Analysis of Quality and Improvement in NHS Discharge Services

This report critically examines the quality of discharge services, focusing on the National Health Service (NHS) in the United Kingdom. It begins by defining quality in the context of healthcare and then uses the Donabedian model to evaluate the structure, process, and outcomes of the NHS's discharge services. The analysis identifies areas for improvement, particularly concerning patient satisfaction and waiting times. The report then delves into the application of change and service improvement theories, models, and tools to address the identified quality issues. It proposes strategies to manage change effectively and enhance the quality of discharge services, ultimately aiming to improve patient outcomes and service efficiency. The report provides a detailed overview of quality management principles and their practical application within a healthcare setting.

Discharge Service

Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................4
Define quality as it relates to your service, then using a quality model/theory, critically review
the quality of the service you provide....................................................................................4
2. As per Analysis identify a problem which related with quality........................................8
2. Using change and service improvement theories, models and tools, critically discuss how
you would manage change to address this problem/issue in order to improve the quality of
your service............................................................................................................................9
CONCLUSION................................................................................................................................1

INTRODUCTION
Discharge is means about to release, a form of health process which coordinated within
patient family all relevant agencies. Quality is playing most important role in healthcare that
effectively helps an organisation to maintain its healthcare services and facilities effectiveness.
For this quality management helps healthcare organisation to consider various factors and safety
standards in order to deal with various situations (MacKian and Simons, 2021). With the help of
emphasising upon quality in healthcare services organisation can make improvement to the
extent of services that they are offering to patient. It is essential for organisation to make sure
that they are offering quality care services with the help of approved regulatory standards in
order to effectively offer high quality services. It is essential for healthcare organisation to
emphasize upon quality management as to make reduction in errors while improving patient
care. By making improvement in quality of care organisation can enhance satisfaction level of
customers and can enhance their loyalty towards health care services and facilities. By having
effective improvement in performance and quality healthcare organisation can offer reliable,
efficient and transparent services to patients that further help them to accomplish their goals in
effective manner while enhancing patients outcomes. There are mainly seven quality
management principles that are relationship management, improvement process approach,
engagement of individual, leadership, consumer focus that helps an organisation to implement
quality management in their practices. It helps them to enhance the degree of healthcare services
that they are offering to populations and individuals. Present report has been conducted on NHS,
which is conducting its operations as the leading healthcare service provider in the provinces of
United Kingdom. This report includes quality along with the use of quality model in order to
effectively review the quality of services that are being provided by organisation to patients. In
addition to this report also include evaluation of problem or issue associated to quality. Use of
change and service improvement theories are also being discussed in this report through which
quality challenges can be effectively addressed that further help in improving quality of service.

MAIN BODY
Define quality as it relates to your service, then using a quality model/theory, critically review
the quality of the service you provide
Quality is termed as continuous delighting the patient by offering them effective, efficacious and
efficient healthcare services as per the latest standards and quality. Quality in healthcare plays
most important role as it allows healthcare organisation to effectively fulfil and satisfy patient’s
needs. It has been identified that healthcare quality is a wide term that involve numerous range of
aspects of patient healthcare. In addition to this has been underlined that quality healthcare is
care which is effective, efficient, safe, patient-cantered and equitable. For healthcare
organisation, patient safety plays most important role and are one of their key priority. It is
essential for any organisation offering their services in healthcare sector to make sure that
patients are experiencing high care quality (Patel, 2021). Furthermore it has been underlined that
quality and safety effectively aim towards reducing and preventing risks, harm and errors that
can have negative impact upon patient during health care service. Continuous improvement is
corner stone approach that helps in making continuous improvement on learning from error
along with its adverse impact. Patient Safety is most important aspect in order to deliver quality
essential health services. Along with this has been underlined that by improving quality
performance healthcare environment can significantly enhance. In addition to this, it has been
identified that quality healthcare service effectively aims improving their delivery that
automatically enhances patient satisfaction level. It also allows healthcare organisations to
effectively accomplish their goals and objectives in effective manner. In order to provide quality
in healthcare services it is essential for organisation to collect data and analyses patient
satisfaction level (Hannigan, 2021). After this it is essential for healthcare service organisation to
set goals and commit to ongoing evaluation while improving access to care. Healthcare
organisation is also required to emphasize upon patient engagement and effectively connect and
collaborate with other organisations in order to provide quality healthcare services to patients.
Healthcare professionals are required to communicate in a clear manner, respectfully and involve
patients in the decision-making process. Along with this in the modern time it is also essential to
encourage digital relationship, in order to effectively reshape healthcare portfolio for future
growth and development. It not only helps in providing effective health care services but also
allow patients to have easy access of healthcare facilities (Parker and Hwang, 2021). Healthcare

