Assessing and Improving Quality Management at Rose Meadows HSC

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MANAGING
QUALITY PROJECT
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EXECUTIVE SUMMARY
The following report is based on the case study of Rose Meadows which is a health and
social care organisation engaged in provision of accommodation and support services to patients
who are in need of medical care and aid. The report is divided into 4 Learning Outcomes. From
the first LO, it can be ascertained that there are various stakeholders in HSC sector out of which
the most important ones are care staff, management and service users. Further, the agencies that
safeguards the interests of patients by way of stipulating standards for HSC are CQC, NHS and
NICE. On the basis of second LO, it can be said that the most primary standard within medical
sector is person centred care. Further, TQM and clinical benchmarking are two effective methods
for implementation of quality systems within organisational premises. There are a number of
barriers to quality service delivery such as lack of skills, communication, leadership, staff and
late response time. Score system, Administration and Quality Assurance System are three
methods to ensure effectiveness within organisational premises. Questionnaire, Inspection,
Scientific method of measurement and Audit can be used to evaluate the quality of HSC services.
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Table of Contents
EXECUTIVE SUMMARY.............................................................................................................2
INTRODUCTION...........................................................................................................................4
LO 1.................................................................................................................................................4
1.1 Perspectives that stakeholders in health and social care have regarding quality.............4
1.2 Role of external agencies in setting standards..................................................................5
1.3 Impact of poor service quality on HSC stakeholders.......................................................6
LO 2.................................................................................................................................................7
2.1 Standards in HSC for measurement of quality.................................................................7
2.2 Approaches to implementation of quality systems...........................................................9
2.3 Potential barriers to quality service delivery within HSC..............................................10
LO 3...............................................................................................................................................12
3.1 Effectiveness of systems in HSC in achieving quality of services.................................12
3.2 Factors affecting accomplishment of quality in HSC.....................................................13
3.3 Ways in which HSC service can improve its quality.....................................................14
LO 4...............................................................................................................................................14
4.1 Methods for evaluation of quality of HSC services in concern with external and internal
perspective............................................................................................................................14
4.2 Impact of including users in evaluation process upon service quality...........................15
CONCLUSION..............................................................................................................................16
REFERENCES..............................................................................................................................17
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INTRODUCTION
Managing quality within HSC is essential as it plays a significant role in enhancing the
effectiveness of medical treatment and aims at raising the extent of satisfaction of service users.
This is ascertained to be one of the biggest considerations within healthcare sector as it directly
impacts upon the satisfaction gained by service users within the organisational premises. In this
regard, the following assignment is carried out upon Rose Meadow which is an organisation run
by Norse Care and involved in provision of accommodation and quality care. This entity aims at
maintaining a balance between tailored and efficacious care package together with support for
versatile regular living by provision of access to individual interests and respected privacy. This
report includes the perspectives of stakeholders in relation to quality within HSC together with
the influence of bad quality upon such personnel. Also, it comprises of analysis of barriers along
with suggestions for delivery and improvement of quality in HSC. Lastly, various methods for
evaluation of HSC quality in relation to internal as well as external perspectives have been
discussed.
LO 1
1.1 Perspectives that stakeholders in health and social care have regarding quality
The extent up to which HSC services are successful in enhancing the likelihood of people
towards the usage of such services is termed as quality of healthcare. HSC is one of the major
sub-sectors of hospitality industry and thus, focuses its overall attention upon satisfaction of
needs and demands of service users. Quality is found to be one of the key issues that are
illustrated within this sector. Healthcare professionals are required to keep in their mind that
nursing homes, hospitals or care home should have security, safety and other essential facilities
which can abstain an individual from feeling depressed within the premises. It is the
responsibility of management team of HSC centres to take into consideration the needs of
patients and undertake measures to fulfil them in timely manner. The special considerations for
maintenance of quality within medical premise are inclusive of care, response, hygiene, safety,
security etc.
Stakeholders can be defined as the person or group of individuals who possess interest as
well as power to take significant decisions regarding the operations and functioning of entity. In
relation to Rose Meadow, the stakeholder groups that can be identified are staff, management,
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vendors, service users, government and many more. All of the before mentioned stakeholders
possess an adequate say in the operations of entity.
