Analysis of Quality Management in Health and Social Care at RUH Bath

This report provides a comprehensive analysis of quality management within the context of health and social care, specifically focusing on the Royal United Hospital Bath NHS Trust. It explores the perspectives of various stakeholders, including service users, external agencies like the Care Quality Commission, government authorities, and the board of directors, regarding quality of service. The report examines the impact of poor service quality on stakeholders, highlighting the importance of stakeholder involvement and the role of external agencies in setting and enforcing standards. It also delves into potential barriers to delivering high-quality services, such as internal resource limitations and external legislative constraints. Furthermore, the report discusses different approaches to implementing quality systems, including staff training, planning, and feedback collection. Finally, it assesses existing standards for measuring quality within the organization and methods for evaluating quality from both external and internal perspectives, emphasizing the significance of involving service users in the evaluation process to improve patient outcomes and overall service quality.

Managing Quality in Health
in Health and Social Care

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
1.1 Perspectives of stakeholders regarding quality................................................................1
1.2 Impact of poor service quality on stakeholders................................................................2
1.3 Role of external agencies for setting standards................................................................3
2.1 Potential barriers to deliver better quality of service........................................................3
2.2 Different approaches for implementing quality systems..................................................4
2.3 Existing standards for measuring quality in organisation................................................6
PART 2............................................................................................................................................7
3.1 Factors influencing achievement of quality.....................................................................7
3.2 Effectiveness of systems, policies and procedures used to achieve quality in services...8
3.3 Ways to improve quality..................................................................................................8
4.1 Methods for evaluating quality with regards to external and internal perspectives.........9
4.2 Impact of involving service users to evaluate process on quality of service..................10
CONCLUSION .............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Managing quality in health refers to improve effectiveness of treatment and increase
satisfaction of patient with medical facilities. It involves the criteria of conducting medication
process with applying efficient techniques or strategies in order to boost up patient outcomes in
appropriate manner. Moreover, it is necessary to increase effectiveness of medications with
affordable cost so that every person can get health services easily. (Aveyard, 2014). The present
report is based on Royal United Hospital Bath NHS Trust which provide acute treatment to
people in Bath and its surrounding towns & villages. It renders health services and care to needy
people and solve their relevant problems properly. This assignment will focus on perspectives of
stakeholders regarding quality and role of external agencies to set standards. It will also include
different approaches to implement quality and factors influencing achievement quality. The
impact of involving users of services in evaluation process on service quality is given below.
PART 1
1.1 Perspectives of stakeholders regarding quality
The quality is necessary to be improved because effectiveness of treatment process is
responsible for providing appropriate care in order to make patient well being. It is necessary to
conduct meetings or discussion with different stakeholders before applying required policies and
practices for increasing quality of medical facilities. In case of Royal United Hospital, they have
various stakeholders who are required to involve in discussion regarding increasing quality
which are given below –
Service users – This can be described as patients and their family members as they get
actual outcomes of efforts contributed by health care organisations. It is necessary to analyse
problems faced by patients which helps to implement correct techniques and practices in order to
provide appropriate quality in facilities to fulfil their needs accurately (Cherry and Jacob, 2016).
The Royal United Hospital should take suggestions and feedbacks from service users which
facilitate to make proper changes to achieve quality in facilities.
External agencies – The external agencies refers to such organisation which conduct
inspection and monitor operations of hospitals along with setting standards of practices as well.
In context of Royal United Hospital, the Care Quality Commission (CQC) conduct inspection to
make sure that desired codes of practices are followed or not. Moreover, CQC has perspective to
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provide desired guidelines for given hospital to provide medication appropriately and ensure the
same by carrying out inspection.
Government authorities – This can be explained about government authorities who
made several rules and regulations which are mandatory to be followed while making effective
policies or practices for improving quality of services. The Royal United Hospital make sure to
obey every legal regulation while establishing new policy to increase patient outcomes as it
facilitate to perform through correct path. The perspective of government authorities include to
solve problems of people take legal actions towards hospitals for their inappropriate attempt with
patients and their family members.
Board of directors – The broad of directors have an authority to make final decisions
with mutual understanding as they think about welfare of employees, service users, organisations
and stakeholders (Glasby and Dickinson, 2014). In case of Royal United Hospital is required to
make appropriate decision for applying fresh innovative techniques or practices in terms of
improving quality of medical services. They have perspective to
1.2 Impact of poor service quality on stakeholders
The stakeholders are responsible for putting their efforts in terms of resources, hard work
and capital to earn required profits of organisation. It involves that overall profits of hospital
will ensure their amount of benefit achieved by them for their actual efforts. However, poor
service quality will results into reduce in number of service users. It will decrease goodwill of
organisation which is responsible declining profit of organisation. Profitability decides about
benefits gained by stakeholders and if Royal United Hospital face loss then it will impacts on
benefits of stakeholders as well.
