An Analysis of Quality Management in Health and Social Care (RUH Bath)

This report examines quality management within the health and social care sector, focusing on the perspectives of various stakeholders, including internal and external agencies like the Care Quality Commission and the Social Care Institute for Excellence. It analyzes the role of external agencies in setting standards and the impact of poor service quality on stakeholders. The report details existing quality standards such as ISO 9000/14000, PS 9000, and TL 9000, and explores different approaches for implementing quality systems, including TQM, Quality Control, CQI, and Quality Assurance, with an emphasis on the Royal United Hospital Bath. It also identifies potential barriers to delivering quality services, such as lack of resources, leadership deficiencies, inadequate training, and cynicism. Furthermore, the report evaluates the effectiveness of systems, policies, and procedures, the factors influencing quality achievement, and methods for improving quality. Finally, it assesses methods for examining service quality from external and internal perspectives and the impact of involving users on service quality.

Managing Quality in Health and
Social Care
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Table of Contents
INTRODUCTION...........................................................................................................................3
TASK 1............................................................................................................................................3
1.1. Perspectives that stakeholders in health and social care have regarding quality.................3
1.2 Analyse the role of external agencies in setting standards ..................................................4
1.3 Impact of poor service quality on health and social care stakeholders..................................5
TASK 2............................................................................................................................................5
2.1 standards which exist in health and social care.....................................................................5
2.2. Use of different approaches for implementing quality systems...........................................6
2.3. Potential barriers in delivering quality services. ..................................................................7
TASK 3............................................................................................................................................8
3.1. Effectiveness of systems, policies and procedures...............................................................8
3.2. Factors that influence the achievement of quality................................................................9
3.3.Methods in which quality in health and social care can be improved...................................9
TASK 4..........................................................................................................................................10
4.1.Evaluate methods for examining service quality with regards to external and internal
perspectives. ..............................................................................................................................10
4.2.Impact of involving users on service quality. ....................................................................11
CONCLUSION..............................................................................................................................11
...................................................................................................................................................12
REFERENCES................................................................................................................................1
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INTRODUCTION
Quality refers to features or characteristics of product/services which has ability to satisfy
the need of it users. It is an essential element in health and social care sector. It is important to
both users of health and social care services and external holders. This report discusses about
perspectives of quality in relation to this sector. Strategies for achieving quality and
methodologies in evaluating health and social care service quality. The Royal United Hospital
Bath is a foundation Trust that runs the Royal United Hospitals for Rheumatic Diseases. It was
established in year 1932.
TASK 1
1.1. Perspectives that stakeholders in health and social care have regarding quality.
Quality standard is a detail of specification, requirements, various guidelines and
characteristics to meet its quality and the purpose of services. The stakeholders refer to group
who have power towards firm. Stakeholders are of two types, external and Internal.
In UK, there is an organisation Health and Personal Services (HSC)that applied a
statutory duty of quality and every organisation whether big or small needs to ensure that
services they provides must meet the standard set by HSC (Bowling, 2014). Further, there is an
independent organisation, i.e. Care Quality Commission that inspects the quality within Health
and social care.
The perspective of external stakeholder regarding quality is:
 To maintain accurate records of patients treated by The Royal United Hospital Bath
 Protection of people from unsafe or inappropriate care and treatments
 The Royal United Hospital Bath must have quality checking systems within their
hospitals to ensure safety, health and welfare of people.
 Hospital must keep the medical records safe and confidential.
 The amount of money and resources hospitals are spending is also viewed by Care
quality Commission.
 It inspects how staff and doctors of hospital communicate with their patients and clients.
The perspectives of internal stakeholders regarding quality are as follows:
 Employees view quality through budget i.e. employers effectively employing budget and
retaining employees.
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 It judges effectiveness of HR. professional on howthey resolve issues and conflicts that
arise within hospitals.
 The clients of hospitals view quality through facilities, hygiene, doctor's support and data
protection.
1.2 Analyse the role of external agencies in setting standards
In setting standards of hospitals, external agencies play a vital role. These agencies
include Government, ministerial department and government agencies.
In UK, there are many health regulatory bodies that set standards to be followed by every
hospital, clinic, organisation and care home, who is involved in health and social care services.
