In the conditions of healthcare reform, the transition from multi-channel to single-channel financing, changes in the legal status, ownership forms of medical institutions are being carried out. Organizational and economic changes in healthcare represent innovations that contribute to the development of the competitiveness of a medical institution. In this connection, there is a need for a consistent and thoughtful change management strategy. Based on the features of various organizational and economic change management concepts, a comprehensive vision when implementing changes in medical organizations is crucial. Therefore, it seems appropriate to use different concepts of change management and quality management. Such a mechanism for managing changes within the health care organization can be the accreditation of medical, social and economic efficiency.
Most Appropriate Accrediting Body
Public authorities, within the limits of their powers, are responsible for ensuring guarantees in the field of healthcare. State control should concern the quality and safety of medical institutions. In addition, it evaluates the circulation of medicines, medicines and medical devices. State accrediting bodies can be divided into two types (Penner, 2017). The first group includes those who carry out inspections in order to control health protection. The second group is other state supervision bodies that conduct inspections of commercial and entrepreneurial activities in the field of healthcare.
The medical activity of the health care organization is the performance of works and the provision of services related to pre-medical, emergency, ambulance, outpatient and inpatient care. This category also includes preventive, diagnostic, therapeutic measures and examinations; all these activities require mandatory accreditation. Based on the nature and duration of the services provided, the crediting body which is the most appropriate for health care organization is a state supervision service in the field of social development and healthcare. This body conducts accreditation by collecting, processing and analyzing the information received during monitoring. This makes it possible to determine the priority of quality, efficiency and safety in the implementation of the activities of the health care organization.
There are four types of accrediting that are applied to medical organizations by this body. The planned one involves accrediting compliance by a legal entity or an individual entrepreneur with the requirements prescribed in legal acts. Unscheduled accrediting is expressed in checking compliance with requirements and compliance with regulations, carrying out measures for the prevention of diseases (Adams et al., 2020). The documentary accrediting is carried out in order to verify the information contained in the documentation. During the on-site accrediting, the employees of the supervisory authorities go directly to the medical institution. They assess the condition of the territory, buildings and structures, equipment, medicines sold, etc. Based on the specifics of the organization, the necessary type of accreditation will be a scheduled inspection.
Requirements To Obtain Accreditation
To obtain accreditation, it is required to get a satisfactory assessment on three factors: medical work, medicines and medical equipment. In order for the check to go well, the documentation of the institution must be kept in order. Often representatives of accreditation pay great attention not only to the object of economic activity, but also to regulatory documents. A medical facility should be safe for patients, that is, so that people do not get infected in the hospital. The environment should not suffer from the activities of specialized institutions. All health workers should be provided with healthy working conditions. On the part of medical institutions, preventive measures of an anti-epidemic nature should be carried out on time.
Such items as the implementation of safe medical care, disinfection, sterilization and parameters of microclimatic conditions fall under special control. In addition, in order to be accredited, a medical institution must dispose of waste in a timely manner and deal with the prevention of infectious diseases that are transmitted through the blood (Leger & Dunham-Taylor, 2018). During the inspection, all documentation should be available, which concerns medical books of employees, employment contracts, diplomas of specialists operating in the clinic. The controlling magazines, the license, the cash register must be in order, and the law that protects the rights of consumers must be enforced. Upon the fact of the inspection, an order is issued, which indicates the shortcomings to be corrected. They are eliminated within the strictly allotted time, and after that another accrediting takes place, according to the results of which final accreditation is awarded.
Performance And Quality Metrics
There are many approaches and opinions regarding the most optimal and suitable ways to improve the quality of medical care for the organization of healthcare. First of all, it should start with increasing attention to the activities of junior and middle staff of a medical institution (nurses, orderlies, laboratory assistants, etc.). They perform significant work, including ensuring safety and high quality of medical services. The level of patient satisfaction depends more on them.
As part of the improvement, it is necessary to determine that the accreditation verifies the social performance of a single institution. It is crucial to proceed from the fact that the result of the activities of a single medical institution is a definite, clearly delimited part of the activities of the entire healthcare system (Adams et al., 2020). The positive result of the activity of an inpatient institution in connection with this approach should directly reflect the personal parameter. This is a change in the state of human health to the extent that the patient can be transferred to another stage of medical care or returned to society to perform their functions.
It is the improvement of the personal nature of the result, and not the fact that the institution provides medical services or their volume, that should be the result of the work of the healthcare institution. The types and volumes of services are only its content. In other words, the completed case, being a volumetric indicator, does not reflect the result (Penner, 2017). A qualitatively completed case used in healthcare to evaluate the activities of institutions is a promising quality metric, the growth of which must be sought within the framework of improvements. The method of assessing the degree of implementation of an individual patient management plan is closer to assessing the result of the institution’s work. The nurse performance and quality metric are key to the quality improvement project that needs to be submitted to the accrediting body.
The available financial resources of the healthcare institution are mainly enough only to finance current activities, that is, the provision of medical services and the renewal of certain types of medical equipment. However, these funds are not enough to stimulate staff, carry out repairs and other things. Due to the upcoming quality changes, it is necessary to improve the quality of financial management. There are many opportunities to improve the efficiency of financial management, but this does not mean simply reducing costs (Leger & Dunham-Taylor, 2018). Efficiency is a measure of the quality and/or quantity of results (i.e., health indicators or services) obtained at a given level of incoming resources (i.e., costs). Thus, increased efficiency can help to contain costs by reducing the cost of providing a service.
It is necessary to conduct a staff assessment based on a needs study and appropriate professional training, and to review the bonus policy. Flexible contracts and performance-based fees should also be implemented. It might be beneficial to reallocate responsibilities and other ways to establish the conformity of skills to needs. When implementing the considered project with the specified metrics of improvement variables, the healthcare organization, without actually carrying out any direct costs, can cooperate with insurance companies. This cooperation can become a significant additional source of profit for the hospital from the provision of paid medical services. Thus, there will be a source of funding for the changes carried out for the successful completion of accreditation.
Accreditation of the quality of medical services is one of the most important parameters that should be taken into account when managing a clinic. The more flexible the clinic responds to the opinion of patients, the more customer-oriented service can be offered. Medical organizations should not hinder the implementation of evaluation measures. On the contrary, they should assist the procedure by creating favorable conditions for a comprehensive accreditation. All information about specialists and services provided in the medical institution must be provided in full. In order for an accrediting of the medical services quality to be as objective as possible, metrics that reflect them should be taken into account. Thus, healthcare organization accreditation is carried out in order to ensure the quality of healthcare and requires careful long-term preparation.
Adams, M. P., Urban, C. Q., El-Hussein, M., & Osuji, J. (2020). Pharmacology for nurses. Hoboken, NJ: Pearson.
Leger, M. J., & Dunham-Taylor, J. (2018). Financial management for nurse managers: Merging the heart with the dollar. Burlington, MA: Jones & Bartlett Learning.
Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders. New York, NY: Springer Publishing.