Profit return for stakeholders – This involves that overall profitability decide
compensation and benefits of stakeholders according to loss or profits faced by hospital (Glasby,
2017). Employees compensation, shareholder's rate of return and amount of taxation to
government depends upon profits achieved by Royal United Hospital.
Reduce brand image of hospital – The poor quality of services will results due to
mismanagement of funds, poor practices or procedures and improper reporting about patients on
daily basis. In context of Royal United Hospital, these problems will responsible for increasing
cost of operations and reduce profit margin. Moreover, poor services of hospital create
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complicated medical situations of patients due to which they starts preferring other healthcare
organisations in future which decline growth of Royal United Hospital.
In context of given case study about Royal United Hospital, stakeholder including
employees, board of directors and owner should focus on strategies which can improve quality of
services. It involves risk management, assure health, patient's records and safety of people which
helps to gain satisfaction of customers. Moreover, it is helpful to increase profits of organisations
which facilitate to improve profit return of stakeholders.
1.3 Role of external agencies for setting standards
There are several external agencies which plays an important role to monitor practices
and procedures of hospitals for welfare of people. For example, Care Quality Commission
(CQC) conduct inspection in Royal United Hospital to monitor their records, procedures and
other aspects which are essential to provide appropriate care to needy individuals. However, such
external agencies have a role to set standards of practices which are mandatory to be followed by
every healthcare organisations (Brownson, 2017).
Conduct inspections – This involves to conduct inspection of different care homes and
hospitals to monitor various aspects such as fluid balance records, other information of patients,
quality checking systems and their safety & confidentiality. In case of Royal United Hospital,
Care Quality Commission provide notice of inspection and then visit there to evaluate care
practices and patient records appropriately.
Set standards of practice – The external agencies plays an important role to set
standards of practices by considering legal rules, ethical norms and priorities or providing
appropriate care to patients fort their well being. The Royal United Hospital are required to
follow all the codes of practices set by CQC in order to render correct treatment to people.
Ensure effectiveness of medicines and devices – The medicines, electronic devices or
equipments and other medical products are also evaluated by external agencies. It is necessary
for Royal United Hospital to utilise appropriate devices, equipments, medicines, clinical products
and other machines as per direction of CQC to gain desired outcomes in healthcare.
2.1 Potential barriers to deliver better quality of service
The better quality services should be delivered by healthcare organisations because a
minor mistake may create complications or may leads to death of patient. It involves different
types of problems and issues which create difficulties to deliver improved quality of medical
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facilities (Nelson and Staggers, 2016). However, it is necessary to evaluate such barriers and put
efforts to remove them in order to boost up effectiveness of better quality of services
appropriately. There are several barriers which are determined in Royal United Hospital and
these are given below –
Internal barriers
Lack of resources – This can be described about lack of certain resources which are
helpful to improve quality of services and reduce risks in proper manner. It includes that required
sources are necessary to conduct operational processes regarding treatment to gain desired
benefits. The Royal United Hospital do not have advanced technological aids and machines
which improve accuracy in diagnosis which facilitate to given correct treatment with accurate
results.
Improper communication – This involves improper communication among professionals
which is barrier for maintaining medical records of patients. It is important to make records and
preserve data with confidentiality for reducing future barriers in treatment procedures (Dickinson
and O'Flynn, 2016). In context of Royal United Hospital, lack of technology is a major barrier
regarding improvement in quality of service. They can utilise Healthcare Information System
and Electronic Medical Records System to communicate correct information.
External barriers
Strict legislations – The strict legislation or acts may responsible many times to avoid
certain effective methods which can increase patient outcomes. The Royal United Hospital face
several essential legislations like carers Act 1995, Human Rights Act 1998 and Health & safety
act. However, it is necessary to follow legal rules properly which is responsible for reducing
patient outcomes so that another techniques should be applied.
2.2 Different approaches for implementing quality systems
The quality system can be applied in healthcare organisation as they helps to increase
patient outcomes in terms of making them well being in limited duration of time. It include
different strategies or techniques which are implemented in more effective as well as efficient
manner so that outputs of treatment processes. However, there are different types of approaches
which should be applied in Royal United Hospital for increasing quality of medical facilities are
as under –
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Staff training – The training and learning programs should be carried out for employees
so that new techniques or policies can be utilised by them appropriately (Eyles and Woods,
2014). It will provide support to gain maximum benefits from newly implemented devices and
strategies for improving quality of services in Royal United Hospital.
Planning – The Royal United Hospital should make an effective plan of action for
applying new practices and methods which facilitate to improve further outcomes with quality
through avoiding possible threats properly.