They set a benchmark to inspect and measure the quality standards. These external agencies
conduct regular inspection and tests like sanitization, safety and equipments. They offer training
to staff members on how to improvise the quality of services. Further, these organisations have
updated care system to assist care providers and advice to maintain public health (Braun and et.
al., 2013).
Most of these external agencies work in partnership with each other to ensure that
everything is aligned and balanced when it comes to hospitals and organisation. This helps The
Royal United Hospital Bath to measure their quality standards accordingly. Further, these
organisations help employees and people with research findings on current health issues and
methods to fill responsibilities of occupational health problems.
There are certain external agencies like;
 Care quality Commission: This is an independent regulatory body in health and social
care in England. It assists care homes and organisations within this sector by conducting
inspection and regulatory services. They provide guidance on how to conduct each kind
of service within hospital and nursing care to achieve quality services. Further, Care
Quality Commission safeguards interests of people by setting fundamental standards to
be followed by organisation in health and social care sector.
 Social Care Institute for Excellence: It is a UK based charity organisation that
improvised lives of people and users of care services, by sharing knowledge about what
practices can work. They identify and spread knowledge about good practices to
workforce in social care.
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 National Care Institute for Excellence: It sets standards and runs national database to
enhance healthcare services. Further, this organisation provides guidance on how to fight
certain diseases like Influenza, brain tumour and Rheumatoid arthritis.
Thus, The Royal United Hospital Bath trust can take guidance on how to improvised there
quality services. Further, compliance to these organisations helps hospital from legal proceedings
and fosters healthy public relation (Cameron and et. al., 2014)
1.3 Impact of poor service quality on health and social care stakeholders
Quality is an essential aspect in health and social care services. The impact of poor
quality affects the working of organisation and health of patients within hospitals. This can be
viewed as follows;
 The needs of patients will be left unfulfilled as services are not accurate to meet needs.
 Issues such as developing bed management, checking patients’ safety and record and
certifying them, etc. will arise due to poor quality.
 Poor quality will risk the health and safety of patients.
 Further, poor quality service management will lead organisation to legal proceedings
which destroy the image of hospitals.
 The Royal United Hospital Bath has to face tough consequences because of its poor
quality services management.
 Further, hospitals will not be able to handle any emergency cases during the time of any
calamities or national issues (Drummond and et. al., 2015)
TASK 2
2.1 standards which exist in health and social care
There are certain standards that exist within health and social care to measure quality of
services. Quality standards are developed independently and in collaboration with health and
social care professionals, practitioners and service users.
These standards are as follows: ISO 9000/14000: This standard is used to ensure that supply and manufacturers of all
products/ services are safer, efficient and cleaner so that consumers get standard quality
of services/products. It sets out international standards on quality management and
assurance. It safeguards consumer and buyers of products and services.
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 PS 9000: It is an application of standard for Pharmaceutical Packaging Materials. The
PS 9000 make sure that all pharmaceutical materials are safe for consumers. It assures
that risk are avoided in purchasing pharmaceutical and drugs. Further, users are
guaranteed for genuine material used.
 TL 9000: It assures global telecommunications' quality and industry wise performance
excellence. Thus, it requires hospitals to have assurance to this standard because
telecommunications are widely used in health and social care sector (Gallan and et. al., ,
2013).
Further quality of services can be measured by other ways i.e.:
 Effectiveness: The effectiveness refers to how staff members, doctors, surgeon, etc.
provide effective services to patients. It is required to measure quality as it shows the
extent to which targeted problems are solved and objectives or goals of firm are achieved.
 Safety: The term is used in health and social care sector to reduce the risk of unnecessary
harm to a minimum level. Safe environment ensures that hospitals or organisation are
providing quality services. This is because strong team will reduce infection rate, ensures
strong line of communications within hospital staff and patients and prevent mistakes.
 Timeliness: In a health care timeliness means that system capacity to provide care
quickly after need of patients is recognised. Timely delivery of appropriate services can
reduce mortality for chronic conditions (Measuring quality of health care in the NHS:
Giving a voice to the patients.2017).