Out of all the above mentioned stakeholders, the perspectives of three stakeholders in
relation to the case study of Rose Meadow have been presented below:-
Management: This consists of individuals who are responsible for devising policies
associated with the entity in order to make sure that the quality of service received by users is
sufficient to meet their needs and demands. Within Rose Meadow, they are the ones who have
the role to monitor and control the services in order to ensure their alignment with quality
standards. In this regard, it can be said that owing to the declining quality of services, the
perspective of this stakeholder group is to obtain answers to some important questions such as
who is service user, how is care paid for, are services consistent with the quality standards, what
are the healthcare considerations that must be taken into account while carrying out planning.
Service Users: These are the individuals who are entitled to receive HSC services. It is
usually seeen that the management team of Rose Meadows ensure that the needs and demands of
service users are met by providing them the required accommodation as well as quality care. In
this regard, the perspective of clients is that they intend to avail best quality care services from
the entity along with stay facilities so that their medical needs can be met. Further, the
perspective of service users is that the healthcare centre must abide by the quality standards
stipulated by law.
Care staff: The employees of a care organisation play an important part in ensuring that
customers are entitled to high quality services. In this regard, the staff of Rose Meadows has
been looking upon the degrading quality and standards of care and thus intend to put their best
foot forward for enhancing the standards of services provided to users. Their perspective is to
ensure that the needs and demands of patients are duly met and renders maximum satisfaction to
them.
1.2 Role of external agencies in setting standards
Rose Meadows is an enterprise that is engaged in provision of accommodation services,
aid and care to patients in order to enhance their quality of living. This entity is involved in
provision of 24*7 services so that no form of discomfort or unease is faced by people within the
premises of hospital at any point of time. In the present context, there are a number of agencies
that are engaged in the field of healthcare and carry out regular monitoring and control of the
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services rendered by hospitals and/or care homes which are referred to as external agencies. In
this regard, the external agencies that are involved in monitoring and controlling the standards of
healthcare services of Rose Meadows are briefly explained below:-
Care Quality Commission(CQC): This is known to be one of the most important external
agencies. This is a non departmental public body that carries out inspection upon the quality
standards of care organisations. This agency holds the role to set standards for quality control
within Health and Social Care (HSC). This agency makes sure that HSC services are provided to
patients in a manner that they are effective, safe, high-quality and pertain to the requirements of
service users.
National Institute for Clinical Excellence (NICE): This is found to be yet another
crucial agency that is engaged in stipulation of standards for HSC. This entity offers advice to
NHS within United Kingdom. The primary role of of NICE is to devise guidelines for health and
social care organisations such as Rose Meadows and to assess the compliance with standards for
care homes.
National Health Service (NHS): It is a public funded organisation that holds the
responsibility to maintain effective HSC services within England and four other nations. This
statutory body monitors the issues associated with provision of medical services. They are
responsible for setting priorities for Health and Social Care and aim at enhancing the existing
quality of healthcare programs.
Nursing and Midwifery Council (NMC): This institution was established in order to
regulate as well as control the roles and functions performed within a care home. It plays a
crucial role in setting up appropriate and effective standards as it regulate the midwives and
nurses in in context with educating and training them in ways which ensure their high quality
provision of care. Moreover, they also ensure that the skills of the nurses are updated and
modified regularly to ensure that the health standards are being met effectively during their care
provision.
1.3 Impact of poor service quality on HSC stakeholders
CQC is a legal body concerned with health and social care sector having extensive
measure as its role is to safeguard the offerings of care homes and healthcare centres to ensure
provision of high quality services for users.
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When the existing standards of quality within an organisation are not adequate and
suitable to meet the needs as well as demands of users, this can be referred to as poor service
quality.
There are a large number of stakeholders that are influenced as a result of the regular
course of action within a healthcare centre. Poor quality services within Rose Meadows had a
massive impact on the stakeholders of this entity. Such effects are briefly described below:-
Management: When service users are not content with the services provided by
hospitals, this tends to become a matter of concern for management which consists of policy
makers. In this regard, management team of Rose Meadows work upon creation of a clean and
healthy environment wherein patients can have a standard living and fulfil their healthcare needs
and demands. Further, top management devise such policies which can cater to the needs and
requirements of service users. Immediate and strict course of action is undertaken by entity in
order to deal with the associated consequences of this phenomenon.
