in adopting and implementing new systems. Similarly, it can be analyzed that if the
culture is not supportive and friendly, the staff may not approve of the new changes
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brought in the system of service delivery (Nordgren, 2011). It may thus act as a barrier in
delivery of quality care.
TASK 3
3.1 Evaluating the effectiveness of systems, policies and procedures
Effectiveness of systems, policies and procedures used in health and social care setting in
achieving quality in the services can be evaluated in the following manner:
 Clinical governance- This is a system which will make the organization accountable
for bringing continuous improvement in the quality of services. With the help of this
system, the residential care setting will be able to safeguard high standards of care.
Therefore, this system will be effective in achieving quality in the services (Zwetsloot
and et.al., 2010).
 ISO9000- This is a quality management standard which is involved in presenting
guidelines for increasing efficiency of businesses and satisfaction of customers. It can
be evaluated that this is an effective system for quality management which will not
only help in increasing productivity but also reducing unnecessary costs. Through this,
the quality of processes will be ensured.
 The excellence model- This model would help in obtaining a holistic view of the
organization. Therefore, through it, the management can determine ways in which
different work systems fit together and complement each other (Street and et.al.,
2009). This model can be used for developing sustainable excellence. At Groveland
Park, this model will help in achieving quality in the services.
3.2 Analyzing other factor which influence achievement of quality
The following are other factors which influence achievement of quality in health and social
organization in the case study: Perceptions of service users and practitioners- Service users and practitioners have
different perceptions regarding quality of care services at the health and social care
setting. These perceptions have influence on the achievement of quality. The service
users who have positive perception towards quality will accept the changes and new
practices easily (Reeves and et.al., 2008). This will lead to achievement of quality. Also,
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the perceptions of practitioners, if positive, will positively influence the achievement of
quality. Expectations of service users- The quality to be achieved will be influenced by the
expect6ations that service users have from the health care setting. Attempts will be
made to fulfill those expectations.
 Resources available- Availability of resources will significantly impact the achievement
of quality. If the resources available are adequate, the achievement of quality will be
enhanced. In contrast to this, if the resources are scarce, it will act as a hindrance in
attaining quality (Büyüközkan and Çifçi, 2012).
3.3 Suggesting ways quality could be improved
The following ways have been suggested for improving quality at the health and social care
setting given in the case study: Implementing quality standards- The quality of service delivery can be improved by
implementing standards in the various areas of health care setting. Considering the case,
there is a need to implement standards of delivery of care with respect to personal
hygiene and isolation of infected individuals.
 Releasing guidelines for good practice- The organization is suffering from issue of
spread of infectious diseases. In order to improve quality, there is a requirement that staff
follows good practices so that spread of infection can be reduced (Yoder-Wise, 2014).
These guidelines can cover the areas such as hand hygiene, patient hygiene, isolation etc.
TASK 4
4.1 Evaluation of methods for evaluating health and social care service quality
General overview of chosen method- quality audit
 It is the process of systematically examining quality system.
 It is carried out by internal or external quality auditor. It is considered as an important part of organization's quality management system
(Kongstvedt, 2012).
Application to issues in case study
 Organization suffers from issue of spread of infectious diseases
 Quality audit can be done at the residential home.
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 Elements of service delivery within the residential home can be reviewed and evaluated.
 Through this it can be ensured whether the service within the residential care setting is
meeting the standards of care delivery or not (James and Savitz, 2011).
 Therefore, the residential home can identify the standards that it is not able to meet;
which may be the possible reason behind the spread of diseases.
Identification of problem areas relating to quality
 Sharing of living and eating accommodation
 Lack of adherence to proper hand hygiene practices
 Scarcity of appropriate resources for preventing the spread of infections
 Lack of maintenance of personal hygiene (Tricco and et.al., 2012)
 Lack of knowledge among the staff regarding prevention of spread of infection
outlining possible solutions and strategies for improving service Separate eating and living accommodation for infected residents- One of the strategies
for solving the problem is to provide separate spaces for eating and sleeping to the
residents who are infected. This is required so that other service users do not get infected
from them. Releasing guidelines for hand hygiene- One of the possible solution to the problem can
be releasing guidelines for strictly adhering to hand hygiene practices. Poor hand hygiene
can be major reason for spread of infection (Song and et.al., 2012). Providing training to the staff- Training can be provided to the staff and they can e
inform,ed about the importance of prevention of infection. They can be trained for other
practices for preventing infection.
 Service users- The service users can be imparted knowledge about personal hygiene.
Advantages and strengths of quality audit
Advantages and strengths
 It ensures that organization is offering value to the service users, their family and staff.
 It also helps in providing information about structures and processes of a health care
service.
 It also assists in comparing the closeness between local practice and the recommended
practice (Zwetsloot and et.al., 2010).
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 Therefore, through this, loopholes can be identified and thus quality can be improved
internally.
Limitations of quality audit
 Diminished clinical ownership
 professional isolation
 costly method
4.2 Discussing the impact that involving users of services in the evaluation process has on
service
quality
Involving service user has significant impact on service quality. This has been explained below.
Involving service users in the problem solving effort
 Service users can be involved in the problem solving efforts through questionnaires.
 They can be made to fill questionnaires in which suggestions and opinions can be asked.
 Further, service users can also be involved through focus groups (Nordgren, 2011).
This helps in gaining information about the weak areas in the hospital where quality needs to be
improved. It positively impacts the delivery of quality service.
CONCLUSION
From the report it can be analysed that stakeholders have various perspectives towards
health and social care organization regarding quality. External agencies like NICE, CQC play a
vital role in setting standards for quality. Poor service quality impacts the stakeholders connected
with health and social care setting. It leads t issues of health and safety, low self esteem etc. there
are various standards that exist in the health and social care for measuring quality such as NHS
performance framework, National Occupational Standards, standards of proficiency for social
workers etc. barriers such as resistance to change, communication interpersonal relationships are
experienced in achievement of quality.
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