Quality improvement in medical care
Introduction
Medical care is an essential field in the present world and providing medical aid is considered a nobel profession. The modern world is comprised of many diseases and their prevalence has been increasing with each passing day. This report is an insight into the quality improvement that could be addressed in the case study “Patient safety at Grand River Hospital and ST. Mary’s General Hospital.” The purpose of this report is to address the improvements that could be worked upon and indirectly the improvements could be used as an intervention towards developing better standards in the healthcare firms.
Quality improvement comprises of certain sets of rules and regulations based on t-which the assessment is fixed. It is a systematic and continuous action which directs towards quantifiable improvement in the medical and health care services. The improvement has a considerable impact on the development of the health status of the patients in general and those belonging to certain targeted groups. This development is beneficial for almost every citizen belonging to any race, community or class.
When concerned with quality improvement the focus is primarily on the improving the system operating the concerned health care firm. The quality in medical care is associated with the organisations ability deliver quality treatment and care. A different level of performance and improved quality in the field of healthcare can be achieved by the incorporation of the following principles: The primary focus for the improvement needs to be towards the patients.
An improved system and process for easy access and better treatment facilities for the patient.
Being a part of the medical team needs to be taken care of and the adequate amount of attention towards its betterment needs to be applied. The focus on the data available and those that are being collected as a part of the patient, care taker, system members or process members have to be well organized and with proper efficiency. Apart from these, it is essential on the organisations part to check for any other flaws left in terms of any sub divisions concerned with the health care system.
General overview of the report
Patient safety is a major concern in healthcare firms and it is one of the major reasons for the decline in the organisations credentials. The adverse condition of a patient resulting from medical condition is different from those occurring as a result of medical negligence. The safety of a person needs to be ensured properly in any hospital and the treatment pattern has to be appropriately followed. It is observed from the report that the Grand River Hospital and St. Mary’s General Hosptital have sufficient facilities and infrastructure for the providing optimum health care benefits to the people. The system and processes associated with the hospital are as well quite well developed and managed. They have developed and maintained a particular set of strategies for the establishment of their quality delivery of the medical care to the patients. They do have an organized and systematic way of maintaining records and communicating with their colleagues and team mates for the execution of an efficient health care practice. The environment in which the patients are treated is good and the patients have a good experience during their treatment.
When concerned with health care firms, a ray of hope always exists. The scope for improvement always exists in case of medical care and treatment. Both these hospitals are efficient in their own perspective however the possibility of betterment still exists. The safety cultures of both the hospitals are not yet completely established and this is key area to be addressed for fulfilling the purpose of providing an efficient treatment facility to the all the patients.
Observations about data analysis
In order to improve the quality of health care facilities offered by the firm, Dr. Sharma conducted a general evaluation of the system and processes associated with the hospital. The observation was quite as expected. There was a deficiency in the number of physicians attending the patients. This is indeed a serious concern and it needs immediate attention as the lack of physician may result in patients being devoid of adequate care and support during their treatment. As mentioned earlier, true safety cultures are missing such that this would act as barrier in providing proper health and medical care facilities for the people. Maintaining a safety culture is necessary for the delivering the patients with quality treatment and care. The set of policies ans associated strategies play an important role in the progress of the organisation.
The data analysis regarding the hospitals’ core ethics are done on the basis of the QCIPA (Quality of care information protection act). Based on the QCIPA rules it has been estimated that significant improvements in the field of medical and health care could be done. Further it is stated that QCIPA ensures to protect the clinicians from any legal actions in case of disclosure of the information regarding the quality bleach. QCIPA reviews every incident that has been reported based on which it sets up a summary of improvements that needs to be attended with immediate action.
The analysis report that the QCIPA receives as a part of the review or the assessment is not systematic. It is usually a general factual description of the incident at different time frame. It does not include the complete procedural context instead, individual factors are stated which are generally not the root cause of the events. The description in of the events or the adverse incidents occuring in the hospital in this manner probably would not be able to provide an exact image of the underlying causes and subsequently the mitigation of the same becomes a difficulty. In such situations it is better to analyse the exact situation extensively and further address the basic causes associated with it. This would definitely provide an idea on how to bring about the modification in the system to solve the issues and further this can also help in creating a better environment in the hospital. Further analysing different versions of the incidents from different perspective would assist in developing better interventions towards solving the problem.
Deficiencies in the quality of health care
Patient safety is one of the prime concern that every hospital or organisation shall be legible to provide. Occurrence of a mishap or an adverse event is not new when concerned with the hospital environment and its premises. The treatments that the patients receive are adequate for them however, the probability of it getting diverted in a different direction as well has a similar count. It is the responsibility and necessity of the hospital to ensure that such incidents are minimal or negligible.
