This paper discusses current strategies that have been put in place to strengthen effective communication and transparent accountability in healthcare. It also highlights the challenges that can threaten the outcomes of such efforts and how to address them.
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Running Head: QUALITY IMPROVEMENT IN HEALTH CARE1 Quality improvement in health care Name University affiliation
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QUALITY IMPROVEMENT IN HEALTH CARE2 Quality improvement in health care Overthepastdecade,healthfoundationshaveshowntheireffortsinmaking healthcare safer by funding thousands of people working in different settings from hospitals to care homes. There have also been cases of specific causes of harm within the healthcare system where front-line teams such as the government, organization, team and individuals working in the organization can use quality improvement methods to address the problems. Such efforts should be made to reduce the number of patients harmed by safety and quality problems. However, despite the efforts made to improve the quality of healthcare in terms of promoting more transparent accountability and effective commination between healthcare providers and their patients, the gap between basic as well as operational action still remains significant. Healthcare systems need more resources, better health financing schemes and cost-effective interventions. This paper aim at discussing current strategies that have been put in place to strengthen effective communication. Also, there is clearer accountability as well as the challenges that can threaten the outcomes of such efforts. Need for maintaining and improving the quality and safety of health services A report produced by the institute of medication commission in regards to excellent healthcare US Department of Health and Human Services (2014) outlined that millions of patients across the world fail to receive adequate healthcare services. This happened every year due to lack of more transparent accountability and effective communication between nurses and patients (US Department of Health and Human Services, 2014). Additionally, the US Department of Health and Human Services outlined that most healthcare systems around the world fail to utilize their resources for better use. Other researchers at the RAND Corporation developed that countless types of medical mistakes due to lack of clearer accountability and lack of effective communication result in the subsequent prerequisite for
QUALITY IMPROVEMENT IN HEALTH CARE3 extra healthcare services to treat patients. The research shows that even the exceedingly fragmented delivery system often lack even basic clinical competences (US Department of Health and Human Services, 2014). Similarly, the results in a poorly designed care processes are characterized by unnecessary replication of services as well as long waiting times accompanied by avoidable delays. As developed by Illingworth (2015) during his research which provided substantial evidence documenting the overuse of many services—Further research provided by the World Health Organization (2016) shows what is most disturbing when it comes to the absence of real progress toward restructuring health care systems is to address both quality and cost concerns. Also, towards applying advances in information technology to improve administrative and clinical processes. Current efforts have been put into strengthening effective communication. According to a 2011report to the congress, the federal government is making efforts to promote effective communication within the healthcare system level by implementing multiple programs (US Department of Health and Human Services, 2014). For example, in 2010, CMS made a public announcement that eight states in America will be participating in the Multi-payer Advanced primary care practice demonstration. This activity was aimed at evaluating how practical professional nurses and other healthcare providers working in a more integrated fashion and more coordinated payment from Medicare, Medicaid, and private health plans. Ultimately, this will ensure that approximately 1 million Medicare beneficiariesacrossthe world willbe providedwith advancedpracticeprimarycare. Additionally, several researchers such as Shaw et al. (2014) and Mosadeghrad (2014) mentioned healthcare systems are now providing support for the establishment of health homes. They ensure that Medicaid beneficiaries, especially those with chronic diseases, receive first-hand personalized health services. Previous research has provided evidence that patients who receive seamless care from their healthcare providers are more comfortable
