MANAGING QUALITY IN HEALTHCARE

Task Assume yourself to be a clinician who has recently been given a project to develop a model for collecting and monitoring quality data that would truly contribute to quality and bottom line. Therefore, you are in a situation similar to that of Cynthia Struk, described in the VNAHPO case study (Struk, C., & Neuhauser, D.(2009) in Reading List) Please develop and submit a report addressing the following: 1. Describe the chosen health organisation, the context where you will develop the model for collection and monitoring quality data. Examples of the content to cover in this section might include: what health services are offered in the organisation, what is the ownership structure (i.e. public, private or public and private) of the organisation, an organisational chart showing the different branches in the organisation (similar to figure II.6 in the case study) and information on quality assurance department, i.e., its role and effectiveness.

Running head: MANAGING QUALITY IN HEALTHCARE
Managing quality in healthcare
Name of the student
Name of the university
Author note

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Table of Contents
Introduction:...............................................................................................................................3
Background of Royal Perth Hospital:........................................................................................4
Leadership actions that needs to be taken for developing the model:........................................5
Discuss whether the development of the model should be based on an evidence based
approach:..................................................................................................................................10
Process of following the steps of developing the model:.........................................................13
Conclusion:..............................................................................................................................16
References:...............................................................................................................................18
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Introduction:
According to Al Khamisi, Munive-Hernandez andCampean (2018) managing quality
in healthcare is one of the most significant matters of consideration as it is the key
ofaccelerating the degree of accountability of healthcare organisations and promotes the
health and wellbeing of patients. It is to be noted here that the fundamental purpose of quality
management in healthcare is to improve the effectiveness and efficiency of treatment and
thereby generate highest satisfaction among patients. The healthcare system comprises of
various factors such as pharmacies, medical clinics and hospitals. Thus, it is important to
manage the quality of the system and thereby improve the service. Kamra, Singh & Kumar
(2016) perceived that managing quality in healthcare is to provide high quality to the patients
on the basis of their need in a safe, affordable and effective manner. This is the collaborative
approach, which involve both patients and healthcare practitioners, family members of the
patient and the healthcare practitioner.
The key goal of quality management system in healthcare is to improve the entire
healthcare system along with the service that is the key of promoting health and wellbeing of
patients, which can eventually improve the entire healthcare system as a whole. Barbé et al.
(2017) put stress on the fact that high accuracy, compliance with applicable standards is some
of the major factors of effective healthcare system, which can ultimately improve the
satisfaction level among patients. This paper aims to evaluatethe quality management in
healthcare. Royal Perth Hospital has been chosen as the organisation. The leadership ship
actions that are needed to be taken for the sake of implementing the healthcare model will be
discussed in the paper. Furthermore, the steps required for developing the model will also be
presented in the paper.
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Background of Royal Perth Hospital:
Royal Perth Hospital is the largest healthcare service provider in Australia, which was
established in the year 1855. The hospital is renowned for innovation, which is serving them
with the ability to gain excellence in medical research and thereby provide the patients with
high quality of service. This hospital is considered as the busiest emergency department
across Australia and the second biggest trauma workload in the country
(Rph.health.wa.gov.au. 2020). Being one of the prime teaching hospitals, Royal Perth
Hospital is highly committed towards collaborating with the universities with the intension of
building global reputation in the field of research and innovation. Both the healthcare
practitioners and patient support staff are highly dedicated towards providing exceptional
care and safe, high-quality and efficient services to the patients. As a whole, the hospital
basically provides supportive and compassionate service to all of the western Australians
(Rph.health.wa.gov.au. 2020). The hospital comprises of more than 400 beds and the service
provided by them include, adult major trauma, complex and elective surgery, highly
specialised surgical services, tertiary mental health, specialist medical services and a range of
same-day clinical support services (Rph.health.wa.gov.au. 2020).