organisation must ensure that they are offering healthcare services with quality along with the
ethical standards of practice. According to the WHO, quality is defined as extent to which
healthcare services are provided to individuals and patient population in order to improve desired
healthcare outcomes. Quality plays essential role that helps in increasing satisfaction level of
patients towards the healthcare service. It helps healthcare organisations to effectively enhance
their image in healthcare sector. However in order to effectively manage quality in health and
social care services, it is essential to overcome various challenges such as leadership and
management training, staff and inefficient resources, along with regulatory bodies standards
(Bergren, 2021). Thus, according to the above mentioned analysis it has been identified that
quality management plays most important role in health care for the organisation as it effectively
allow them to maintain the effectiveness and enhance quality of the products and services that
they are offering to patient. Thus according to the above mentioned analysis it has been
identified that quality management is one of the most important aspect in healthcare that allows
organisation to effectively enhance patient satisfaction and experience. Further, it is essential for
organisations like NHS to implement quality management in the healthcare management system
in order to effectively manage resources and other equipment and facilities that are being offered
by them. This mechanism will effectively allow top management and team to significantly
commit towards quality. Patient satisfaction is a major component which is the significant
outcome of quality assurance program. It is essential for NHS to have patient centred care
delivery approach in order to conduct their operations with the compliances and standards
according to the government protocols. In order to provide qualitative services it is essential for
healthcare organisations to undertake use of quality management as to make sure that safety and
consideration of elements have done in effective manner, as to effectively deal with various
situations in order to provide high-quality healthcare facilities to patients. Mentioned below
critical review of the quality of the service provided by NHS is being defined with the help of
quality model:
Donabedian approach
Donabedian approach is basically a component approach that evaluates the quality of care and
management for improvement. In this there are three main components that are process, structure
and outcome. It has been identified that the main purpose of Donabedian approach is that it is
effectively provides a framework to examine healthcare services and evaluate quality of

healthcare (Fitzsimons, 2021). Quality plays most important role in healthcare and requires
measurement of process in order to provide high quality health care services and facilities to
patients. With the help of this approach evaluation of the services offered by NHS is being done.
This approach offers advantage to effectively deal with their concrete and accessible
information. This model effectively supports quality improvement. To comprehend quality the
key highlights are dependability, affirmation and responsiveness. The seven mainstays of value
as introduced by Donabedian are efficacy, efficiency, optimality, acceptability, legitimacy,
equity, and cost. As per the Institute of Medicine, administrations are of value, when they are
protected, compelling, patient focused, ideal, effective as well as equitable.
Figure 1: The Donabedian model for quality of care
Structure:
According to this component of Donabedian model for quality of care, it has been
identified that NHS offer all the services and facilities to patients under proper licensing. NHS
offers their services according to the government regulation of new paramedical products. In
addition to this it has been underlined that NHS is having five ministerial appointees those who
are responsible for health and personal services. NHS is a publicly owned Hospital in which
there is more than 165, 844 beds. This organisation offer appropriate amount of doctor’s ratio as
well as nurses in order to provide effective care and patients to patients. Comparatively to other
geographical region in NHS United Kingdom London there is more number of rooms and
hospital bed services are being provided (Xu and Zhang, 2021). Along with this, comfortable
atmosphere and physical environment of the building of this organisation encompasses nurses
and doctors those who are having professional registration and are specialist and are awarded of

qualification in their specialisation. In addition to this it has been underlined that in NHS general
practitioner of a primary care services are responsible for offering high quality services to
patients. In addition to this it has been underlined that in the year 2004 NHS significantly added
2000 GPs, 20,000 nurses and more than therapists.
Process:
Furthermore it has been underlined that health resources allocation is being effectively
done along with equality of access. Each and every patient is having right of information.
Furthermore it has been underlined that those patients who need emergency medical care can
seek consultation with a general practitioner. In this there is no payment for this consultation.
Effective and high quality services are being provided to patient along with no payment for
consultation service. In addition to this it has been underlined that diagnostic services procedure
is effectively conducted with the help of laboratory services such as MRI and CT scan.
Ambulatory care is also being offered by this hospital in which patients are allowed to select to
register with any general practitioner within the designated practice area. NHS also offers high-
quality secondary care which is also termed as acute healthcare. Immediate care services are also
being offered by this hospital. Furthermore, it has been underlined that drug administration of
these services are being managed by community pharmacist those who supply drugs from
scripted orders by general practitioner.
Outcome:
According to the evaluation of patients satisfaction acute care and it has been reflected
from the findings of NHS survey is that patient those who are suffering from coronary heart
conditions are required to be admitted as soon as possible. Future upon entering the world gives
perhaps the broadest marker of the general soundness of a populace. In the UK, the future for
female rose by five and a half years, male by six and half years. In addition to this, it has been
evaluated that survival rate for disease which represents around a quarter passings in the UK was
improving however lingering behind the remainder of Europe. It has been underlined that the
major concern about NHS is long waiting time for appointments. It is essential for NHS to
effectively overcome this challenge in order to reduce waiting time in order to enhance
effectiveness of their care services. As per the patient satisfaction level of acute care it has been
identified that acute care patients with coronary conditions are required to be admitted sooner.

