Analysis of Quality Management in Health and Social Care Settings

This report provides a detailed analysis of quality management within the context of health and social care, specifically referencing St. Thomas and Guy's Hospital. It begins by examining the diverse perspectives of stakeholders, including patients, healthcare professionals, and nurses, highlighting how their differing priorities shape their understanding of service quality. The report then explores the roles of external agencies like the Healthcare Inspectorate, Care Quality Commission (CQC), and Medicine and Healthcare Products Regulatory Agency (MHRA) in establishing and maintaining quality standards. It delves into the adverse effects of poor quality services on stakeholders, such as reduced funding and damage to organizational reputation. Furthermore, the report analyzes methods for maintaining quality, including the use of ISO standards, Good Manufacturing Practice (GMP), and national safety standards, alongside the evaluation of various quality management systems like Total Quality Management (TQM) and benchmarking. Finally, the report assesses both external and internal barriers that impede the delivery of quality care, offering suggestions for enhancing service quality within healthcare settings.

Managing Quality in
Health and Social care

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
TASK 1............................................................................................................................................1
1.1 Analysis of various perspectives of parties associated with the services. ............................1
1.2 Role of various external agencies in order to set up the standards........................................2
1.3 Major affect of poor quality services on stake holders.........................................................2
TASK 2............................................................................................................................................3
2.1 Maintaining the set objectives for the measurement of effective quality of facilities. .........3
2.2 Evaluation of various important methods..............................................................................4
2.3 Assessment of various issues that affects the services...........................................................5
TASK 3............................................................................................................................................6
3.1 Analysis of appropriateness of system ..................................................................................6
3.2 Assessment of various other components that impact on quality..........................................6
3.3 Providing various suggestions of ways to enhance quality..................................................7
TASK 4............................................................................................................................................8
4.1 Analysis of methods used to evaluate quality of service.......................................................8
4.2 Communication of impact that process of evaluation has on service quality........................9
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Stakeholders are the persons with an interest or having concern in something especially
related to the business. Along with this it is also known that stakeholders are the persons who are
involved in something and are effected by any action performed in the things they are involved.
The three important stakeholder in St. Thomas and Guy’s hospital are health care professionals,
nurses and patients (Stakeholders' roles and responsibilities regarding quality of care, 2016.).
TASK 1
1.1 Analysis of various perspectives of parties associated with the services.
Different stakeholders have variety of perspectives regarding the quality of health and
social care provided by St. Thomas and Guy’s hospital. The quality of health and social care is
depended on the type of care provided to different care receiver in order to improve their health
condition and quality of life. Many healthcare institutes tend to highlight the various types of
care provided by them in order to determine the quality of health and social care (Brett and et.al.,
2014). This generally includes focused attention on disease prevention strategies, punctuality of
service providers and stress on effective medical care and use of resources. As mentioned every
stakeholder have different perspective and while talking about perspective of the patients they
tend to define the quality of health and social care service as response to their needs and
fulfilment of them in order to achieve better quality care. Along with this they also desire the
continuity of efficient care services and strong interpersonal relation.
According to the perspectives of health care professionals such as doctors and physicians
for good quality of health and social care they mainly focus on skills required for provision
effective care to the patients. They determine the quality of health and social care on the basis of
knowledge and experience that particular physician or other health care professionals having.
And as per the perspectives of the nurses and midwives the quality of health and social care
completely depends on the focus, commitment and motivation that is carried by particular
employee while performing their duties in work place. And it is also thought that those nurses
working only fort the fulfilment of the job tends to leave the nursing profession when they get
some better opportunity with high money (Valentijn and et.al., 2013). Thus to provide the
patients with effective care that fulfil their all needs in order to lead a good quality life there is
need of St. Thomas and Guy’s hospital to fulfil the perspectives in order to provide a good
quality of care service.
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1.2 Role of various external agencies in order to set up the standards
There are various external agencies that play an important role by proving aid to St.
