Patients’ Safety: Quality Management and Improvement

Introduction

The need for safety and quality improvement schemes pervades health care. Lohr and Schroeder define quality healthcare as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (2000, p. 1161). Many of the errors that occur in health facilities emanate from faulty processes and systems, not from healthcare providers. Lohr and Schroeder posit, “Factors like health insurance, variable and inefficient processes, and variations in healthcare provider’s experience and education add to the intricacy of health care” (2000, p. 1163).

These intricacies make it hard for nurses to guarantee the safety of patients seeking their services (Lohr & Schroeder, 2000). To make sure that nurses guarantee patients’ safety, health facilities require integrating quality improvement (QI) strategies into their performance measurements. Besides, they require incorporating information technology into the management of quality improvement. This paper will discuss three methodologies for integrating quality improvement strategies into patients’ safety measurements. Besides, the paper will discuss how health facilities may use information technology, benchmarks, and milestones to manage quality improvement.

Methodologies for integrating QI strategies into performance measurements

Health facilities can use numerous methodologies to integrate quality improvement strategies into patients’ safety measurements. Some of the methodologies include clinical practice improvement (CPI), failure modes and effects analysis (FMEA), and lean methodology. Clinical practice improvement is a “multidimensional outcome methodology that has direct application in the clinical management of individual patients” (Rosenthal & Sutcliffe, 2002, p. 160).

One of the pros of the methodology is that it assists to gain a broad understanding of the challenges of health care delivery, thus guaranteeing the safety of the patients. The methodology collects information, which helps nurses make necessary changes in service delivery processes. Hence, it helps healthcare providers make requisite changes whenever they realize that their services do not meet the safety standards.

The only disadvantage of using this methodology is that it is time-consuming and requires several participants. To enhance patients’ safety, nurses require collecting adequate information to understand all the factors that hamper the safety, thus implementing the necessary changes. This case would require thorough research; hence, it will be time-consuming (Rosenthal & Sutcliffe, 2002).

Another methodology that might help enhance patients’ safety in health facilities is the lean methodology. The methodology identifies patients’ needs and works to enhance safety in service delivery by eliminating activities that pose a threat to patients (Endsley, Magill & Godfrey, 2006). One of the pros of lean methodology is that it helps improve the quality of services offered to patients. The methodology addresses the origin of a challenge.

Consequently, it guarantees a lasting solution to the challenge. The lean methodology helps healthcare providers identify the problems facing individual patients and address them individually. Hence, the lean methodology helps offer customized care to individual patients. The success of lean methodology calls for cooperation among all the healthcare providers (Endsley, Magill & Godfrey, 2006). However, in many cases, it is hard to win the support of all healthcare providers, thus affecting the success of the methodology. Moreover, the lean methodology requires thorough training and research. Consequently, the methodology is time-consuming (Endsley, Magill & Godfrey, 2006).

FMEA is another methodology, which can aid in the improvement of patients’ safety in healthcare facilities. Spath and Hickey describe FMEA as “an evaluation technique used to identify and eliminate known and/or potential failures, problems, and errors from a system, design, process, and/or service before they occur” (2003, p.17). FMEA methodology assists healthcare providers in anticipating and analyzing possible dangers that patients are likely to face and coming up with measures to mitigate them. The methodology helps maintain patients’ safety by identifying all the possible threats that might affect the patients and taking the appropriate steps to deal with the threats.

Besides, it analyzes the system of care that a health facility utilizes and works to enhance the safety of the system. FMEA depends on the skills of the involved healthcare providers. Hence, in case the providers do not have vast experience, it is hard to come up with a comprehensive quality improvement mechanism (Spath & Hickey, 2003). The methodology is incapable of identifying convoluted failure modes that entail numerous challenges facing a system. Hence, healthcare providers may not be able to guarantee patients’ safety using this methodology alone.

Clinical practice improvement (CPI) is the appropriate methodology for improving patients’ safety in healthcare facilities. The methodology helps healthcare providers gain a comprehensive understanding of the safety challenges that might affect individual patients, unlike the other two methodologies that might not be able to identify all the factors that may cause a threat to patients’ safety. Besides, the methodology promotes staff empowerment, thus encouraging creativity among the healthcare providers, which in return adds to the quality of services.

Information technology applications

Chae et al. posit, “Information technology plays a critical role in the management of quality improvement processes” (2006, p. 344). Healthcare facilities may use numerous information technology applications to improve patients’ safety. Some of the information technology applications that are accessible in healthcare facilities include electronic patient records applications, telemedicine applications, and consumer e-mail links applications.

Beth Israel Hospital in Boston has been using electronic patient records applications for decades (Chae et al., 2006). The information technology application assists healthcare providers in examining test results, sending e-mails, requesting referrals, and searching for drug information without the need to visit the healthcare facility. This application would go a long way towards improving patients’ safety. It would assist the healthcare providers in making real-time decisions on challenges that a patient is facing. Moreover, the application would help the healthcare providers access all the past medical records of a patient instantaneously; therefore, guaranteeing quality treatment.