The hospital acknowledges the collaboration with the aboriginal comunity and
promotes their health and wellbeing. This is one of the major parts of East Metropolitan
Health Service, which are the fastest growing health services in Australia. Being the leading
healthcare practitioners in Australia, there are four different operational departments in the
hospital, who are highly committed towards providing excellent service and care to the
patients (Rph.health.wa.gov.au. 2020).
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Figure 1: Organisational structure of Royal Perth Hospital
(Source: Rph.health.wa.gov.au. 2020)
This is the public-private ownership hospital, which is highly committed towards
offering the patients with effective treatment on the basis of their health related issues. The
quality assurance department of this hospital is highly committed towards meeting the
prescribed healthcare centre. Two of the core principles of the hospital are clinical excellence
and patient safety. In order to work as per these principles, the hospital has implemented the
approach of after-hours space- one of the revolutionary approaches towards improving the
accountability of senior clinicians.
Leadership actions that needs to be taken for developing the model:
Ginter, Duncan & Swayne (2018) shaded light on the fact that leadership is referred
as the behaviour of individual people for directing to the activities of a group and thereby
accomplish the shared goal. In the context of health and social care sector, the fundamental
role of leadership is to influence the activities of the group of healthcare practitioners and
lead them to provide excellent service on the basis of requirements of patients. Papp (2018)
showed that as the monitoring and evaluating the quality of data has become the matter of
utmost importance in the healthcare sector, it is important implement an effective health
model, which will serve the healthcare practitioners with the ability to monitor the data
regularly and thereby promote the health and wellbeing of patients. However, in order to
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implement the new framework, it is important for the higher authority of Royal Perth
Hospital to change the organisational structure and culture. Still,Venkataraman (2015)
contended on the ground that these changes can result in negative attitude among the staffs,
which will eventually hamper their accountability.
There lies the significance of effective leadership, which will help the hospital to lead
the staffs towards appropriate direction. D’Andreamatteo et al. (2015) observed that clinical
skills, business competencies, and interpersonal or soft skills are some of the major skills of
successful healthcare leaders, which help the leaders to guide their organisation properly. As
the healthcare sector of Australia is characterised by continuous reforms in order to deliver
safe, effective, and high-quality care, the higher authority of Royal Perth Hospital should put
stress on practicing effective leadership in order to drive proposed change in every level of
the hospital.
Strong leadership is the key factor of transforming the vision into practical health
system, which is the key of improving the quality of care. Lindlbauer, Schreyögg& Winter
(2016) shaded light on the fact that in the healthcare system, the role of leaders is to work
collaboratively with healthcare practitioners and be accountable towards mitigating health
related issues among the patients. It is important for the leaders to make necessary
modifications in nursing practice and education in order to strengthen the skills and
competencies of the nurses and thereby serve them with the ability to offer excellent care to
the staffs. In addition, Grimes & Judd (2020) stressed on the ground that it is the role of
leader to improve the communication skill among the nurses, so that they can work
collaboratively with the health professionals and patients and thereby reform their effort
across the heath system. In the context of health and social care, the nurses plays a major role
in the way of identify and develop evidence-based improvements to care and transform
research findings to the practice environment. Clay-Williams et al. (2020) opined that
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therefore, it is important for the leaders of Royal Perth Hospital to translate the research
findings to the nursing education which is the key of strengthening the quality of care.
It is important for the leaders to apply their skills in the profession and collaboration
with healthcare practitioners for the sake of offering the patients with comprehensive care. In
the healthcare environment, it is important for the leaders to take full responsibility of
identifying problems among patients, developing and implementing plan for improvement,
tracking the plan regularly for the sake of resolving the health related issue among patients.
Taylor et al. (2020) commented that it is the role of leaders to allow the nurses in decision
making process. It is the prime responsibility of the leaders of Royal Perth Hospital to
influence nurses to participate in the decision making process and share perception about how
to improve the quality of care. At the same time, the nurses must be involved in the policy
making process and work cohesively within the team. At the same time, Braithwaite et al.