Service User: The satisfaction received on part of users is largely dependent upon the
quality of services rendered. Thus, provision of poor quality services lead to dissatisfaction
among users and this has a direct impact on the quantum of users who visit the healthcare unit on
a regular basis. Poor quality can be seen in terms of late service provision, lack of staff, non
access to clean and hygienic living etc. This hampers the existing image of medical centre in the
minds of users. In this regard, owing to the poor quality services rendered by Rose Meadows, its
customer base is not content and thus do not prefer to visit the hospital which is the reason
behind the declining market position of this entity.
Care Staff: It is often seen that care staff also like to work in an organisation where
quality of services is optimum to meet the wants of users. This is so because their individual
goodwill is associated with the hospital. When the quality services rendered to patients is of poor
quality, a large quantum of staff within the entity prefers to leave the organisation. In regards to
Rose Meadow also, if strict action is not undertaken by management in a timely manner, the
organisation will soon lose its competent, skilled and knowledgeable HSC professionals.
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LO 2
2.1 Standards in HSC for measurement of quality
Standards are the rules and regulations stipulated by regulatory bodies or law in order to
maintain service delivery of optimum quality by organisations. Within healthcare sector,
standards are formed by NHS, CCG and CQC. These agencies are involved in stipulation of
standards associated with quality assurance, audit, monitoring and controls. With the stipulation
of these strategic standards, the aim of law is to ensure that all the organisations operating within
medical sector maintain high level of services so as to provide maximum comfort, ease and
satisfaction to patients. However, in relation to Rose Meadows, it was seen that the level of
quality, equipments, care and services being provided within this hospital are below the
acceptable standards and thus, this organisations falls in the confines of legal bodies of HSC
sector and any strict action can be taken against this entity as a result.
As per case study purpose behind setting these standards is to improve quality of services offered
through proper code of conduct, care quality commission, etc. With the help of standards, there
is authentication of working style of Rose Meadow and they do not make faith promises with
relative of patient (Craig and et. al., 2013). Managers of health and social care will aid them to
provide specialized services in terms of assurance, control, audit, etc.
There are a number of purposes behind setting up of standards, the main of which is to
maintain quality of service delivery. The government assures the local residents about the
provision of optimum quality of services. The standards stipulated for HSC organisations such as
Rose Meadows are useful for tangible as well as intangible diseases.
A number of standards are set for maintenance of service delivery within HSC entities. In
this regard, CQC devise policies and standards to monitor and assess if the organisations
operating within this sector are able to meet the needs of service users. Code of conduct as well
as legislation is devised by this body within the standards in order to raise the experience driven
by users of service during the tenure of their diagnosis.
Person Standard Care
One of the most essential and significantly relevant standards devised by CQC is Person
Centred Care. This implies that individuals who receive health and social care services must
receive tailored care in accordance with their needs and requirements. It has been found that
Rose Meadows breached this standard as it was not responsive towards the calling of patients.
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CCG is found to be yet another crucial organisation that sets up the standards to ensure
best practices within healthcare organisations. To effectively facilitate this, relevant diagnosis
and medication are rendered to patients.
Within this standard, the rights of service user, correct diagnosis and effective plan for
medication are integrated with a view to enhance the quality of services in an entity. This
standard was violated by Rose Meadows.
NHS is a publicly funded national healthcare system within the confines of England, and
one of the four National Health Services for each constituent country of the United Kingdom.
Nursing Midwifery Council (NMC) is an organisation which provides standards which
nurses and midwives are required to follow while caring for the patients. The standards provided
by this organisation are provided by several categories that set up several priorities related to
patients, ensure working and practice appropriately, maintain safety standards as well as promote
professionalism as well as trust with patients. Thus, it is highly crucial for the employees within
the care home to follow these standards so as to ensure effectiveness in their provision of care.
Information Standard
This agency stresses upon organisations to follow an Information Standard that can be
taken into use by HSC entities to convey data. This is a type of documentation that comprises of
standards associated with processing of data. With its use, information can be easily
communicated within organisational premise. Rose Meadows has been found to be running with
ineffective communication, the probable reason behind which can be the violation of this NHS
standard.
2.2 Approaches to implementation of quality systems
Quality systems can be defined as the systems which are adequate and sufficient to serve
effective amenities to service users. Such systems comprise of equipments, services, responses
etc. There are a number of approaches that provide assistance in development of quality services.