Thus according to the above mentioned analysis it has been identified according to the
Donabedian model for quality of care that in NHS effective services and high quality facilities
are being provided to patients. However it is essential for NHS to make significant improvement
in there working operations as to satisfy customers according to the latest trends. It will help
them to offer efficient services to patients in effective manner.
2. As per Analysis identify a problem which related with quality.
In health care sector there is many issue generally generate for people’s ad medicine or other
health base resources that not implemented through better manner. Health care having better
expectancy fascinating fluctuates on major programming that creates effective affordable
towards new quality and other resource which is measure public domain (Mitchell, Cribb and
Entwistle., 2020). In general term health care quality is level of value provided to any
healthcare resources as determined by measurement. To overall improving the quality and
performance in health process that enable to accomplish goal and objectives. The quality health
care high priority for measure to assess tools or quantity healthcare processes in high quality
health care relate to one quantity goals towards health. In perspective of issues prevails in health
care that highly create impact in negative manner such as:
 As per report there is problem information and service integration that having better
data advancement of patients but implementation is not proper managed. There is
non-relational data information from many sources to provide actionable sources.
Their technology presents about itself perfect time need to exploit patient
information.
 Another challenges is effective payment discovery and implementation that emphasis
about non profit medical association Academy Health states that to decrease cost to
increase better service quality. To better insures and benefactor have instituted
towards new payment model. In perspective NHS is facing problem to not get
payment in offline manner, there is some critical problem arise more times.
 In clinical variation towards increasing number of medical mistakes prevails to
contribute which rising health care that represent cost and poor quality (Gilbert, and
et. al., 2020). Through this negative aspect it also create negative impact on
infrastructure in where patients are not comfortable for long term staying in hospital.

 National Health Service is concerned are related to having involve critical structure
that merger acquisition, partnership with other organisation along with departmental
basis internal restrucring.
 Some of financial issues in terms of budget through government funding, and
reimbursement for medical delays on dental or other medical check ups.
 To increasing about to attempts to decrease about operational cost where staffs,
supplier of medical raw materials and other volunteers.
 As lack of facility it can decrease the facility factor.
 The hospital initiatives like transaction through quantity to quality, free for service,
price transparency and commercial insurance payments to managed care.
 Patients Safety quality is more facing issues that creates lack of resources such as
proper bed, medical facilities and poor infrastructure.
Thus, above overall describe about issues, problem or challenges for health care which
prevails more disadvantages in health business (Robert and et. al, , 2021). In perspective of
National Health Service company there is major problem arises. For these above issues there
is need of strategy which helps to prevails more challenging outcomes. Overall team and
management focusses to build better hospitality service in health care perspective in which
patients can survive for long time period. Through positive strategy implement can prevents
better benefits for National health services.
3. Using change and service improvement theories, models and tools, critically discuss how you
would manage change to address this problem/issue in order to improve the quality of your
service.
Change management: It is define about certain method and manners through which company
describes that implements that change which it depicts about internal and external
processes. In this management excellence communication plays an important role to
attain better outcomes effective manner. Discharge Service improvement is having
systematic process of approach that enhance specific technique to deliver for measure to
sustained improvement within quality (Moudatsou and et. al., 2020). There are some of
change improvement models which focuses into different aspect in National Health
Services perspective:

