An Analysis of Quality Management in HSC at Royal United Hospital

This report analyzes quality management within the context of Health and Social Care (HSC), specifically focusing on the Royal United Hospital (RUH). It explores different perspectives on quality from various stakeholders and the role of external agencies like the Care Quality Commission (CQC) in setting standards. The report assesses the impact of poor service quality on stakeholders, examining standards of health and social care, approaches to implementing quality systems (benchmarking, TQM, quality control), and potential barriers to delivering quality services at RUH. It evaluates the effectiveness of systems, factors influencing quality, and suggests improvements. Methods for evaluating HSC services are discussed, including the impact of involving service users in the evaluation process. The report highlights the importance of patient satisfaction, staff perspectives, and technological advancements in maintaining and improving quality within healthcare settings. The report emphasizes on the role of planning, policies, and audits in enhancing service quality, which is a key aspect for students to grasp.

MANAGING QUALITY IN HSC
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TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
TASK 1............................................................................................................................................3
1.1 Understanding different perspectives of quality in relation to HSC................................3
1.2 Role of external agency in establishment of standards....................................................4
1.3 Assessing the impact of poor service quality on HSC stakeholder..................................5
TASK 2............................................................................................................................................6
2.1 Standards of health and social care..................................................................................6
2.2 Approaches for implementation of quality systems.........................................................7
2.3 Potential barriers for delivery of quality health and social care service at RUH.............8
TASK 3............................................................................................................................................9
3.1 Evaluating the effectiveness in systems of RUH.............................................................9
3.2 Factors leading to various influences in the achievement of quality................................9
3.3 Suggestions for improvement in quality.........................................................................10
TASK 4..........................................................................................................................................10
4.1 Evaluating methods for evaluating HSC services..........................................................10
4.2 Discussing the impact of involving users of services in the evaluation process............11
CONCLUSION..............................................................................................................................11
REFERENCES..............................................................................................................................12
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INTRODUCTION
Maintenance of quality in health and social care services is an important aspect that is to
be considered by all. It is highly important for both the users of health and social care services
and external stakeholders as well. This aspect might be interpreted differently by different
people. The differing perspectives are clearly highlighted in the report. The strategies that can be
applied for attaining quality in health and social care services is also outlined in the following
report. Along-with the involvement of users of services, the significance to address the
requirement of external regulatory bodies is also shown. Lastly, the methods that can be
employed for the assessment of different quality perspectives and ability for evaluating such
methods against the service objectives are discussed in detail.
TASK 1
1.1 Understanding different perspectives of quality in relation to HSC
There are many stakeholders that a health and social care organization needs to recognize
to a great level. Each of them has their own perspective to the term regarding quality of services.
Their perception of term quality and its view point on it is of great significance to the
organization (Wonderlich, 2007). The bodies such as Care Quality Commission have expected
all quality related standards and principles that are specifying the quality maintenance by those
who are involved in services. According to senior nursing staff, it was difficult for them to know
what was being delivered by the lower staff. The perspectives of different stakeholders are-1. Conformance- Conformance criteria are specifically identified standards by every
organization. The aim of these criteria is to measure whether the standards have been
successfully implemented by an organization or not. Such criteria are measured at the end
of the completion of task. In the current report, Royal United Hospital Bath NHS trust
needs to adopt these criteria that fit to the needs of patients as well as the firms ( Kwak
and Anbari, 2006).2. Perception of staff- Staff members are the ones who are delivering the adequate services.
They must look on providing the quality of services. For enhancement in the standards of
operations of staff members, they must undertake the efforts to improve their quality of
services.
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3. SERVQUAL- This is the model of quality management which has been developed by
Zeithaml, Parasuraman and Berry to measure the level of quality of services. Such model
has highlighted the key components of esteem qualitative services that are stated by
healthcare services.4. Quality Audit- This is a process that indicates a systematic examination of a quality
system which is carried out by either an internal or external quality auditor (Perera and
Kuruppuarachchi, 2010). The hospitals have been undertaking informal spot checks on an
ad-hoc basis.5. Technical quality- This is closely related to technology which is employed within health
care setting. Effective utilization of technical services makes the staff member's work in a
more convenient manner. Technological models are required to gather the information in
relation to client and their problems. Assistive technology has been introduced after the
incident where a patient had left their ward unattended.