One of the key approaches to ensure quality within an organisation is TQM. This
approach is keen on formulation of systems such as Quality, Environment and HSE management
system. TQM approach works on four principles which are briefly explained below:-
Strategic approach for facilitation of improvement: This principle stresses on
continuous education being imparted to employees in order to facilitate this organisation to
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effective respond to demands placed by market. With respect to Rose Meadow, it is required that
this entity should provide training to staff members in order to ensure effective service delivery
for users.
Emphasis upon users: This principle is keen on gaining a comprehensive knowledge of
requirements placed by customers and treating it as a base for quality. With respect to Rose
Meadows, it is required that the entity take into due consideration the needs and wants of patients
in order to optimally fulfil them. When a patient seeks for any response, it should be provided by
the respective entity instantly.
Constant Improvement: TQM’s third principle is keen on development or execution of
a healthy working atmosphere as this is found to stimulate the interests as well as development in
healthcare unit. Thus, Rose Meadows should ensure cleanliness and hygiene within the hospital
at all times.
Fostering teamwork: This principle is free from risks and emphasizes on regular
enhancement of Health and safety at workplace allowing the service users as well as employees
to be safe. This can be facilitated if there is an opportunity available within the entity to reduce
the burden levied on care staff. This fosters personnel to operate with the usage of their
competence as well as potential, thereby ensuring fulfilment of needs and wants of users.
ADVANTAGES OF TQM
It is an effective technique which successfully enhances the quality of services within an
organisation. Training and development within this approach seeks to help employees in building and
improving their professional career.
DISADVANTAGES OF TQM
TQM emphasis upon enhancement of quality instead of management.
Yet another approach which ensures quality management within a HSC organisation is
Clinical Benchmarking. This is a well structured and systematic process where there is contrast
of existing practices with amended ones in order to achieve best conduct. With the comparison of
standards and performance, the aim is to accomplish improvement against stipulated targets. The
evaluation of this technique is made as follows:-
ADVANTAGES OF CLINICAL BENCHMARKING
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This approach assists in enhancement of productivity as well as quality within the
organisational premises. With the help of this technique, efficiency of processes and reduction of
costs can be attained in a suitable manner.
DISADVANTAGES OF CLINICAL BENCHMARKING
This approach cannot provide guidelines in relation to success factors which led to
success of rival firms. Further, it is time consuming as well as expensive.
In relation to Rose Meadows, TQM approach is found to be suitable and relevant as this
assists in enhancing the quality within the entity. This quality approach is chosen because it
emphasizes upon provision of training to staff members as per the latest trends and technologies
prevailing within the industry. Thus, this approach will be useful for enterprise to enhance its
existing service delivery.
2.3 Potential barriers to quality service delivery within HSC
Barriers can be referred to as those hindrances that abstains the completion of an activity
or procedure within the organisation. There are various barriers that are noticed within the
confines of health and social care, such as lack of proper planning, market analysis, changes
taking place within technological trends etc. All of these cause a significant impact upon the
operations and functioning of hospitals and small medical care units. In relation to Rose
Meadows, potential barriers do not allow the organisation to effectively provide amenities of
optimum quality to patients which leads to dissatisfaction among service users. Such barriers are
briefly described below:-
Lack of skills: This is found to be one of the most significant barriers that act as a
hindrance while achieving quality within the services. The workforce of Rose Meadows lacks the
competence as well as the sufficient skills to meet the needs and demands of users. In this regard,
training can be given to them in order to equip them with the required skills and knowledge so
that they can effectively handle the needs and demands placed by patients.
Late Responsiveness: This is yet another constraint that hampers the performance as well
as service provision within a hospital. In regard to Rose Meadows, it was noted that the staff did
not respond well to patients which lead to dissatisfaction among users. For improving this, a
ringing bell should be effectively taken into use.
Lack of adequate staff: This is a constraint that hampers the provision of quality services
and an effective performance. Also, as a result of this, the entity may not be able to meet its goals
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and objectives within the stipulated time limit. In this regard, Rose Meadows should maintain
adequate staffing at all times to timely accomplish long term goals.
Lack of leadership: The biggest constraint behind ineffective and poor services
prevailing within Rose Meadows is the absence of leadership. Owing to this, the services
rendered within the hospital were not able to meet the needs and demands of users.