 This change majorly provide about important and organising framework that having
suitable change and transformation to delivers on benefits about public major
platform. the delivers essential benefits to the patients that occurs long term
outcomes generates.
 This particular model has eight types of elements which it covers considered to
implementing change where the components to directs about effectively implement
to creating performs deliver transformational sustainable changes (Garcia-Alonso
and et. al., 2021). The eight elements are denote to health quality improves such as
Change model guide, Mode of Action planning, Model of GAP analysis tools,
Improvement tools etc. These changes is majorly belongs to National Health
Service company as their management team is scrutinise their betterment
infrastructure perspective.
From these changes and service improvement, in this further National Health Service is facing
Cultural diversity and gender discrimination factor issue in their premise. In following some
factors denote importance and approaches to enhance better culture diversity. culture diversity at
workplace is essential to reduce the uncertainty which creates conflicts as in context of
miscommunication to actual conflict where employees get to compromising with their
performances as well as productivity. Similarly for National Health Service there are some
important factor to bring better Discharge Services.
1) Communication factor: As working in organization there is essential requirement of effective
work and team performances the communication between among discharge service coworkers or
superiors create the balance of managing the situation which arises and coordinate with proper
execution (Bramer and et. al, 2020).
2) Proper legal formalities: At the time of discharge service, legal formalities which every
health care service must follows such as patients information and their families too which is
important for audit process. In perspective of National Health Service allows overall facilities
that specify to complete discharge service procedure.
3) Better time management: the most important thing is to manage the time as by pursuing a
project in the organization where the assignments are driven to complete in given particular time
by which superior follows the discharge Service where they appointed high potential worker
whose having better competences which can helps to complete the assignment by allotting time,

it leads to providing the effective team as per target allotted in terms of time by completion of
assignment objective which enhanced the culture diversity at workforce as well as in work
culture of organization perspective
4) Having a objective which can bring changes: By creating with fixed and actual visible
objective which can reduce the gaps where it depends upon the individuals to business division
and achieving the task importance which eliminate the gender biasness (Agarwal, Gupta and
Navathe., 2020).
5) By implementation of changing the workplace rhetoric: By elimination the rhetoric with the
aspect to that women’s are not efficient enough to achieve more where there should be proper
coordination which implies the empowerment of gender equality within the organization.
6) Preventing the sexual harassment: There should be a proper compliance of laws applicable in
organization which helps to women by eliminating the sexual assault within the organization by
which increases the women interaction as the work development (Kostal and Shah., 2021). As
above points are highlighted for the National Health Services company favor of gender equality.
Approaches for better Discharge in National Health care:
 To prevents better hiring enhancement: For NHS management or Human resource
team need to bring potential and discipline candidate that they hire better candidates
who have proper nursing type of skills and attributes to manage overall hospitality
services.
 Effective leadership roles towards men and women in workplace as it enhance
various time of men’s supposed to be leader through which it having aim to seems
proactive and productive for a reason. It is important to having leadership quality in
National Health Service as it improves employees skills and abilities in better
manner.
 Provide equality opportunities as well as pay structure that would reduce the
negativity factor of biasness. For National health Service their management team
need to must focus on their better roles and responsibilities to facilitates equal work
and pay wages on the basis of job role.
 To provide importance better work life balance by maintain personal and
professional life goals. In health care as staffs need to contribute their 24 hours
duties to serving patients and manage other health service requirements in better

manner. In perspective of women, it is hard to manage the work life and
professional life where they have to face some challenges in context of childcare,
personal homecare etc which can create barrier into their professional work by
which they get distracted or somehow they try to maintain the work life balance.
Work life balance is considered to be a vital aspects of healthy work environment,
maintaining a proper work life balance which helps minimize stress level in the
workplace. For the National Health Services company the above discussion are
generates the gender equality development in the organization by which it enhanced
the work productivity.
Ways to improve quality in Discharge Service within health care aspect.
Improving discharge service health care quality enhance both internal and external level of
systematic changes which delivers better systematic individual physician towards better
practise for their patients. Furthermore, the chance of development of health care through
better quality which is having greater transparency which require practise to accessible for
enhance better provide resources to patients care in better manner. There are main steps
which demonstrate about National Health Care are:
 Gather patients information: It is one of important aspect which helps to mange better
improving discharge service quality about to care to organisation. For further analysation
it is provide better work outcomes on the basis of health care development. for collecting
information of patients and their visitor enhance more opportunities to develop the
infrastructure and more aspects.
 Setting goals and objectives: This is provide better work in health care service where it
need particular goals and objective that enhance clarity to attain for growth (Navathe and
et. al, 2020). By examine of goals and objective is allows to National Health Service for
motivates their employees and other staff to create better work improvement in discharge
service in health care perspective.
 Improve about access to care that having single most important factor to create better
quality healthcare and patients customer outcomes. Patients that must have to analyse
proper care on the basis of utilisation of medical resource in better manner.