6. Functional quality- Functioning of staff members is truly critical as it has to keep on
understanding the type of problem that persists with the patients.
1.2 Role of external agency in establishment of standards
With an aim to measure the level of quality of services rendered by Royal United
Hospital Bath NHS trust, there persists a number of external agencies who have played a crucial
role in setting up of standards for maintaining quality in services. Some of these external
agencies are-1. CQC (Care Quality commission) - Main aim of this body to check the quality of services
provided in health and social in UK. The key role played by this body is to assure that the
quality in service provided by the hospitals RUH are adequate and there is non-existence
of any complaints from the patients (Ricard, 2014). According to the commission, quality
of services provided must be safe, effective and highly qualitative.2. National institute for Clinical excellence- This is also an organizational body formed by
the UK government. Their main role is to assess the quality in efficiency of drugs and
treatments as and when provided. Simultaneously, it also provides the specified
guidelines on the way in which patients can receive optimum support services.
3. Health Service Commission Act 1993- It is an Act of the parliament of UK. Here, in this
act, a commissioner is appointed who provides confidential services. The key role of
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employing such commissioner is to support the enhancement in provisions of health and
services.
1.3 Assessing the impact of poor service quality on HSC stakeholder
The mentioned health-care setting, that is, Royal United Hospital Bath NHS trust,
different stakeholders have observed that the quality in their services is not satisfactory.
However, different methods can be used to assess the quality in services which are as follows:1. Outcomes: These are the last or terminating component which highlights the effect of
health care services on individual or patients who have been admitted for the treatment.
By measuring the difference between current and expected outcome on quality can be
ascertained. It incorporates the changes in patient's health status like mortality,
physiological measures along-with the perceptions towards health care and their
preferences (Vellnagel, 2013).
2. Patient contentment- It is another good way for assessing the quality of services which
are provided by the mentioned health care. It allows patients to personally make an
assessment of both technical and interpersonal attributes of those staff members that are
performing their care.
The underlying quality issues are resulting in RUH during inspection. Some of these
issues were-
1. The elderly people wards showed instances of the way in which patient's dignity and
privacy was not maintained.
2. Risk was persisting for inappropriate or unsafe care (Hasson, 2010).
3. Inadequacy in appropriate inspection on the monitoring of fluid balance and hydration
records.
Monitoring is required for keeping on the check onto poor services so provided by the
health care to different stakeholders
Rendering poor qualitative services by the staff members of RUH facility care leave a
great impact on the stakeholders. There are numerous stakeholders of hospital like government,
suppliers and competitors. The key stakeholder of a hospital is their patients who get extremely
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disappointed by the level of services rendered by the staff. This leads to a threat that the patients
due to resentment can shift themselves to other health care organization.
The poor level of services also leave an adverse impact on the organization resulting in
diminishing goodwill of economy and outsiders might not take the initiative to approach health
care systems of UK. The government can also issue a legalized notice to the hospital for
inadequacy in their efforts for meeting the maintenance of minimum standard for a stipulated
time period.
TASK 2
2.1 Standards of health and social care
In order to bring in improvements in quality of services in RUH Healthcare, there are
different kinds of standards which can be implemented or carried on by the manager with the
help of whom the operations in a firm are sustained. Some of them are explained below-
1. CQC standards- These focus on the fundamental standards which are person-centered
care, dignity and respect (equal treatment to all and privacy is provided as and when
demanded by patient), patient consent is undertaken, adequate provisions are set to
provide safety, safeguarding from the abuses like neglect, good governance etc.
2. Code of Practice for social care workers- each person is required to be treated with
equality, respect in diversity and differences in culture as well as values, support in
service users and carers etc. As social care it is important to recognize that service users
are required to undertake risks for themselves and others (Evans, Barer and Marmor,
2014).
3. NMC- their code shows that the professional standards that nurse and midwives must
withhold in order to get registered to practice in the UK.
4. Best practices- such principles are set forth to encourage people and health care
organization for undertaking decisions regarding its own personal life and managing risk
which is likely to occur. Herein, the management of RUH is required to permit all its staff
member to work in coordination with one another. Patients serving in such type of health-
care are independent on their own decision whether to undertake service from a particular
health care or not.