The Royal United Hospital Bath can use these standards to formulate and measure the
quality within their hospital. It can use these standards to take necessary range of actions and
improvised their health and record management.
2.2. Use of different approaches for implementing quality systems.
The increasing awareness and concern for improving quality and about cost and
appropriateness within health and social care sector has led to implementation of quality system
in health care field. Quality management or system seeks to improve effectiveness and increase
patients satisfaction regarding services. There are various quality management system that can be
used by organisation and hospitals like; TQM, Quality Control, CQI and Quality Assurance. To
implement these approaches within The Royal United Hospital Bath starts from:
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 There must be effective and efficient staff to perform each function and provide adequate
and needed services.
 The Royal United Hospital Bath need to have right staff or group of people to perform
designated job. ]
 The staff need to be flexible and adaptable to different situation. It s an essential feature
that need to be there because the hospital deals with different kinds of patients and
clients.
 The Royal United Hospital Bath manager and BOD must comply to practice and code of
conduct within their field.
 Further, The Royal United Hospital Bath has introduced “rolled out for use across the
trust”. This means that hospital is introducing new system for recording and evaluating
safety of patients.
 They want to promote “use of the fluid intake and output / fluid balance charts” through
awareness session and workshops for staff members and patients.
 The Royal United Hospital Bath needs to conduct coaching and provide proper training
on how to improvised the existing services which is conduct by hospitals.
2.3. Potential barriers in delivering quality services.
There are innumerable barriers in providing quality services within health and social care
industry. The low adoption of quality standards and lack of concern is one of the most common
barrier within this sector. Other barriers are: Lack of Resources: The organisation needs to have adequate resources like; Employees,
time and money, etc. in order to maintain and meet quality standard. The Royal United
Hospital Bath lacks adequate resources in order to meet the quality standard set by Care
Quality Commission. Leadership: Lack of leadership within organisation creates barrier in delivering quality
standard. Leaders help in developing goals of organisation and provide accurate training
and development to achieve those objectives. Further, leaders concern about the wants of
all stakeholders who has power to influence working of The Royal United Hospital Bath.
Thus, effective leadership is required to maintain quality management (Lewis and West,
2014).
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 Training: The lack of trained employees hamper working of organisation. Employees
who do not have effective training on how to perform given job disrupts work of
hospitals and even when they are assigned to any team.
 Cynicism: The cynical employees will show more negative attitude when any changes
occurred within organisation. This creates hindrance in quality management as certain
group of employees or individual staff member do not allow to foster any change within
organisation. This attitude occurs among employees due to lack of trust between the co-
workers and managers. As employees think that these changes are extravagant and will
benefit only managers and not them (Zarei, Arab, Froushani, Rashidian and Tabatabaei,
2012).
TASK 3.
3.1. Effectiveness of systems, policies and procedures.
The effectiveness of having system, policies and procedures within health and social care
ensures that services offered is adhered to quality and standards set. These procedures and
system help by providing accurate and reliable guidance by conducting specific test and
inspection. Further, these system are there for long time. They are established and maintained by
tested by experience. The effectiveness of procedures, policies and system in quality
management is as follows;
 The use of electric risk management helps managers to evaluate risk within The Royal
United Hospital Bath.
 Procedures and guidance provided by different regulatory bodies in health and social care
sector help The Royal United Hospital Bath to evaluate there quality management and to
check the loop holes within their management system.
 These policies, system and procedures are always upgraded to meet current challenges
and requirements in the field of health and social care. This assist The Royal United
Hospital Bath to utilised concept of “rolled out for use across the trust”.
 The Royal United Hospital Bath has implemented system for assessing and checking
quality of services provided by trust. This was implement to check every part of trust.
 Further, the RUH implement Monitoring tool “ comfort round records” to test clients'
well-being needs. This was conducted for all the clients and patients of The Royal United
Hospital Bath (Murti, Deshpande and Srivastava, 2013).
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3.2. Factors that influence the achievement of quality.