Monitoring and evaluate – This involves the criteria of monitoring the practices or
procedures carried out for implementing quality system in order to evaluate possible problems. It
is necessary for Royal United Hospital to determine threats so that they can be solved
immediately to improve quality of services.
Collect feedbacks – The Royal United Hospital are required to collect feedbacks from
patients to analyse actual threats of medical facilities which facilitate to implement desired
quality systems in appropriate manner.
Questionnaires – This refer to a set of questions with choices of answers which helps to
take individual views of patients and their family members (Henderson and et. al., 2014). Royal
United Hospital can take opinions of every person which is helpful to apply quality improving
techniques more accurately.
Fishbone model -
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Illustration 1: Fishbone Diagram
(Source: Fishbone Diagram, 2018)
2.3 Existing standards for measuring quality in organisation
There are different types of levels of medical services which are set by external agencies
and healthcare organisations in order to gain accurate outcomes of treatment. It involves various
types of strategies and standards which provide support for measuring quality of services in
Royal United Hospital. Some of these standards are explained further –
Minimum standards – This involves to apply correct medication procedures with
appropriate planning and proper management of medicines. It includes wear gloves, hygiene
policies drug control, prevention of infections, Care standards act and maintaining medical
records of patients in proper manner. It involves several standards like protect public from harm,
improve quality of health services and ensure safety of patinet. In context of Royal United
Hospital, above factors including care standards act can help to measure quality of services in
proper manner.
Benchmarks – The benchmarks involves an accurate level of outcomes gained by
medical procedures which should be achieved while conducting similar process of medication on
another patient (Nakanishi and Nakashima, 2014). However, it involves certain benchmarks
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related to productivity, quality, time and cost of medication. The Royal United Hospital, should
follow codes of practices and standards set by CQC in fulfil care needs of patients accurately.
Best practice – This involves to utilise more effective as well as efficient strategies of
techniques which provide support to reduce risk factors along with improving quality of medical
services. It involves correct concepts, interventions and techniques which are different fro every
health problems for treating the same appropriately. In case of Royal United Hospital, they
should implement best practices in increase quality in terms of functionality, assurance, control,
audit and management.
PART 2
3.1 Factors influencing achievement of quality
The healthcare organisations are required top put efforts in order to boost up quality of
relevant services so that patients outcomes will be improved. It involves different ways through
which quality of medical facilities or procedures can be improved in respect of making people
well being in limited duration of time. However, there are several factors which are responsible
for influencing achievement of quality of services in hospitals. The factors influence attaining
quality in Royal United Hospital are as follows –
Trained staff members - The Royal United Hospital should conduct training and
learning events on regular basis which make employees capable to utilise advanced machines
properly. It is also favourable to boost up efficiencies of people which facilitate to attain better
quality of services to improve patient outcomes (Baxter and et. al., 2014).
Performance of employees – This refers to evaluate regular performance of employee
sand determine threats which should be conveyed to them with effective techniques to overcome
with working issues. The Royal United Hospital can put efforts to increase performance of staff
as it impacts positively on outcomes of treatment procedures.
Effective communication – The Royal United Hospital should implement Healthcare
Information System and Electronic Medical Records System for communicating accurate
information about patients to each other. It will facilitate to reduce risk factor and helps to
increase patients outcomes respectively.
Stakeholders analysis – The stakeholders of Royal United Hospital are government,
customers, employees, board directors and external agencies which plays an important role to
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increase patient outcomes. It is necessary to take their suggestions and mutually make an
appropriate decision for boosting up quality of services.
3.2 Effectiveness of systems, policies and procedures used to achieve quality in services
There are different types of systems, policies and procedures are carried out for providing
desired facilities to patients for solving their health problems. In context of Royal United
Hospital, they use several policies and processes to achieve quality in services which are given
below –
Total quality improvement – As per this process, the Royal United Hospital is required
to improve quality in overall operational procedures or activities. It is necessary to improve
every single activity of medication so that overall outcomes can be increased for welfare of
infected people.
Continuous quality improvement – The quality achievement process should be
followed continuously on regular basis in order to gain more perfection in treatment procedures.
The Royal United Hospital is required to conduct improvement efforts on regularly to gain better
outcomes of medications.
Feedbacks – The Royal United Hospital should take feedbacks from patients and their
family members about difficulties faced by them. It will provide support to remove present
threats of treating procedures and solve their issues properly (Berwick, 2016).
3.3 Ways to improve quality
The healthcare organisations are required to put efforts on regular basis for increasing
patient outcomes along with solving their issues in correct way. Every hospital or care home
make their own strategies or policies which provide support to reduce threats of medical facilities
and satisfy actual requirements of infected people accordingly. In context of Royal United
Hospital, they can use several ways to improve quality which are as follows –
Functional quality – This involves the criteria if improving quality in every single
process of medication which is carried out for well being of a patient. It includes several
activities such as pathological process, exchange desired report of person and then medication
activities so that overall outcomes of patient will be improved in Royal United Hospital.