Grand River hospital in Ontario ensures to provide a quality treatment for its patient and to fufill these needs it has a dedicated quality and patient safety committee which aims to address any needs of the patient or caretaker in concern with the safety off the patient. Moreover, it has a qualified set of team which perform the tasks associated with establishing the purpose of delivering quality care. It checks about the modification or the betterment standards based on certain benchmarks. On the other hand St. Marys General Hospital employs a management system which aims to continuously improve the quality of health care provided to the patients. Although both the hospitals have a set of rules and regulations to establish a better living for the patient and they are striving hard enough to fulfil those. Still they can be betterment in certain aspects concerned with patient safety, errors in preventable adverse events and near misses, critical incidents rate, miscommunication, and consequent reduced team work. Apart from these major concerns, some improvements in the regulatory environment concerning the system of the hospital, the reporting pattern of the adverse incidents and there subsequent analysis can be considered in a better way. All these require an extensive analysis towards the system and organisation and further a process redesign to fufill the basic requirements that would ensure to maintain the credibility of the hospital.
Quality improvements
The improvement in the aspect of quality of any health or medical care service demand deep attention and analysis. As mentioned above there are many concerns which need to be addressed for establishing a safe and sound environment in the hospital and around its premises. The prime concern for improvement is patient safety. Usually, patients availing treatment for general illness are provided with adequate treatment facilities and their experience with the hospital as well turns out to be fruitful. In contrast, patients with advanced and severe illness generally do not have a similar perspective. Adverse incidents that are reported are at times associated with some or the other medical errors which are often neglected and covered with the superior disease that the patient suffers from. These errors are so minute that they often go unnoticed. However, in medical field a slight bleach can result in serious adverse events which are irreversible. In 2001, Journal of the American Medical Association conducted a survey in which they found that out of 10,000 patient who are admitted to the hospitals, about 1 patient died would have possibly lived for at least three months with good mental and cognitive condition in case the patient was provided with optimal care and quality treatment (Hayward & Hofer, 2001).
Non-preventable adverse events are unavoidable. Such incidents could not be avoided. However, the preventable ones are those which occur due to human negligence. The occurrence of these can be possible prevented by paying enough attention to get the patient to a better, stable condition. Preventable adverse events and the near missed cases in any hospital necessarily are included in the errors conducted by the human hands. These are unintended however, they pose a major threat to the patient safety and consequently affect the society. According to WHO it is said that about 2000 deaths every year occur due to the unnecessary surgery that is imposed on the patients by the doctors. Further, 7000 deaths every year occur from errors in the administration of medication. This is possibly due to the difference in the amount of the medication or due any variation in the concentration being administered. Miscommunication among the staff members and teammates is another cause which may hamper patient safety. Nearly 20,000 deaths every year occur because of such miscommunication. The cultural safety of the hospital environment is necessary for the physicians and the staff to be aware that they need to have a morale and rationale towards the treatment process. Subsequently the patients would be delivered quality care and treatment. the non-error deaths caused due to the adverse effects of medication accounts to about 106,000 deaths an year. The environment of the hospital is also a major issue and it is reported that about 80,000 deaths an year occur from the infections from within the hospital premises. The maintenance of the hospital environment is necessary for the establishment of a safe, sound and aseptic treatment for the patients. Cumulatively, the total deaths from errors are nearly similar to the natural, non-error deaths which sum to a total of 225,000 every year. This is the vivid truth that occurs in the medical care system. It has become a necessity to check each and every aspect concerned with the patient safety as the purpose of a hospital is to save lives.
Goals towards achieving the improvements
The objective towards achieving a feasible and an effective treatment for the patients can be done by aiming at mitigating the problems associated with the organization or the hospital. To achieve those the following goals need to be followed with complete attention.
Ensuring a safe and sound environment for the betterment of the patient.
To make sure that the patients get adequate amount of medications and in appropriate manner. The medications should be given to the patients with proper care. Specific attention should be given to the concentration of the medication to be administered as directed by the physician.
A proper regulated environment should be maintained for the benefit of the patients.
The system should be well organized and maintained. Records should be evaluated from time to time and each and every proceeding associated with every incident should be maintained.
The occurrence of adverse events due to human error should be minimized or made nearly negligible.
The staff and physicians should aim at having a cultural safety that ensure proper treatment and safety to the patients.
The equipments and instruments associated with the organization especially those in patient care system should be maintained properly.