There are numerous factors that influence in achieving target of quality services within
The Royal United Hospital Bath. They are: External Agencies: It is most crucial factor that assess The Royal United Hospital Bath
to achieve there desired quality. They provide help by setting standards and
benchmarking the quality check procedure and system. External agencies work on
finding methods to improve and train staff in workshops and seminars and equipped them
with more knowledge in impart better quality services to clients (Factors improving
Healthcare Service Quality.2018). Workforce: The role played by employees and staff members cannot be neglected as they
are will only help The Royal United Hospital Bath in achieving what they desired. It is
important that care takers, doctors and managers must build desired among them to
achieved and distribute quality services within their organisation.
 Quality Systems: These systems provides necessary guidance on how to managed quality
within organisation. They act as laws and govern every organisation in providing right
procedural methods that result in success in area of quality management. Further, they are
effective as it is been established on tested method (Penrod and et. al., 2012).
3.3.Methods in which quality in health and social care can be improved.
To improvised quality in health and social care sector. The Royal United Hospital Bath
can use followings methods or ways: Customer Service: The improvement of quality can be achieved by setting high customer
services standard. Trained employees and staff members to effectively address to needs
and requirements of customers or patients. Strengthening supplier relation: The Royal United Hospital Bath should work on
building equally benefiting supplier relationship. Maintaining effective supplier
relationship will benefit trust as high quality of equipments increases customer
satisfaction. Process and Realistic Approach: The Royal United Hospital Bath needs to adopt
realistic approach and should accept mistakes and lacking of trust in providing quality
services. This would help to make faster decision on how to improvised the existing
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management of quality. Further, use of process approach would help management to
control and manage the process which makes up organisation system.
 Conduct surveys: The Royal United Hospital Bath needs to conduct surveys in order to
take reviews of clients about there service provided. Employees and staff members of
The Royal United Hospital Bath should also be included in these surveys. These
feedbacks would assist trust that what are the issues and where they can improvised.
TASK 4.
4.1.Evaluate methods for examining service quality with regards to external and internal
perspectives.
There are many ways through which service quality can be inspected from the
perspective of internal and external stakeholders. These are; Quality Audits: It is the process of systematic examination of quality system carried out
by an internal or external quality order. It is an on site verification activity like;
inspection or examination of a process or quality system. Customer Surveys: The Royal United Hospital Bath can conduct surveys with there
current and past patients in order to review quality of service provided by trust. They can
ask patients to review quality on basis of satisfaction they derived by using services of
The Royal United Hospital Bath. Quality Inspection: The aim of conducting inspection is to check and examine one or
more services characteristics. Quality control: This refers to set procedure through which organisation reviews the
quality of all factors involved in providing services (Zainuddin, Russell-Bennett and
Previte, 2013).
 Compliance to Standards: To check and evaluate quality procedure The Royal United
Hospital Bath can use quality standards like ISO 9000/14000, PS 9000, TL 9000. this
will help to assured that each products and equipments used are certified and standard.
Further, it will help to evaluate telecommunications' system within trust.
4.2.Impact of involving users on service quality.
National organisation such as, The Patient's Forum, Consumer in NHS research, The
Commission for Patient and Public involvement in Health were set up to help involve users
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carers in NHS service planning. The positive impact service user involvement in health care is as
follows:
 Users involvement can help in improving the quality of public health activities.
 Further, there are less chances of conflicts among users and carers.
 The benefit of involving users will help in transferring power to public from medical
professionals and policy makers. This would result in effectively formulating health care
policies.
 Involving users in service planning increases their commitment to understanding and
influencing issues and problems that affects them (User and Carer Involvement in
Service Planning. 2016).
The negative impact of service involvement is as follows:
 They do not poses technical knowledge required for implementing policies of health care.
 Involvement of users in research projects may result in time consuming and high cost of
that project.
 There are chances of getting negative comment purposefully from certain users.
Though, it is Important for The Royal United Hospital Bath to involved service users as they
provides necessary information regarding their needs and demands from trust. It shows the
satisfaction level of consumers.
CONCLUSION
This report concludes about importance of quality management in health and social care
organisation. There are several regulatory bodies who assist organisation within this sector on
how to maintain quality in services provided by them. Further, the report shows impact of poor
quality on stakeholders and different approaches in implementing quality system. The Royal
United Hospital Bath can implement various ways in which it can improve quality of services.
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