Putting people first – The method of putting people first involves to focus on actual
needs of people and suggestions of employees so that required treatment can be provided
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appropriately. The Royal United Hospital should evaluate desired requirements of patients and
make effective practices to fulfil them to gain improve quality of services.
Planning structure – The Royal United Hospital is required to analyse actual needs of
patients and threats of present techniques to make accurate plan of action to achieve better
quality of medical facilities. It involves to follow priorities of specific patient case, manage
standards of performance and risk management for planning appropriately (Lecca and et. al.,
2014).
4.1 Methods for evaluating quality with regards to external and internal perspectives
The efforts are not only sufficient to ensure about quality achievement but it is also
necessary to evaluate level of improvement attained in hospital. It is essential to apply several
required methods which provide support to analyse about quality with regards external and
internal perspectives. In case of Royal United Hospital, they are required to focus on certain
methods which are given below –
Internal perspectives
Working together – This includes to work together as team which is very common in
hospitals because specific case of patient cannot be solved by single medical professional. The
Royal United Hospital employees can work with each other and analyse threats for evaluating
quality.
Performance appraisal – The performance appraisal is helpful to know about
effectiveness and threats of every employee by evaluating their working. It is helpful to analyse
level of quality improved in Royal United Hospital so that further actions can be taken properly.
External perspectives
Focus groups – This can be described as discussion within group involving desired
individuals in order to share opinions, perceptions and ideas about specific area like level of
quality. In case Royal United Hospital, they can conduct meeting of externals including
customers and external agencies to gain their opinions about present services in terms of
evaluating level of quality.
Interviews - The Royal United Hospital should conduct individual interviews of required
people to analyse their views about quality of services provided by given healthcare organisation.
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4.2 Impact of involving service users to evaluate process on quality of service
The involvement of service users are effectively capable to provide correct opinions
about actual problems or threats of medical facilities provided by Royal United Hospital. It will
provide help to sort out problems along with boosting up patient outcomes through improving
quality of services. Moreover, some of impacts are as under –
Analyse actual threats – The Royal United Hospital can able to analyse real problems of
people to solve them in respect of improving quality of services appropriately. The quality
should be improved to increase patient outcomes so that accurate issues cam be evaluated by
suggestion of service users to solve them properly.
Improvement of services – The medical facilities or services can be improve more
effectively as well as efficiently by taking opinions of services users in Royal United Hospital.
Putting efforts to sort out problems faced by patients as per their feedbacks provide support to
boost up quality as well as outcomes of medication procedures.
CONCLUSION
From the above report, it is conclude that managing quality in health can be described as
to improve effectiveness of treatment and increase satisfaction of patient. It includes perspectives
of stakeholders regarding quality including service users, external agencies, government
authorities and board of directors. However, it involves roles of external agencies like to
conduct inspections, set standards of practice and ensure effectiveness of medicines & devices
along with certain barriers such as lack of resources, improper communication and strict
legislations. Moreover, several factors influencing quality including trained staff members,
performance of employees, effective communication and stakeholders analysis.
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REFERENCES
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integrated care and how can we deliver it?. Policy Press.
Glasby, J., 2017. Understanding health and social care. Policy Press.
Brownson, R. C., 2017. Dissemination and implementation research in health: translating
science to practice. Oxford University Press.
Nelson, R. and Staggers, N., 2016. Health Informatics-E-Book: An Interprofessional Approach.
Elsevier Health Sciences.
Dickinson, H. and O'Flynn, J., 2016. Evaluating Outcomes in Health and Social Care 2e. Policy
Press.
Eyles, J. and Woods, K. J., 2014. The Social Geography of Medicine and Health (RLE Social &
Cultural Geography). Routledge.
Henderson, C. and et. al., 2014. Mental health-related stigma in health care and mental health-
care settings. The Lancet Psychiatry. 1(6). pp.467-482.
Nakanishi, M. and Nakashima, T., 2014. Features of the Japanese national dementia strategy in
comparison with international dementia policies: How should a national dementia
policy interact with the public health-and social-care systems?. Alzheimer's &
Dementia. 10(4). pp.468-476.
Baxter, S. and et. al., 2014. The relationship between return on investment and quality of study
methodology in workplace health promotion programs. American Journal of Health
Promotion. 28(6). pp.347-363.
Berwick, D. M., 2016. Era 3 for medicine and health care. Jama. 315(13). pp.1329-1330.
Lecca, P. J. and et. al., 2014. Cultural competency in health, social & human services:
Directions for the 21st century. Routledge.
Online
Fishbone Diagram. 2018. [Online]. Available through:
<https://creately.com/blog/diagrams/fishbone-diagrams-tutorial/>
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