(2020) commented that the leaders must develop the health policy decision making process in
such a manner, so that the nurses can take part and share their point of view. In addition, the
nurses must be involved in the committees, commissions, and boards and the leaders must
influence them to work actively within these spheres in order to advance both health system
and patient care.
The leadership action in healthcare system must be implemented in such a manner,
which will be consistent with the complexity of health system. Horvat&Filipovic (2020) said
that practicing clarity of practice is one of the major practices, which the leaders in health and
social care sector must implement for the sake of making the staffs to understand the main
purpose of healthcare. In order to implement the model of monitoring the quality of data, it is
important for the health leaders of Royal Perth Hospital to build a clear and compelling
purpose that will reflect the core impact of the model. In addition, the power should also
reflect integrated system across the healthcare setting, which is the key of accomplishing the
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intended outcome. Based on the observation of Henrique &GodinhoFilho (2020), it can be
said that alignment of effort is another major practice, which the leaders of health and social
care follow It is the prime responsibility of leaders to communicate effectively set clear
direction for the staffs. As Royal Perth Hospital is going to implement the new model for the
sake of monitoring the quality of data, it is important for its leaders to create effective
organisational structure by aligning the roles and responsibilities of individual and group of
healthcare practitioners in the hospital. Buckė, Ruževičius&Buckus (2020) stated that this is
the way through which the leaders would be able to develop functionally efficient
organisation with clear alignment of efficiency and accountability. It is important for the
leader tFppoo align the vital figures likeboards and CEOs, clinicians, and other front line
staffs in the policy making process and influence them to work collaboratively in order to
develop shared vision for future and work accordingly to accomplish the vision.
Singh &Prasher (2019) opined that both courage and risk taking are the vital activities
of transformative leadership. It is the role of authentic and credible leaders to model their
behaviour and values properly and thereby promote health and wellbeing of service
providers. It is the prime responsibility of efficient leaders to identify and nurture with skill
and capability. This is so with the case of leaders of Royal Perth Hospital. As the hospital is
aiming to implement the new model in order to monitor the quality of data, it is important for
its leaders to drive improvement and sustain change by nurturing people with capability. In
addition,Rotter et al. (2020) shaded light on the fact that the leaders must also put significant
effort in the way of influencing the people to be willing towards change. This is the way,
through which smooth flow of operation the healthcare organisation can be maintained.
Sharing control is another major factor of effective leadership, which the courageous leaders
must follow (Vaughn et al. 2019).
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It is important for the leaders of Royal Perth Hospital to set direction and
communicate the purpose with that of the staffs. Wang et al. (2019) put stress on the ideology
that through this way, the leaders will be able to engage everyone in a single platform and
influence them to work on the basis of prescribed healthcare standard. It is the prime
responsibility of leaders to explore the opportunity to develop trusted relationship with
subordinate healthcare’ practitioners and take care of the patients in a collaborative manner.
As Royal Perth hospital comprises of various departments, its leaders should allow people
from various departments to interact and get their work complete appropriate within time.
White, Dudley-Brown & Terhaar (2019) said that effective relationship with the
subordinates’ will play a pivotal role in the way of increasing collaboration, understanding,
mutual accountability and trust, which are the key of delivering patients with excellent care.
Practicing integrity in the organisation is another major practice, which the leaders of Royal
Perth Hospitalshouldfollow in order to implement the model properly. Tasi, Keswani&Bozic
(2019) stated that it is the prime responsibility of the leaders to practice morality and
authenticity, which are very much needed in order to strengthen the quality of health service.
As the internal structure and working process of Royal Perth Hospital is going to be changed,
it is important for its leaders integrate the values with professional action and frame both
personal and organisational value constantly. Barba, Foreman &Robey (2020) opined that
this is the way, through which the leaders would be able to strengthen the credibility of both
of them and the organisational as a whole. In addition, by practicing integrity, the leaders
would also be able to promote coherence in the entire healthcare system, which is the key of
improving the degree of creativity among them.