Lack of communication: Communication is the key aspect in the absence of which the
activities and processes can not take place in an orderly manner as well as a proper coordination
can not be set between the departments. With respect to Rose Meadows, this has been found out
that the hospital lacks effective care and service due to lack of optimum level of communication
persisting within the organisational premises, owing to which the patients are not able to derive
high quality facilities.
LO 3
3.1 Effectiveness of systems in HSC in achieving quality of services
Systems can be referred to as the set of things integrated together as a whole mechanism.
In regard to Rose Meadows, systems are the management of safety, security, administration and
machineries.
The three systems in context of Rose Meadows along with their effectiveness are
described below:-
Score system is used within an organisation with a view to give ratings to the quality of
offerings rendered by staff and management. Provision of rating to employees in accordance
with their performance strives to give motivation to hard working employees and facilitate them
to work with the same zeal in future also. This is found to be very effective as it helps in
improving the quality of services together with the experience driven by service users.
Administration can be referred to as the system where a number of aspects are managed
with a view to enhance the services provided to patients. This provides assistance to organisation
in management of the resources in an effective and efficient manner. Resources are inclusive of
machinery, human resources etc. Within Rose Meadows, such resources when effectively
managed can ensure optimum delivery for patients. Its effectiveness can be seen with the fact
that it enhances the individual productivity of employees as well as the organisational output.
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Quality Assurance System is dependent on a set of rules as well as regulations that are
stipulated by HSC departments. Such kind of a system is very effective as this tends to improve
the existing level of service and efficiency in order to raise the output and user satisfaction.
Further, the effectiveness of Quality Assurance System will assist Rose Meadows to accomplish
its goals and objectives within the stipulated course of time.
Infection Control Policy: The main purpose of NSW Health Infection Prevention and
Control Policy is regarded as the provision of leadership to NSW Health Organisations (inclusive
of Affiliated Health Organisations). This helps in gaining comprehensibility of the manner in
which it effectively prevents, manages and controls healthcare associated infections (HAIs). This
minimises negative health outcomes upon service users treated within health care and reduction
of the burden of HAIs.
Safeguarding Policy: With the help of this policy, NHS England seeks to safeguard
young people, children and adults who are at risk, as this is a shared responsibility. For the
effective execution of this, relevant collaborative working is required between professionals and
agencies. It protects all of the before mentioned categories from abuse as well as neglect.
Medicine Policy: World Health Organisation proposes that all the nations need to
formulate as well as execute a universally accepted national medicines policy. This serves as a
way to enhance the accessibility to effective and safe medicines of good quality.
Risk Assessment: The purpose of this policy is identification of hazards and evaluation of
any related risks to health and safety emerging from iBSL’s activities, allowing informed
decisions to be undertaken for elimination or minimisation of risk of harms to those who may be
affected.
Training Procedure and Policy: This policy is implemented within care home as to
provide essential training to the staff so that they could provide effective care and welfare to the
patients within the organisation. Staff at Rose Meadow are not being provided with appropriate
training and thus, these needs of staff are not yet being. This also requires the firm to ensure
appropriate and effective aspects associated with engaging the staff in ethical and appropriate
practices which are necessary for sustainable performance while provision of care.
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3.2 Factors affecting accomplishment of quality in HSC
In context of Rose Meadows, there are a number of factors that have a significant impact
upon the accomplishment of quality in services and provision of such services to users. Such
factors are briefly described below:- Staff related factors : This is being considered as one of the most crucial element, which
might affect the accomplishment of quality within the HSC. It has been analysed that
within Rose Meadows, the quality of services can improve or deteriorate depending on
the staff that is engaged in provision of care and other associated services. This helps in
ensuring that patients are satisfied with the services offered by health care centre, Rose
Meadows. Knowledge and skills : The level of knowledge and skills largely affect the
accomplishment of quality standards within a health and social care centre. In this regard,
it has been analysed that Rose Meadows could easily improve the quality through
enhancing the knowledge along with the skills of care staff. This could be done by way of
provision of training opportunities as this acts as an effective measure through which
quality can be enhanced. Motivation : This is ascertained to be yet another crucial factor which might affect the
accomplishment of quality within HSC. It has been analysed that by way of offering
patients with high range of benefits in specified time frame and gaining satisfaction as
well as appreciation from them, the motivation of staff can be enhanced. High
motivational level among staff can significantly raise the standards of quality within Rose
Meadows.