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2.2 Approaches for implementation of quality systems
There are different types of quality systems-
1. Bench-marking- This form of technique look upon the best practices of other firm
belonging to similar industry. With the help of this it can focus on its own trademark and
try to enhance their profitability margin. Herein, this case by undertaking improvement or
betterment in their quality of services, management of RUH require on addressing its best
state of services by comparison to its benchmark (Davies, Nutley and Mannion, 2011).
2. TQM- it is also another tool which has its key focus on the quality of services provided in
an organization. It is not easy to measure the standard of quality in a health care but the
level of satisfaction of the patients can ascertained by the firm by gathering their
perspectives from external sources.
3. Quality Control- it is a procedure or set of the procedure whereby a quality criterion are
determined (Kaplan and et. al., 2010). The methods are intended to ensure that a
performed services are adhering to a defined set of quality.
The following are the approaches which are meant to implement the above quality systems-
1. Planning- in today's era, no organization is capable to run their business operations
without an improper planning. This aspect is the most crucial for a business and as per
the case of caring staff in a health care. It turns out to be very important because it is
associated to enhancement in the services for most accurate planning by way of executing
operations properly.
2. Policies and procedures- through continued policies by the management of RUH, the
staff working within the organization will have to abide themselves by it. The policies
framed by the RUH should be in tune with both health care and their patients (Pang,
2003).
3. Audit- this is a form of inspection which is conducted either by the organization
themselves or by some other institution. The audit allows organization to acknowledge
about those areas where the staff is lacking and areas where patients are feeling
discontentment towards the organization.
The application of above approaches will assist RUH to enhance its standards in quality
of services. The non-compliance of these approaches will result in degradation in goodwill of the
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hospital. The best approach is the audit through which company can find the loop holes and
internal auditor can help in identification of the problems from the root cause.
2.3 Potential barriers for delivery of quality health and social care service at RUH
In a health care, organization there is numerous bodies which signify its importance and
have a role to play within the organization. The management of firm faces various external as
well as internal barriers causing hindrances in their workings.
Some of internal and external factors that have an impact on the quality standard of RUH are as
follows-
Internal Factor
1. Risky resources- the resources used show an indication towards the tools and equipment
being employed by RUH for the treatments. Barrier in this reference refer to that if any
caretaker or staff member commit a slight mistake in using them, it can turn out to be
very costly for both the patient and the caretaker (Vogeli and et. al., 2007).
2. Organizational structure- the structure of the organization must be constituted safe and
without any risks, the environmental conditions state that wherein patients are feeling
treated hazardously. In various cases it has been seen that patients feel discomfort in
health care due to a blistering structure at workplace.
3. Interactions between staff- in a health care, only those people come who are having some
sort of mental or physical disability. In such a case new staff appointed might feel that
patients aren't interactive enough or they find difficulty in evaluating patient's problems.
External factor
1. Inter-agency interactions- theses refer to interaction of firm with other external or non-
governmental bodies who play a specific role in the operation of the business. Also, the
cited firm is unable to undertake steps without the appropriate interaction or
communication with them (Strunk and Reschovsky, 2002).
2. Social policies-there are some social norms that needs to be fulfilled by RUH, this will
help them serve their patients with effectiveness. Providing patients with care is difficuly
in itself and on top of it taking due care of the various social norms make it even more
difficult for organizations to comply with.
3. Legislation- RUH is a health and care organization therefore it is quite obvious to have a
interference of various legislation to play a part in the policy formations. The constant
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changes in rules and regulations can lead to constant hindered in the organizational
sworkings.
TASK 3
3.1 Evaluating the effectiveness in systems of RUH
There are key techniques which are given for drawing effectiveness of the systems,
policies and procedures which are undertaken by RUH sector-
1. TQM (Total Quality Management)- in the modernized era, under-developed and poor
quality in delivering high quality services in health care sector turns out to be very
difficult. Therefore, westernized cultures have introduced TQM technique by which
overall enhancement in the services of staff member can be attained that to at a lowered
cost (Savage and Scott, 2004).