QUALITY IMPROVEMENT IN HEALTH CARE4 sharing personal information than those who do not. This means that both gaps and duplications when it comes to patient care delivery are reduced as well as eliminated due to accurate health records, telemedicine as well as e-prescribing. Over the past decade, research indicates that leaders within healthcare borrowed several performances from the work of other profound scholars. Deming, a known scholar, is known for implementing Total Quality Management (TQM) which encouraged constancy of persistence as well as to the systematic analysis. Also, the measurement of process steps concerning better outcomes (Deming, 2014). According to the World Health Organization (2016), creating an environment for offering improved healthcare service through better communication between professional nurses and their patients is made possible by utilizing the TQM model in a healthcare organization. This approach incorporates team work, implementation of defined processes as well as system thinking (Mosadeghrad, 2014). Additionally, according to the World Health Organization (2016), the system does not only incorporate the view that the entire organization must be committed to quality. However, it ensures there is constant improvement when it comes to achieving better results. Current efforts that have been put into strengthening more transparent accountability. Resultsof research conductedby indicatethat most healthcaresystemsat the organizational level are now encouraging patient cooperation. It is essential to involve patients when it comes to decision making in regards to their healing process as well as helping them to be corporate. It is very crucial since it affects the quality of healthcare service. For instance, in cases where professional nurses and healthcare providers do their job well, but their patients fail to do so. The objective and goals of the treatment will not be achieved. Therefore, Mosadeghrad (2014) developed that clinical outcomes tend to be highly dependent on the ability of patients to provide accurate information as well as cooperate with
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QUALITY IMPROVEMENT IN HEALTH CARE5 their healthcare providers. Patients should pass any concerns in regards to the medication prescribed to them. In the same way, physicians should provide explicit instruction to avoid deterioration of the patient and other complications that are likely to occur. Otherreportshaveindicatedthatmaintainingandpromotingmoretransparent accountabilityrequires.Constantmonitoring.Evidencefromresearchconductedby Mosadeghrad (2014) showed that healthcare organizations in the past decade, have been making efforts to increase accountability by building on the assets they already have in place. This means that they created training programs to develop skills and knowledge of their professional nurses and other healthcare providers. Other researchers, such as Mosadeghrad (2014) and the World Health Organization (2016) have also mentioned that healthcare systems are encouraging. In addition, they simultaneously enable professional nurses to develop as well as deploy the abilities, tools and the awareness crucial when it comes to improving the quality and safety of the healthcare services they provide to their patients. For example, the board of directors offered new support to the several healthcare systems in Americabyencouragingvisitstosimilarorganizationsthathavebuiltimprovement capability at scale. Other efforts made to promote more transparent accountability include implementation of coaching programs as well as mentorship programs. Challenges that can threaten the outcomes of such efforts Through combined efforts from the healthcare systems, individuals, private entities as well as from the government, there much progress in regards to quality improvement of the healthcare services provided. However, the gap between need and effective action is still vast. This is because of challenges such as lack of better financing schemes and cost-effective interventions which tend to hinder and threaten better outcomes when it comes to healthcare services.Healthfacilitiesinmanycountriesaroundtheworld,especiallydeveloping
QUALITY IMPROVEMENT IN HEALTH CARE6 countries, encounter communities with low levels of coverage in life-saving services even where capacity exists to provide that coverage or encounter high rates of absenteeism from trained workers. In other cases, healthcare systems, especially those situated in developing countries, experience challenges of lack of resources such as low supplies of drugs and misuse of the facility’s funds. Evidence from research conducted by the World Health Organization (2016) indicated that implementation of just technology within the healthcare systems is sufficient to improve the quality of health services being provided. Meaning that improving services and safety of healthcare has to be accomplished in order to achieve possible advances when it comes to better health outcomes from increased finance as well as enhanced technology. Several researchers such as Hughes (2015) and Safari et al. (2017) developed that effective management and leadership in any healthcare system is crucial when it comes to promoting quality. Also, safer health services from the perspective of providers, payers, policymakers, as well as managers. For example, in cases where professional nurses and healthcare providers have great ideas to improve the quality of health, but there is good leadership with poor management. The ideas will be useless. Participantsin research conducted by Hughes (2015) complained about the lack of professional managers which affected service quality at their place of work. The analysis of qualitative data indicated significant obstacles to better outcomes of efforts made to improve health quality and safety were initiated by lack of management stability. Results of the research concluded that most manager, especially those employed at public hospitals, have insufficient power when it comes to making sound decisions. This means policies put in place at the national level are incredibly prescriptive, where they do not consent adequate flexibility when it comes to adopting to local and ever-changing environments (Mosadeghrad, 2014). From a report created in 2010, universal policies developed by the ministry of health often tend to have