Thomas and Guy’s hospital to set up the standards of quality care. These agencies conduct
variety of inspections and audits regarding various aspects such as quality of nursing care,
sanitization in health care setup, availability of advanced equipment’s for conducting various
tests and safety measures and keep a check on implication of standards set by particular
institution. In case if any difference is found in quality during the process of inspection these
agencies take strict action along with the provision of intense training to healthcare professionals,
nurses, doctors and care takers. Few agencies that help in setting standard and their role: Healthcare Inspectorate: This agency tends to monitor and keep a check on all the
activities that are performed in healthcare setup. After completing the investigation
process this particular agency provides the health and social care hospitals with findings
gauge ratings that helps the administration to take steps to increase the facilities
(Hatziargyriou, 2014). Care Quality Commission: CQC also known as Care Quality Commission acts as an
individual body that regulates the health and social care institutions in England. In St.
Thomas and Guy’s hospital the CQC tends to ensure that all the care facilities that are
utilized in this particular hospital provides its user with safe, high quality and effective
services. Thus the important role of CQC is to encourage the St. Thomas and Guy’s
hospital for the improvement of quality of health and social care services.
 Medicine and Healthcare Products Regulatory Agency: It is a government agency
whose role is to ensure the quality of medicines used, working of care devices in safe and
acceptable manner in St. Thomas and Guy’s hospital. MHRA also ensure that quality of
social and health care in St. Thomas and Guy’s hospital is highly improves to fulfil the
demands to care receiver (Azevedo and et.al., 2013).
 Thus, from the above discussion it can be inferred that there are variety of external
agencies that play major function in the regulation of service and standards of quality in
health and social care settings.
1.3 Major effect of poor quality services on stakeholders
Poor quality services pose a hazardous effect on the health and social care stakeholders
which includes nurses, healthcare professionals, care providers and patients. Some of the adverse
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impacts includes: hinders the funding, spirit of care givers is reducing and most important is the
damage to the reputation of organisations (Brett and et.al., 2014). It also leads to poor decision
making procedures and reduction in the quality of care provided to the patients. As the first thing
that a patient looks in health care setting is the quality of care provided by them. There major
focus the advanced care for the problem they are dealing with and is worth for the money they
are spending for the particular care. Being a health care hospital the prime objective of the St.
Thomas and Guy’s hospital is to provide efficient services to the patients by the use of latest
technologies in order to improve the quality of life. But due to poor quality services the care
workers and nurses working in St. Thomas and Guy’s hospital lack confidence which leads to
low productivity. Thus it directly impacts the quality of care provided to the patients. Thus there
is need of provision of intense training to nurses and care workers in order to improve the
confidence among them to provide patients with best quality care (Millar and Hall, 2013).
Along with this there is need of proper management of funds and improvement in the
reporting process to improve the quality of services. As due to poor reporting process nurses are
not able to provide the patients with appropriate care and can pose threat to health of patients.
TASK 2
2.1 Maintaining the set objectives for the measurement of effective quality of facilities. Many standards are establishing by UK government in order to measure and achieve the
quality in health and social care in St. Thomas and Guy’s hospital. Few highly used
standards are given below: ISO 9000/14000, Good manufacturing practice (GMP), TL
9000, Federal standard 1037C, BS 5400, PS 9000, AS 9000 and many other targets.
These measures act as base for the health and social care settings and help in ensuring
them in with provision of quality care on the basis of these available standards (Streiner,
Norman and Cairney, 2015). These standards also help in the provision of effective and
timely services to the patients. Standards in case of St. Thomas and Guy’s hospital are
mentioned below: ISO Standards: These standards safeguard the consumers and buyer’s rights. Along with
these ISO standards also guarantee the continuous improvement in the quality of services
provided by health care settings in order to come up with desired outcome. Good Manufacturing Practice (GMP): GMP regulations focuses on safety approaches
and acknowledge companies in order to eliminate the chances of contamination that
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encourages customers to buy products that are not hazardous to health. This regulation
not only focuses on safety measures but also ensures the cleanliness, and equipment
verifications. National safety and quality health service standards: These standards focus on various
areas for providing good quality health and care services to individuals which includes:
governance for safety in health care organisations, forming a partnership with consumer
of care, controlling the infections in health related settings, medications, appropriate
clinical handover and effective response to clinical deteriorations in health care
organisations (Millar and Hall, 2013).