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Discuss whether the development of the model should be based on an
evidence based approach:
Implementation of evidence-based approach is the matter of utmost importance in the
cotemporary healthcare sector. Feibert, Andersen & Jacobsen (2019) commented that by
practicing evidence-based approach, the healthcare practitioners become able to improve the
quality of care and satisfaction of the patients. Through this effective treatment related
decision can be taken. As the Royal Perth Hospital is aiming to implement new model, it is
important for them to follow the evidence-based approach, which can help them to amplify
the quality of care. Shaw & Carter (2019) said that due to the increased complexity within the
health and social care sector, it is becoming quite difficult for the healthcare organisations to
evaluate and manage any kind of risk that are prevalent in the health and social care sector.
Evidence practice is the mode of using best evidence of contemporary times in the
healthcare decision making process regarding the way, through which high quality of care
can be delivered to the patients. Streimelweger, Wac&Seiringer (2020) observed that this is
the process of integrating up-to-date information and recent research into practical medical
field and offering the patients with excellent care. As the Royal Perth Hospital is aiming to
implement new model for the sake of monitoring the quality of data, it is imperative for them
to follow evidence based practice, which eventually will help them to accomplish the
intended outcome. Apart from designing effective treatment plan, evidence-based practice
helps in encouraging the dialogue in between patients and provider and thereby paves the
way for patients to share in the decision-making and make their values and preferences
known. Through this way, both the patients and service providers can determine best course
of action that will fit with the health related issues. According to the ideology of Hollnagel &
Braithwaite (2019), one of the greatest benefits of this approach is that here, the healthcare
practitioners can listen to the concern of patients and make the treatment plan accordingly in
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order to improve the health of patients. Therefore, in order to implement the model properly,
it is important for the higher authority of Royal Perth Hospital to follow the evidence based
practice. Bouranta et al. (2019) said that this is the way, through which the clinicians will be
able to stay current on standardized, evidence-based protocols that is the key of resolving
complicated health related issues among the patients.
With the assistance of evidence-based practice, the clinicians would be able to analyse
the current best practice and act accordingly in order to protect the health and wellbeing of
patients. By implementing evidence-based practice, the doctors of Royal Perth Hospital
would be able to improve their way of treating staffs by gathering valuable idea. This is the
way, through which the clinicians of Royal Perth Hospital can have an idea regarding the
current best practice. As evidence-based practice uses real-time data for framing care
decisions, this can serve the medical practitioners of Royal Perth Hospital with the ability to
get more knowledge (Buchbinder, Shanks & Kite, 2019). Advancement of technology will
also help them understand current outcome of revolution within the medical field such as
electronic medical records (EMRs), decision support systems, built-in protocols, data
warehouses, and sophisticated analytics, which are the key of improving the treatment and
care of the patients. Improved accessibility of up-to-dated data of healthcare will help the
clinicians to use evidence-based medicine, for the sake of offering the patients with better
care in a timely and cost effective manner. Wang et al. (2019) commented that by practicing
evidence-based approach the degree of uncertainty in healthcare decision making can also be
reduced.
By practicing evidence-based approach, the transparency,accountability, and value of
the healthcare can also be accelerated. Both the healthcare practitioners and patients are
highly willing towards transparency and values such as high quality and safe care at the
lowest possible cost. There lies the significance of evidence-based practice, which is one of
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the major ways of mitigating the need of healthcare practitioners andpatients regarding
transparency and values of healthcare. Therefore, it is important for the higher authority of
Royal Perth Hospital to practice evidence-based approach, while implementing the model.
Through this way, they can improve their transparency and offer the staffs regarding the
sense of purpose regarding the healthcare model. This is the way, through which the hospital
authority can also improve their accountability by making justifications of the decision in
accordance with the valid information about the fundamental purpose of implementing the
model. This is the way, through which the best outcome from the healthcare can be attained.