QUALITY IMPROVEMENT IN HEALTH CARE7 little consideration for the local factors. This means managers in most healthcare systems have been denied the authority to change such policies. Other factors such as bureaucracy, severe dependency on government interventions as wellascentralizationhavebeenrecognizedassignificantfactorswhenitcomesto threateningoutcomes.Thesefactorsaffecttheimprovementofqualityandsafetyof healthcare (Safari et al., 2017). Healthcare systems with this structure tend to have all their decisions in regards to the allocation of resources and general goals made at the central level. Effective quality management systems in every organization should have more autonomy for the operation manager when it comes to the process of making sound decisions. These decisions promote high quality health service delivery. How to address these challenges to maximize the continuous improvement of the quality and safety of health service provision The first step when it comes to resolving problems that threaten the outcomes of qualityhealthservicedeliveryshould be theimplementationsubstantial.Also, strong leadership support in the organization as a whole. Additionally, according to research conducted by Safari et al. (2017), more policies that promote consistent commitment towards continuous improvement of health service should be implemented to make significant change within the healthcare system. Other researchers found that increased engagement from the hospital board of directors and members of the management made substantial changes in regards to improving the quality and safety of the health service provided. Additionally, healthcare systems should implement schemes which are agreed by the stakeholders to promote the improvement of safety. These strategies should not only protect the cultural beliefs of the patients but also mark clear boundaries between culpable breaches of care as well as unintended failures (Mosadeghrad, 2014).
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QUALITY IMPROVEMENT IN HEALTH CARE8 Conclusion It is evident from different researchers that health care complexity is a challenging area thus requires guidance and cooperation from various bodies. In addition, this area is being developed slowly but steadily by the body of knowledge, which according to several researchers such as Safari et al. (2017) and Mosadeghrad (2014) could be due to the sustained predicament. It also answers as to whether a quality improvement inventiveness is just that or whether it encounters the characterization of different explorations as well as whether it employs procedural rigor—even if it meets the necessities for publication. Additionally, quality and safety enhancement are a dynamic process that tends to require the utilization of different approaches. The factors such as understanding the root cause of problems, essential stakeholders’ involvement when it comes to the critical decision are crucial. Also, there should be constant monitoring of the performances, not only of the professional nurses but also that of their patients should be put into consideration.
QUALITY IMPROVEMENT IN HEALTH CARE9 References DemingWE.(2014).OutoftheCrisis.Cambridge,MA:MassachusettsInstituteof Technology Center for Advanced Engineering Study. Hughes RG. (2015). Tools and Strategies for Quality Improvement and Patient Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US) Illingworth, J. (2015).Continuous improvement of patient safety: The case for change in the NHS. Health Foundation. Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality.International journal of health policy and management,3(2), 77. Mosadeghrad AM. (2014). Essentials of Total Quality Management in Healthcare: A systematic review.Int J Health Care Qual Assur ;27:544–58. doi: 10.1108/ijhcqa-07- 2013-0082. Safari, Y., Sharafie, K., Karimaei, M., Asadi, F., Ghayebzadeh, M., Motlagh, Z. J., & Sharafi, H. (2017). The role of educational intervention in changing knowledge and attitudes of rural homemakers in relation to food safety and hygiene: a case study: iran (2016).Annals of Tropical Medicine and Public Health,10(4), 1024. Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient Protection andAffordableCareAct:opportunitiesforpreventionand publichealth.The Lancet,384(9937), 75-82. US Department of Health and Human Services. (2014). Report to Congress: National strategy for quality improvement in health care.Washington, DC: US Department of Health and Human Services.
QUALITY IMPROVEMENT IN HEALTH CARE10 World Health Organization. (2016). Quality of care: a process for making strategic choices in health systems.