 Record Keeping Standard: Care quality commission introduced many standards and one
of them is record keeping standard that helps in ensuring the patients to get effective
treatment. Record keeping includes important information regarding the treatment
procedures, medical history and other information related to the provision of effective
care to the patients. Thus, these standards help in maintaining the records which can be
easily accessible when required.
2.2 Evaluation of various important methods
Various standards are discussed above for measuring the quality of services in health and
social care services. Thus there is need of understanding and evaluating different approaches that
are important for implementation of quality system. There are various approaches few of them
are mentioned below:
The first quality management system that can be implemented is Total quality management
(TQM) system. This management system is completely person focused and the major aim of this
system is complete satisfaction of the need of patients and provision of care standards to provide
value for their spent money (Van Boekel and et.al., 2013).
Second important approach is the effective communication to share the important
information among peers. It is important to ensure what kind of information is shared with
different working bodies such as professionals, nurses, care providers, mangers and other
important regulating bodies. And the feedback received form the different clients helps in
assuring the quality of services they provide.
The next important approach is importance of roles and responsibilities. The nurses play an
important role in the provision of effective care to the patients. Along with this the St. Thomas
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and Guy’s hospital also have the responsibility to support individuals and other working
professionals to perform their task in effective manner by coordination each other. Another
important quality system is the benchmarking system, in which the quality of care provided by
one organisation is compared with another famous healthcare setting. With the help of this
comparison procedure the organisation discovers many different trends and involve them in their
practice. Thus this will be helpful to healthcare settings in identification of the fields that require
improvements and meet all the demands of clients (Carayon and et.al., 2014).
2.3 Assessment of various issues that affects the services.
There are various external and internal barriers that hinders the proper delivery of quality
health and social care to the clients. Following are the external and internal barriers:
 External barriers: there are various barriers that are created by external factors
which hinders the St. Thomas and Guy’s hospital to achieve mentioned quality
standards. The first and the most important barrier is legislation. There are many
cases in which St. Thomas and Guy’s hospital faces many legal issues in provision of
some facilities. Thus these barriers affect the image of the hospitals along with the
quality of care that is provided to the patients. Several hospitals also receive the
warning letters after the inspection by CQC. Second important external barrier is
social policies.in order to provide the high quality services to the user’s safety is
promoted in the health care settings. In lack of certain social policies, the working
staff is not able to acquire the adequate skills and training that is necessary for the
improvement of quality of services provided (Glasby and Dickinson, 2014).
 Internal barriers: For maintaining the good quality of practice in the health care
setting there is need of a correct working staff with positive attitude towards work.
But in many cases the lack of this attitude and less communication leads to initiation
of internal barrier. There are several negative impacts of this barrier as working staff
doesn’t feel motivated and lack confidence while working in the practice area. Due
to lack of confidence and motivation the nurses and other working staff is not able to
provide the effective quality care to the patients in the hospitals.
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TASK 3
3.1 Analysis of appropriateness of system
In this analysis, suitability of systems, ways and methods have been used in achievement
of quality in the St Thomas and Guy’s hospital offered is significant as per the outcomes in
pursuing the appropriate path, better outcomes will be achieved in terms of quality services.
These systems, ways and strategies which are applied by them are considered as completely
tested by any other method like trial and error (Parekh and et.al., 2011). These types of systems
are obtained through the appropriate results of every hospital, where it applied effectively in
previous case. It has become very essential for the hospital to apply appropriate systems and they
also have responsibility to enhance the quality.
Apart from the first policy which was used in this scenario was safe wandering policy
which has implemented that helps on the ground of creating balance among the external and
internal legal arrangement or faculties of quality.
Total quality management: It is the most significant approach which is used by the St
Thomas and Guy’s hospital which involves development of strategies with the involves of
employee in order to get the set quality standards. This system is based on the 8 principles like
customer centred, strategic and systematic approach, participation of employees, making change
s and decision making (Cherry and Jacob, 2016). These principles will help the management of
hospital to provide effective services to their patients as well as reduction disease like dementia
that is caused due to unhealthy environment. It mainly includes resolving the issues and
increasing the areas which changes ways of departments. The types of management are mainly
focused on the person and aims to provide the satisfaction as well as standards of facilities in
health and social care for the patients which provides value to their money.