2. Continuous Quality Improvement- this is a process whereby manager ensures that the
firm whose operations are systematically and intentionally being improved and increasing
favorable outcomes in favor of patients can be recorded. This method also calls in for
identification of problems, implementation and monitoring of corrective actions can be
gained.
3. Prevention of problems- It is so indirect way of enhancing quality in the services so
specified in the health-care. By keeping proper inspection of different areas staffs are able
to continuously inspect the various mistakes and areas where the high amount of costs is
being spent indirectly leading to overall improvement in the quality of services.
3.2 Factors leading to various influences in the achievement of quality
There are various numbers of factor which play a major role in influencing the quality of
services in a health care. In the current scenario of RUH health care is suffering from major
quality issues. In order to improve their quality of services following factors have been inserted-
1. NHS trust- Such form of trust was established under the National Health Service and
Community Care Act 1990. The key advantages of this form of trust is that all staff,
patients and other caretakers are free to get involved in the activities of firm.
2. Local authority social care service- there are different people who have been recognized
to be those who lead themselves completely a free life and such people require support
and emotional care (Negi, 2000). In such a case local authority has provided assistance to
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disabled people by providing specific equipment to which they can adapt themselves
easily.
3.3 Suggestions for improvement in quality
The recommendations are as follows-
1. The top management and staff can enhance its quality by rendering services through
drawing focus on the patient problem and by treating them in accordance with their
comfort. As a result, patient’s satisfaction is gained easily.
2. The quality of operation is also enhanced by firm by providing them with more valuable
offers. This encouragement provided patient and make them realize the sort of
importance.
3. The value of firm can also be increased among the staff through motivation and
encouragement. The engagement of staff with complete satisfaction can help in
delivering them effective services.
TASK 4
4.1 Evaluating methods for evaluating HSC services
The evaluation f health and social care services is very crucial and significant part of the
developing the quality of services within the companies. These measures help the organization in
attaining high impact on the growth and development of the companies. Both internal and
external means of evaluation helps in developing an effective impact on the growth and
development of organization.
This is a measure which helps the companies in creating an effective impact on Royal
United Hospital has implemented the following measures in order to carry out the internal
evaluation program. The measures adopted by the organization are:
1. Questionnaire: RUH carry out an effective survey with the employees of the hospital in
order to analyze the needs and requirements of the company and problems that are being
faced by staff and patients (Aldine de Gruyter.Druss and et. al., 2009). Questionnaire is
treated as a prime method of recording individual’s suggestions in definite manner. The
major issue for conducting this measure is that it is a time consuming measure which
demands high level of time and resource implementation.
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2. Surveys: Focus group survey from the selected panel of employees of the company as
well as industrial experts is yet another measure of evaluation that the organization has
adopted. Under this measure RUH select a panel of doctors, investors and care takers in
order to analyze the needs and demands of the company. Under this, researcher will focus
on reviewing skilled employees as they emphasize on giving the best solution to
overcome the infectious disease. This measure creates an internal crises within the
company by creating an internal rift between employees thus minimizing the motivation
level of the employees.
3. Inspection agencies: These measures help the companies in creating an effective impact
of developing the service measures by taking the expert team advice. CQC seeks the
effective services of inspection agencies which focus on inspecting the organizational
activities on the basis of industrial norms and standards. This is useful way of creating
wide impact on organizational growth. However, this proves to be a costly measure for
the company (Singer and et. al., 2011).
4.2 Discussing the impact of involving users of services in the evaluation process
Service users are the ultimate consumers for RUH. These are the people who closely
examine the services of the organization in order to create an effective impact on overall
organization growth. Involvement of patients in the evaluation process of the entity helps in
building trust and loyalty for the unit (Malley, 2010). Moreover, patients are the effective
measures of analyzing the employee performance for the services. Evaluation patients’s needs
and demands helps RUH in developing a positive impact on growth of the unit by enhancing
competitiveness of the unit. It clearly helps in analyzing the positive and negative impact of
services on organizational growth and development.
CONCLUSION
In the report it can be articulated that quality in a health and social sector is an important
aspect. Without the aid of this firm cannot effectively run its operations. The perspective of
different stakeholders and value that it holds for an organization also holds of critical
importance. RUH have used different methods like bench-marking, TQM and quality control to
bring in enhancement in quality.
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