Improving the quality of care is the best benefit of evidence-based approach. The
inclusion of evidence-based approach will enable the health system to work diligently by
using best clinical expertise. As Royal Perth Hospital is aiming to implement new model to
monitor the quality of data, the integration of evidence-based practice will ensure the fact that
the treatment is consistent with that of the values of patients. This is the mode of acquiring
better health outcome. In some, it can be said that evidence-based practice actually helps in
improving the patient’s outcome by making effective treatment plan. However, Hasanpoor et
al. (2020) contended on the ground tha evidence-based practice may sound improper in
various improper in various aspects. Lack of effective infrastructure and healthcare practice
and lack of education among nurses can make it difficult for the healthcare practitioners to
implement evidence-approach. Therefore, the healthcare practitioners sometimes face
difficulty in the way of implementing evidence-practice, which eventually hamper their
ability to provide the patients with high quality of care and service. One of the major
criticisms related to evidence-based practice is that it fails to apply the models, which are
supported by those people, who are living with experience. Thus, application of this approach
will make it difficult for the hospital to implement the model as this approach lacks
effectiveness. In addition, evidence-based practice may also limit the participation of people
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with specific health related issue (Vainieri et al. 2019). Thus, execution of this approach in
the way of implementing the model of monitoring the quality of data can eventually lower the
degree of accountability of Royal Perth Hospital. Moreover, evidence-based approach is not
taste for specific group of people. As Royal Perth Hospital aims to collaborate with the
aboriginal community and treat them as per the prescribed standard, application of this model
can affect their ability to treat the aboriginal people and address their culture specific issues.
Process of following the steps of developing the model:
There are six different steps, which the Royal Perth Hospital should follow in terms of
implementing the model of monitoring the quality of data in the healthcare sectors. The
steps are as follows:
 Step 1- Formulating the question
This is the first step, which shows the main purpose of implementing health model. As
the degree of complexity within the healthcare sector is rapidly increasing, it has become the
matter of utmost importance for the Royal Perth Hospital, one of the leading healthcare
organisations in Australia to implement the model in order to collect and monitor quality
data. Responsibility will be given to the head clinician of the hospital to develop and
implement the model and integrate evidence-based approach in terms of addressing the
standard of care (Harrison et al. 2019). The aim of this hospital is to offer better care to all of
the patients in accordance with health related issues.
 Step 2- Using internet to acquire the indications of evidence-based practice
This is the second step of implementing the model. The webpage namely “Evidence-based
practice and service-based evaluation”, as published by Australian Institute of Family
studies, comprises of the evidence based practice, which is to be followed by the hospitals in
terms of improving the quality of care. According to the website, it is imperative for the
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healthcare practitioners to gather knowledge regarding multiple types of evidences in order to
test the objectives of program. In-depth understanding about different types of evidences will
serve the healthcare practitioners with the ability to make strong conclusion regarding the
treatment of a patient (Child Family Community Australia, 2020).
Based on this website, it can be said that the clinicians must practice evidence-based
approach which can help them to make constructive conclusion regarding the treatment of
patients. This is the best quality improvement site, which must be followed by Royal Perth
Hospital in order to ensure the fact that their approach towards healthcare is consistent
with that of the national quality standard and is aligned with evidence-based management.
“Implementing evidence-based practice is another major website”, published by Victoria’s
hub for health service and business is another major website, which is to be followed by the
Royal Perth Hospital for the sake of practice evidence-based approach. According to this
website, it is important to implement this approach, which is the key of strengthening the
clinical knowledge, introducing new interventions and therapies in order to minimise the
functional difficulties, especially of the elderly people (Www2.health.vic.gov.au. 2020).
Based on this approach, it can be said that it is important for the clinicians of Royal Perth
Hospital to communicate with staff, patients, family and carers in order to promote adoption
with the new intervention.