Along with this, the escalation procedures are also used by the hospital in order to
manage the time of waiting of patients. It has been clearly told by the senior staff that as per the
new factor provides major effect on assignment waiting time has been occurred then it majors
right of patients to notify it will lead consult that who will provide other doctor. It is therefore on
considering the suitability of the escalation procedure which has been found to be appropriate for
the service users. It is basically on considering the fact of assisting the users with a streamlined
process to help them complaining about any ill treatment occurred with them by the staff
members. It is basically on considering the existent situation of the present organisation who
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strictly follows London quality standards with a special consideration of handling cases related
to acute emergency and services related to maternity.
As per the case scenario, the London acute hospital have come with each other to share
the good practices on the change and improvements they have made in meeting the health and
social service quality standards for the acute medicine and emergency general surgery. These
hospitals are royal free, North Middlesex University, Kingston, The Whittington Hospital, St
Thomas’ and Homerton University hospital. The royal united hospital bath, service provider or
nurses of NHS provide care services to the users, Other than this, nurses also provides the
palliative care to the elder users, who are suffering from heart attack and cancer etc. Specific
policies and procedures and system scenario, within the hospitals is that quality health and social
care institutions are incorporated with the service providing organisations (Streiner, Norman and
Cairney, 2015). These organisations tend to achieve their goals through implementation of
various policies such as severe disease programs, providing better healthcare towards the service
users and providing health care benefits to the professionals and other technical staff. Thus, these
policies are effective in implementation of in home care as well as social care as these will
ensure the improvement of quality in Thomas's hospital Bath NHS trust.
3.2 Factors that are influencing the achievement of quality
For the achievement of success in task, it is essential to get any support along with the
accomplishment of task appropriately. In this, there various factors analysed that provides major
Influence on the health care organization in achievement of quality of services and attaining
positive response from the users. These major factors are described below:
 Funding: For providing the service, it is important for the organization to have
appropriate funding to provide quality service and facilities and having sufficient
resources (Reeves and et.al., 2011). For health care economic factors are the major
factors that have impact on the process of achieving the quality of products and services.
In present context, london acute hospital have stated that natural resources are limited
and process of improvement in quality and service require more resources.
It has raised the trust and causes important change effectively. The financial resources have
been utilized by Thomas and Guy’s hospital to support major changes and new ideas will
provide support to enhance the quality.
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 Expectation of service among users: It is also an important factor that clearly described
the rise in expectation of users that influence the organisation to enhance the quality of
facilities to meet their expectation. In the cited hospital, the management is also focusing
on analysing the various facilities which are provided by other health and social care
service firms to their users (Singer and et.al., 2011). It also uses various new effective
and innovative practices that creates a major influence the users and also provides them
satisfaction to improve the quality of services. It mainly involves large amount of
financial resources that means people want to consider them to work more effectively and
support the people of excellence. This major influence will move the organization
towards enhancing the quality of health care facilities and services.
 Quality system- It is known to play a crucial role in managing the quality of the services
offered by the cited enterprise. This is mainly because of its strict instruction in the form
of guidelines that are required to be followed by all organisational members. It together
involves policies that clearly defines right procedural methods for attaining success in
those areas that requires improvement for offering quality services to the users.
 Size and service mix: For maintain quality standards and effectiveness of service the size
of organisation and its service mix planning has major influence (Millar and Hall, 2013).
According case study, London acute hospitals along with the NHS are providing their
service in both rural and urban locations but the lack of skilled staff is effecting the
processes of achieving the quality in healthcare.
Moreover, these factors can influence the achievement of quality care standards in the Thomas's
hospital Bath NHS trust through the application of effective and prosperous quality systems,
generally include the requirement to work towards the effective performance level. Company's
which are operating without setting the standards, will fail to accomplish their objectives because
of poor internal control system.
3.3 Providing various suggestions of ways to enhance quality.
For the enhancing the quality, it is essential to find out the problems that affects the
reputation of hospital among its users. In this scenario, there are some problems have been faced
by hospital which are very critical and creates problems for them to manage their operations. In
some cases, it has been found that patients are not treated well by the service providers or staff.
