Proposal Review

Running head: ENHANCING QUALITY SERVICES 1

Quality Improvement Proposal at California District Hospital: Reducing Infant Mortality

Evette Grayson

University of Arizona at Global Campus

Professor Janie Hall

MHA 616 Health Care Management Information System

August 1, 2022

ENHANCING QUALITY SERVICES 2

Background

Setting: California District Hospital is in the spotlight for increasing cases of infant mortality. These

cases are prevalent among black American mothers who lose their children due to racism and

negligence of the health care providers (Senchyna et al., 2019). While this project focuses on the

cases of negligence and understaffing of this hospital, it will also evaluate ways of improving the

quality of health care services with a view to reducing infant mortality. This will ensure that the

hospital provides better services to expectant mothers now and in the future.

Health Care Service

There are various health care services that I can propose for the California district hospital. First,

the hospital is seriously understaffed and the available health care services cannot deal with the

high number of patients (Young et al., 2014). This affects the expectant mothers since they do not

get timely and quality services on time and hence, the majority of them usually end up losing their

children. First, the governor needs to ensure that adequate and quality medical personnel are hired

at California District Hospital. They will improve the quality of services and reduce the infant

mortality rate. Secondly, I also propose that the hospital management forms an inclusion council

that will oversee the daily management of this hospital. This inclusion council will consist of a

group of 5-10 professionals that will ensure that all patients are equally treated and that all

expectant mothers are given quality medical services that will guarantee safe delivery. This will

also help to reduce cases of infant mortality at the hospital (Obucina et al., 2018).

The Problem

We conducted a survey at the California District Hospital. A sample of 100 respondents was

conducted in order to determine the effectiveness of the medical services provided by this health

care organization. The sample consisted of 60 expectant mothers and 40 medical providers. This

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survey indicates that 56% of expectant mothers are not satisfied with the services provided by this

health care organization (Kokko, 2022). According to them, understaffing at California District

Hospital has resulted in the death of many infants since the mothers do not receive timely and

quality medical providers. Moreover, only 40% of the expectant mothers are satisfied with the

services while 4% are not sure. Consequently, 70% of the health care providers only decry

understaffing that leads them to overwork and hence, low-quality services. They admitted that

understaffing is the real reason for high infant rates at California District Hospital (Kokko, 2022).

Barriers to Quality Health Care Services

Various barriers have been identified in the quest to provide effective medical services in California

District. First, there is a lack of support from the California District and the leadership in California

State. As Young et al. (2014) state, the hospital management has on several occasions written to the

district and state requesting reinforcements in terms of medical personnel. However, the California

government is yet to provide any assistance to this healthcare organization. Furthermore, Senchyna

et al. (2019) state that the California District hospital has also failed to form a committee that will

oversee the functions of this health care organization. There are several laws and regulations

regarding how the hospital needs to operate but there is no committee to enforce the laws and

ensure that the policies are adhered to.

The Intervention

Various organizations such as the Center for Disease Control and Prevention (CDC) and the

institute for health care improvement (IHI) have written to California District Hospital and are

ready to help with quality improvement (Obucina et al., 2018). They have requested this health

care organization to identify the areas that need to be reinforced. Consequently, they will request

the federal government to provide additional support to this hospital with a view to providing

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enough medical personnel. Moreover, the IHI also requests that once the hospital receives

additional health workers, they will have to specifically assign some of their staff the role of

attending the expectant mothers at all times (Roubinian et al., 2021). This will help to reduce the

perennial cause of infant mortality in the future.

Process Defect

This process will use the triple aim health care approach to improve the quality of services at

California District Hospital;

I -improving patient care and ensuring that expectant mothers receive the best possible treatment

and attention.

R -reducing the cost of medical cover to ensure that even those without cash or medical insurance

are treated.

E -enhancing the health of patients by hiring more health care workers to oversee the interests of all

patients including expectant mothers.

Aim (Objective)

The main objective of this intervention process is to improve the quality of medical services to the

patients’ especially expectant mothers while also ensuring that they receive medical services at a

relatively low cost

Strategy for implementation

To implement this process, the California Health Organization will rely on the services of an

inclusion council. It is a group of professionals that will be selected by the state to ensure that they

oversee the transition or the changes. They will work under the following process;

S -Survey the hospital systems and processes to identify strong and weak areas.

C -communicate with all the stakeholders within the hospital about the imminent changes.

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P - Plan how the hospital will receive additional resources such as adequate personnel and medical

products.

D - Deliver the resources and ensure the plan is implemented according to the triple aim (Care,

health, and cost).

M - Monitor all the processes and ensure that patients receive proper medical services.

Measures

The hospital will comply with the triple aim in health care. The first aim is to reduce the cost of

medical services immediately. The second policy is to ensure that patients are adequately monitored

to improve their care and the third is to ensure that there is enough medical personnel to provide

proper medical services to the patients.

Barriers to change

The triple aim is a new health care policy and hence, healthcare providers may initially struggle to

implement this policy (Senchyna et al., 2019). However, experts will be deployed to implement

this health framework and help the health care providers understand and internalize this policy.

Simple rules

Only three rules need to be followed in triple aim healthcare; reduce the medical costs for patients,

monitor their progress to improve their condition, and have adequate health personnel to provide

quality medical services.

Cost implications

The process does not require any additional costs.

References

Kokko, P. (2022). Improving the value of healthcare systems using the Triple Aim framework:

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A systematic literature review. Health Policy , 126 (4), 302-309.

Obucina, M., Harris, N., Fitzgerald, J. A., Chai, A., Radford, K., Ross, A., & Vecchio, N. (2018).

The application of triple aim framework in the context of primary health care: A systematic

literature review. Health Policy , 122 (8), 900-907.

Roubinian, N. H., Dusendang, J. R., Mark, D. G., Vinson, D. R., Liu, V. X., Schmittdiel, J. A., &

Pai, A. P. (2021).

Incidence of 30-day venous thromboembolism in adults tested for SARS-CoV-2 infection

in an integrated health care system in Northern California. JAMA Internal

Medicine , 181 (7), 997-999.

Senchyna, F., Gaur, R. L., Sandlund, J., Truong, C., Tremintin, G., Kültz, D., & Banaei, N.

(2019).

Diversity of resistance mechanisms in carbapenem-resistant Enterobacteriaceae at a health

care system in Northern California, from 2013 to 2016. Diagnostic microbiology and

infectious disease , 93 (3), 250-257.

Young, D. R., Coleman, K. J., Ngor, E., Reynolds, K., Sidell, M., & Sallis, R. E. (2014).

Associations between physical activity and cardiometabolic risk factors assessed in a

Southern California health care system, 2010–2012.