Possible outcome of the initiatives
An organization implementing and efficiently executing a quality program would experience a range of advantages. The outcomes associated with the implementation of a quality program would ensure the availability of quality treatment to all the patients. The health of the patients would be improved in both the aspects of process and clinical health. The quality improvement strategies would considerably decrease the mortality rate of the patients and subsequently improve the standard and credibility of the organization or hospital (Staines, Thor & Robert, 2015). The managerial and clinical processes would become efficient and the assessment or tests conducted on the patients would provide accurate results with high precision. Improving the quality of the treatment and care provided by an organization, the cost associated with system failures and redundancy could be avoided (Choi, 2015). This money which would otherwise be spent on the repairing or re-analysis could be utilised for developing better infrastructure for the patients nd and their family. Inefficient and nonstandard systems makes it difficult to handle them because of their repeated errors in the readings and subsequently the need to make them rework. Stream lined and efficiently manged systems do not create such situation and it is easier to maintain them as well.
Extensively preplanned environment within the organisation shall ensure that the incidents are stopped before their occurrence. Proactive processes would be able to recognize the problems before hand and this would ensure that the system of care provided to the patient is reliable. Improved quality would ensure that the number of adverse incidents occurring within the organization is minimized. This would ensure that the patients gain belief in the fact that the hospital or organisation is capable of delivering quality services in terms of clinical treatment as well as personal care. Quality improvement in the system among the staff and physician would enable better communication between them and would assist in avoiding the errors caused by the miscommunication among the staff members (“Is Total Quality Management/Continuous Quality Improvement or Quality Assurance Applicable in Health Services?”, 2016). A commitment towards maintaining a quality of treatment would increase the possibility of partnership and funding opportunities. A quality improved infrastructure enhances the communication with the outside world and these result in resolving critical issue associated with the organisation. A commitment to quality shines a positive light on an organization, which may result in an increase of partnership and funding opportunities. When successfully implemented, a QI infrastructure often enhances communication and resolves critical issues.
Timeframe for a new analysis
Though the given analysis is complete yet there are spaces for further improvement. A quality check in every aspect is essential for the purpose of maintaining the integrity of the organization and it would also ensure that the current status and standard is maintained. In order to improve the qualities further it would be necessary to incorporate certain modifications or improvements. The improvements or modifications stated could be incorporated by performing an extensive research in this field followed by an analysis that would be focusing on the key issues discussed in the “deficiencies of quality care” section. The analysis process might be time consuming but the assessment would definitely prove to be beneficial in every aspect in concern with the organization and also the patients. The time for the new analysis after incorporating the improvements might vary from three to four months depending upon the efficiency of the people involved in performing the analysis.
Conclusion
Global awareness about the quality of health care facilities is increasing and the people are becoming more conscious about the care and treatment being provided to them. They are interested in understanding more about the proceedings associated with the treatment that is being offered to them. This trend has commenced after the current global scenario where the population is being faced with lot of crisis and issues related to health. Majority of them are found associated with human negligence. This is the cause of the decreased belief among the people. In such a situation it is essential to provide the quality care to the patients and make sure that they are having a sound experience during their treatment in the hospital. The standard and credibility of the care and treatment offered to the patients have a great impact on the society and the citizens.
The scope of quality improvement always exists and the possibility of doing the same is as well higher. Engaging primary care practices in the improvement of the quality of the medical care administered to patients creates an impact on three levels : the improvement in the health of the population, the improvement in the experience of the patient and the subsequent outcomes, and reduction in the cost of the maintainance required for the organization or hospital in the treatment and care of the patient. On the whole, the quality improvement would ensure that delivery of quality care is experienced by every individual reaching the hospital and the organizational authorities provide utmost care and concern towards their betterment from the starting of the treatment till its completion. The quality improvement strategies aim at maintaining the credibility of the organization and increasing the belief among the people about the treatment offered to them. The credibility about quality assurance is essential for any organization to reach different people and locations globally. It would also facilitate the chance of increased funding opportunities from different sources and this would help developing the infrastructure of the organization in a better way and consequently the people would have better experience and treatment.
References
Choi, H. (2015). Prevention of Missing the Fee of Medical Supplies and Improvement Activity of Cost Cutting. Quality Improvement In Health Care, 21(1), 52-61. http://dx.doi.org/10.14371/qih.2015.21.1.52
Hayward R, Hofer T; Hofer (2001). “Estimating hospital deaths due to medical errors: preventability is in the eye of the reviewer”. JAMA. 286 (4): 415–20. doi:10.1001/jama.286.4.415.
Is Total Quality Management/Continous Quality Improvement or Quality Assurance Applicable in Health Services?. (2016). International Journal Of Health And Medical Sciences, 2(1). http://dx.doi.org/10.20469/ijhms.2.30002-1
Staines, A., Thor, J., & Robert, G. (2015). Sustaining Improvement? The 20-Year Jönköping Quality Improvement Program Revisited. Quality Management In Health Care, 24(1), 21-37. http://dx.doi.org/10.1097/qmh.0000000000000048