They have not maintained the dignity and there is also requirement of training for staff as they
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not have the complete knowledge of handling the patients (Kocher and Adashi, 2011). They have
also required to learn the aspects to maintain the safety while treating the children and patients
under serious conditions. This issues of hospital can make a huge difference is getting the quality
of services. There is major requirement for hospital to ensure the safety, effectiveness and
availability of qualified employee in hospital. There is also a requirement of availability of high
quality services so that it will reduce the issues and problems faced by patients.
The capability and efficiency of the workforce at the Thomas's hospital has reduced to the
vast level because of the overcrowding. Additionally, the service users of the hospital also have
to wait in queue. The facilities at the care home was almost full and extra beds were also
occupied which has resulted in the problems in the home care (Brett and et.al., 2014). The major
issue of hospital was lack of staff members as well as the lack of equipments due to which
hospital was facing difficulties in admitting the new users and because of overcrowded the
management of the care was not able to maintain the quality. Above discussed issues are
identified and removed through implementation a comprehensive approach along with the
palliative approach due to requirements. These approaches will be supportive in increasing
demand of the workforce which can be fulfilled. Apart, Thomas's hospital needs to upgrade its
system of technology in make its working more efficient. Just because of this company may be
required to expand its premises and infrastructure as well.
TASK 4
4.1 Analysis of methods used to evaluate quality of service.
For the assessing effectiveness of quality of service, it is significant to use the surveys
and questionnaires that provides helps in understanding the perceptive of different service users
and providers and commission.
Based on the study method, following outcomes were gained that the perception of work-
person depends upon the mode of reasoning, experience, belief and results they have gained
through previous healthcare. The quality depends on the services that affected person will
receive, behaviour of health facility members, their self-respect, circumspection and condition
(Nwabueze, 2011). If members of the health safety are providing these services, they there are
chances that health safety can be improved at that area. For the cited health facility, it has been
considered that indicators that provide safety to patient’s life were not in appropriate manner or
decreased. Patients have to wait for the surgery as well as electoral medical procedure operations
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were not carried out. Such activities lead to negative viewpoint on people about the quality and
removes trust. Another example, can be considered which shows that the St Thomas and Guy’s
hospital are not able to meet personal requirements of users of their services and there are also
lack of some instruments and medical devices and accessibility of qualified expert doctors make
comfort among patients. Hence, in order to improve the quality services, health members have to
provide greater safety, effective and efficient medical care and instruments. Surveys and
feedbacks helps the hospital to make changes of state of condition and motives. Such knowledge
can be used by the authorities to improve hospitality function and operation.
4.2 Communication of impact that process of evaluation has on service quality.
In present scenario, the users are involved in all aspects of design and delivery of service.
Their response is considered as essential to improve the design and effective measures they are
utilizing in their day to day activities. In this context, St Thomas and Guy’s hospital their people
try to improve the services and bring equality as-well-as favourable healthcare instruments.
(Cherry and Jacob, 2016). Further, they were trying to improve the treatment level of the
students through adopting the new inspection and regulation by doctors. They are getting their
services updated after consulting with NHS and other trusts to provide satisfaction to the patients
and fulfill their needs. Along with this, through appropriate decision, various instruments, staff
members and with the help of media they are going to make modification in the current system.
Besides this, the case shows that professionals were unable to gain about the record system
which is essential part of the healthcare system. There were also some senior members that were
not showing any interest for making any improvements and services users.
CONCLUSION
In this report, it has been concluded that stakeholders are the persons with an interest or
having concern in something especially related to the business. According to the perspectives of
health care professionals such as doctors and physicians for good quality of health and social
care they mainly focus on skills required for provision effective care to the patients. Managing
the quality in healthcare, it is essential that government should provide support to the institutions
to develop appropriate facilities for users and also provide appropriate funding. At last, it is also
analysed that CQC plays a significant role in providing helps to the institutions in resolving
issues through development of appropriate services.
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REFERENCES
Books and journals
Nwabueze, U., 2011. Implementing TQM in healthcare: The critical leadership traits. Total
Quality Management. 22(3). pp.331-343.
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