 Step 3- Assessing the Applicability of the Evidence
This is the third step of implementing the new model. In this step, it is imperative for the
higher authority of Royal Perth Hospital to assess the extent, to which, the evidence practice
will help in offering the patients with excellent care. Conduction of meeting with advisory
committee is one of the major factors of consideration in this context as it will help in
gathering expert advice regarding the process of implementing the approach. In addition, by
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conducting meeting with the higher authority, the senior clinician of Royal Perth Hospital
would be able to gather necessary information and thereby expanding the scope of project on
implementing the model for monitoring the quality of data (Asif et al. 2019). Moreover,
evaluation of the applicability of the evidence will also serve the healthcare practitioner with
the ability to assess the characteristics of quality and performance measurement which will
match with the mission, vision and objectives of Royal Perth Hospital. It is important to
assess the most important indicators, which can help them to measure the performance
against the prescribed standard.
Apart from setting the indicators, the senior clinician of Royal Perth Hospital should
explore the way of presenting the data properly across various departments of the hospital in
order to share the data related to quality to the both internal and external stakeholders.
 Step 4- Defining the Quality Measures
This is one of the most important steps of implementing the model of monitoring quality
data. In the context of Royal Perth Hospital, it is important for the senior clinician to set
effective strategic objective. This is the way, through which the clinician will be able to set
the criteria for good measure (Dai &Tayur, 2019). Customer satisfaction is one of the major
indicators of quality of healthcare. This is the experience of customers during the process.
There are multiple people engaged in healthcare, which include patients, internal customers
and employees. Clinical performance is another major indicator of measuring the
performance of healthcare. It is the prime responsibility of the healthcare practitioner of
Royal Perth Hospital to put stress on the outcome of health care.
The clinician should focus on corporate compliance and ensure the fact that the staffs are
working as per the regulatory requirement. Risk management is another vital indicator of
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measuring quality of healthcare service. This practice focuses on the factors that can have a
larger impact on the health and social care sector.
 Step 5- Aligning the Quality Measures with Quality Improvement
After measuring the accountability of healthcare, it is imperative to align the quality
measure with that of the quality improvement. This is the way of ensuring that the staffs are
getting effective care in accordance with the prescribed standard. The clinician should assess
the primary data source, which can help them to ensure the fact that evidence-based measure
has been taken in order to offer the patients with high quality of care (Hasanpoor et al. 2020).
By measuring both the performance and data source, the clinician of Royal Perth Hospital
would be able to set both quality improvement thresholds and recommended threshold in
order to measure the performance of healthcare on the basis of both external and internal
requirement.
 Step 6- Final Results
This is the last step of developing the model of monitoring the quality data. In this step, it
is important for the Royal Perth Hospital to develop the description of each of the indicators
of performance, their source and accepted benchmark (Buchbinder, Shanks and Kite, 2019).
The assigned clinician must produce the summate report to the governing body of the
hospital. Growth of the program in the key strategic areas, satisfaction of customer and staffs
are some of the vital parameters, against which the head clinician will evaluate the
performance of healthcare.
Conclusion:
Based on the discussion, it can be concluded by saying that managing quality in
healthcare is the matter of utmost importance in order to improve the quality of both
treatment and care and thereby keep the patients happy and satisfied. The patients look for
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correct diagnosis and treatment. Thus, by managing quality, the healthcare practitioners
become able to deliver safety to the patients by improving the efficiency of care. In addition,
by managing quality, the healthcare practitioners become able to implement patient-centric
approach, which is the key of delivering timely and affordable services to the patients. In the
health and social care sector, the fundamental objective of quality management is to improve
the quality of services and ensure compliance with rules and expected standard, which
ultimately lead to greater satisfaction among patients. In order to improve the quality of
healthcare, it is important to put stress on evidence based practice. This is the mode of
integrating research evidence within the practical medical field. This is the way, through
which the healthcare practitioners can make treatment plan on the basis of preferences of
patients.
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