Communication: One of the most effective ways which influence achievement of quality
in health and social care services is the exchange of information. In case the care home
indulges in appropriate and essential communication between the staff as well as with
patients and their peers, it would result in a better and consistent sharing of information,
which would be appropriate and effective in providing quality care to the patients.
However, In Rose meadow, this communication was lacked, which resulted in an
inconsistent sharing of crucial information, that caused inappropriate provision of care.
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3.3 Ways in which HSC service can improve its quality
In present context, where Rose Meadows serving to mental health patients, and while
serving to them there were many issues that came in front. It can be said that Rose Meadows'
management was not looking into all the issues faced by patients while getting treated. Along
with this, it can also be said that safety measures was also one of the crucial issue that was faved
by Rose Meadows to mental health patients. Here, it is analysed that, there are number of ways
which can be utilised in order to reduce the issues and risks attached to it and these are given
beneath:
Service users’ satisfactions : This is being considered as one of the crucial approach,
which Rose Meadows could effectively use to improve the satisfaction level of patients who
were going through issues related to safety and management of staff. Offering patient's with right
service is not an easy task within the Rose Meadows and this is because, patients were dealing
with many mental health related issues.
Level of demand : This could be considered as one of a crucial approach, which can be
utilised to see, which is one of the most important issue that is impacting the most. Here, safety
factor, which was faced by patients and staff of Rose Meadows, and there was the demand of
individuals which was required to be fulfilled and through this reduction can easily be done by
staff.
Complexity of illness : For Rose Meadows, it will be required for the care home to fill up
all the blank seats in order to reduce the problems. Through this, it can easily be said that all the
complex issues faced by patients along with the staff within the Rose Meadows could be reduced
to minimal.
LO 4
4.1 Methods for evaluation of quality of HSC services in concern with external and internal
perspective
Evaluation is the process of determining the worth of doing something. The evaluation
process includes both the positive and negative impact of applying some changes within
organization. In case of Rose Meadows, the evaluation process will help the organization to
understand the impact of applied changes
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Quality in HSC is the most important concern. The methods of evaluating services
quality in this sector are evaluated underneath:-
Internal
Questionnaire: A questionnaire should be prepared from the quality team and given to
the patients. This will help them in filling their own time so that any type of issue in quality can
be inspected. It will help the administration of Rose Meadows to take a fair and honest opinion
about the running services. This allows to take proper feedback from the customers. Thus
administration will be able to evaluate the quality of Nursing Home.
Inspection: This is yet another effective method of evaluating quality of health and social
care. Within this method, enquiries are made from a number of persons inclusive of care staff
and management regarding the quality of services rendered and equipments used within the
organisational premises. This can help Rose Meadows in evaluating the existing level of quality
services within the entity and thereby gain knowledge of the variances prevailing between actual
and desired standards.
External
Scientific method of measurement: This is necessary for the evaluation of quality in
Rose Meadows. In this method an evaluation is done which requires good methods in order for
the resulting data to be useful. This data is being collected and important modifications can be
done with the help of that data in quality. Therefore, the evaluation of quality can be done with
the help of scientific approach.
Audit: This is ascertained to be yet another crucial approach which helps in evaluating
the existing standards of quality persisting within the premises of health and social care
organisation. This is a part of CQC inspection. With the help of this method, Rose Meadows can
effectively measure the quality of services and equipments in order to provide care and aid to
patients.
4.2 Impact of including users in evaluation process upon service quality
Service users can be referred to as end users within hospitality industry. The indulgence
of such users within quality evaluation is a significant step towards the enhancement of services.
It has certain advantages and disadvantages which are stipulated underneath:-
Advantages
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The biggest advantage of such inclusion is that they can easily identify the issues in
relation to quality. Service users can provide guidance to the management team of Rose
Meadows to properly bring about changes in services in order to enhance the quality.
Disadvantages
One of the biggest liabilities of such inclusion is their views and opinions can create
confusion among the administration. The policies as well as plan of action is stipulated by
management and involvement of users tends to cause delay in carrying out the strategies.
CONCLUSION
It can be concluded that quality is one of the most crucial aspects within HSC sector. The
organisation has been ineffective in provision of quality services and adequate output. To
enhance the quality of services, it is essential to boost the morale of employees as well as work
upon Quality Assurance Measurement. Further, it has been identified that service users can be
significantly engaged in the evaluation process in order to enhance the quality.
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