E-mail links application enhances communication among the healthcare providers. The application improves the quality of services delivery since healthcare providers take a short time to make critical decisions. Nurses and other healthcare providers would have to wait for weekly staff meetings to pass across crucial information, in the absence of the application. E-mail links application may help enhance patients’ safety in healthcare facilities. Instantaneous delivery of critical information would prompt healthcare providers to work on means to address the prevailing problem immediately (Chae et al., 2006). Moreover, e-mail links application would help healthcare providers share information concerning safety measures, thus guaranteeing the safety of all patients.

In Australia, medical practitioners use telemedicine applications to liaise with diagnostic imaging experts. This case has enhanced the speed and precision of patient diagnosis and cut down on operations costs. Telemedicine application would help improve patients’ safety in healthcare facilities since they would be able to diagnose and address the exact problems that a patient is facing (Reeves, Matney & Crane, 2004). The medical practitioners would be able to attend urgent cases without having to wait for specialized practitioners. Telemedicine application allows medical practitioners to collaborate with remote specialists. Hence, it would help improve the safety of patients by consulting the specialists in areas that healthcare providers do not understand.

Benchmarks and milestones

Healthcare facilities may use benchmarks and milestones to manage the use of quality indicators. Gift and Mosel describe benchmarking as, “the continual and collaborative discipline of measuring and comparing the results of key work processes with those of the best performers” (2003, p. 5). Healthcare facilities may use benchmarks and milestones to enhance patients’ safety. For instance, the facilities may commit themselves to lowering the mortality or infection rate by a certain percentage and work towards accomplishing the target. Besides, one facility may use another facility’s accomplishments as its benchmark and work towards attaining the same (Gift & Mosel, 2003).

To improve patients’ safety, a healthcare facility may identify various Achievable Benchmarks of Care (ABC) and work on them. The benchmarks may include lipid screening, blood pressure screening, and circumventing antibiotics in respiratory illnesses. These benchmarks may work as crucial quality indicators in helping a healthcare facility to determine if it is making positive progress.

On the other hand, a healthcare facility may establish numerous milestones to help it to improve patients’ safety. For instance, the facility may adopt policies aimed at helping it to address the blood pressure problem. The policies would assist the healthcare facility to lay down strategies for addressing the problem. Another milestone that may help to manage quality indicators is the development of the alone program, which encompasses all the activities aimed at improving patients’ safety. Such a program would make it easy for a healthcare facility to monitor its progress (Gift & Mosel, 2003).

The development of a service or program that helps patients deal with safety challenges is another milestone that can help a healthcare facility manage its quality indicators. The program would augment the facility’s endeavors to offer safe and quality services to patients.

Quality improvement and organizational mission, vision, and strategic plan

Many organizations do not align their performance measures with organizational mission, vision, and strategic plan. Consequently, such organizations end up not attaining their vision since the staff does not work towards the vision. An organization may align performance and quality measures with its mission, vision, and strategic plan by devising a personal goal card for every employee (Reeves, Matney & Crane, 2004). The personal goal card connects organizational goals with the employee’s goals. The card is developed using organizational mission, vision, and strategic plan. From the three, an organization comes up with a performance management system that assigns individual goals to particular employees to help the organization to achieve its vision.

In this case, the organizational mission, vision, and strategic plan are aimed at improving patients’ safety. This goal can be achieved by aligning the mission, vision, and strategic plan with performance and quality measures. The organization has identified numerous benchmarks to act as its quality indicators. Hence, the organization may use the benchmarks to develop an operations strategy that seeks to accomplish the benchmarks.

For instance, the organization may develop various goals that are in line with the benchmarks and assign them to different employees. This case would imply that, as employees work towards accomplishing the individual goals, they would help the organization to achieve its benchmarks. Therefore, the organization would have aligned performance and quality measures with its mission, vision, and strategic plan.

Reference List

Chae, Y., Kim, S., Lee, B., Choi, S., & Kim, I. (2006). Implementing Health Management Information Systems: Measuring Success in Korea’s Health Centers. International Journal of Health Planning and Management, 9(1), 341-348.

Endsley, S., Magill, M., & Godfrey, M. (2006). Creating a lean practice. Family Practice Management, 13(4), 34–8.

Gift, R., & Mosel, D. (2003). Benchmarking in health care. Chicago, IL: American Hospital Publishing, Inc.

Lohr, K., & Schroeder, S. (2000). A strategy for quality assurance in Medicare. The New England Journal of Medicine, 322(1), 1161–1171.

Reeves, S., Matney, K., & Crane, V. (2004). Continuous Quality Improvement as an Ideal in Hospital Practice. Health Care Supervisor, 13(1), 1-12.

Rosenthal, M., & Sutcliffe, K. (2002). Medical error: what do we know? What do we do? San Francisco, CA: Jossey-Bass.

Spath, P., & Hickey, P. (2003). Home study programme: using failure mode and effects analysis to improve patient safety. AORN Journal, 78(1), 16–21.

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