Quality Improvement in Healthcare
Benefits of Good Communication among Healthcare Professionals
Rebecca L. Uckele
School of Business, Liberty University
BUSI 511: Healthcare Administration
Dr. Lynn Bulloch
Assignment Due Date: July 18, 2022
Quality Improvement in Healthcare Benefits of Good Communication among Healthcare
Professionals
Bartunek, J. M. (2011). Intergroup relationships and quality improvement in healthcare.
BMJ Quality & Safety, 20(Suppl 1), i62–i66.
This article discusses the importance of communication among physicians, nurses, and
administrative staff, focusing on initiatives and recommendations that can improve quality.
Communication is lost at times when errors may occur among nurses, who may be able to fix the
problem, but do not communicate the error or the course that was used to fix it. The physician
may see themselves as “higher” than others and assume the communication relationship is
working, as the nurses and administrative team feel itis not. The goal of this article is to improve
the intergroup relationships and discuss intergroup dynamics such as social identity,
communities of practice, and socialization into professional identities (p. i62) while also
identifying where the weaknesses lie in communication and the ability to work together.
Batalden, P. (2018). Getting more health from healthcare: quality improvement must
acknowledge patient co production—an essay by Paul Batalden. BMJ, k3617.
Batalden focuses on the primary goal of how, and what tools to use to transform and improve
healthcare. The author of this article thinks more along the lines of systems and processes to
integrate in order to improve healthcare, i.e., electronics and cars, comparing the two, “making a
product”, and “making a service” (p.1). The author expresses this as “product dominant
thinking” (the customer/patients or service view), good communication between provider and
patient is important as this will determine the patients’ health output. Knowledge needed to
improve healthcare systems are many, in order to achieve measurable performance improvement,
there needs to be a “Generalizable (a group dedicated to community-based research) scientific
knowledge and particular context” (p.3). The author uses formulas to reach measurable
improvements in the healthcare systems.
Brandrud, A. S., Nyen, B., Hjortdahl, P., Sandvik, L., Helljesen Haldorsen, G. S., Bergli,
M.,Nelson, E. C., & Bretthauer, M. (2017). Domains associated with successful quality
improvement in healthcare – a nationwide case study. BMC Health Services Research,
17(1).
This article focuses on successful domains used for quality improvement in healthcare.
Brandrud et.al. lists five domains that were used in this nationwide study; measurement and
guidance, leadership engagement, professional environment, group process, and leadership
impact (p.5). The authors discuss two of the domains that were successful in quality
improvement, measurement and guidance, and professional environment. A combination of
knowledge-based factors show success in quality improvement and patient-centered care, factors
such as "knowledge of best practice, provided by professional subject matter experts, knowledge
of current practice provided by simple measurement methods, learned from improvement
knowledge experts who provided good guidance and help with measurement" (p. 8). All these
factors can improve quality and patient care, good communication with professional experts is a
necessary link between practice and care.
Cohen, R. I. (2018). Lean Methodology in Health Care. Chest, 154 (6), 1448-1454.
https://doi.org/10.1016/j.chest.2018.06.005
Improvement methods and strategies have been around for decades in the manufacturing
industries, this article will review a Lean project (an improvement philosophy), that was made
known by Toyota Motor Company. Cohen states, Lean "focuses on eliminating waste as
perceived by the patient, thereby maximizing quality and safety for the patient" (p. 1448). A
combination of innovative leadership and motivated healthcare professionals is required for the
success of Lean goals; communication will have to be a major priority between the two in order
to achieve these goals. In this article the focus is the discussion on how the use of the Lean
project is a quality improvement method and how its utilization in healthcare over the last
approximately 15 years has shown to engage frontline health -care workers and administrative
workers to improve safety, quality, and service.
de Jonge, V., Nicolaas, J. S., van Leerdam, M. E., & Kuipers, E. J. (2011). Overview of the
quality assurance movement in health care. Best Practice & Research Clinical
Gastroenterology, 25 (3), 337-347. https://doi.org/10.1016/j.bpg.2011.05.001
Quality assurance (QA) is defined as "part of quality management focused on providing
confidence that quality requirements will be fulfilled" (ASQ, 2021). This article focuses on the
need for QA and its importance in quality improvement. The importance that is described here is,
improving healthcare by way of QA and quality improvements can help build a safer health
system. This article lays out the basic principles addressing QA and how throughout history
healthcare has learned from it and its importance throughout the healthcare industry. The authors
of this overview address the constant efforts healthcare has taken and continue to take in order to
deliver quality care, a collaborated effort with all stakeholders in health care will give further
quality initiatives. Quality assurance relies on the ability to communicate and work well with
your team, in order to be successful your team must be dedicated to communicating and can
work in sync with one another, quality does not come from one single individual. (Debiazzi,
2020).
Field, J. M., Heineke, J., Langabeer, J. R., & DelliFraine, J. L. (2014). Building the Case
for Quality Improvement in the Health Care Industry. Quality Management in Health
Care, 23 (3), 138-154. https://doi.org/10.1097/qmh.0000000000000036
Field et.al., explains the importance of improving quality within health care organizations, since
the passing of the affordable care act (ACA), and the increase in the aging population there has
been pressure on healthcare to improve the efficiency and effectiveness of care delivery (p. 138).
One idea that has been common among these articles is where quality improvement originated
from, that being "industrial", more specifically automotive industry. The improvement
methodologies, for example, Six Sigma and Lean that had been used in these industries were
believed to also benefit healthcare industries.
Fischer- Grönlund, C., Brännström, M., & Zingmark, K. (2021). The 'one to five' method –
A tool for ethical communication in groups among healthcare professionals. Nurse
Education in Practice, 51, 102998. https://doi.org/10.1016/j.nepr.2021.102998
This article brings an ethical approach into quality care and communication. The author's aim is
to implement inter-professional ethical communication in healthcare organizations (2021).
Communication between healthcare professionals and patients is just as important as
communication between the healthcare professionals themselves.
Communication in healthcare can sometimes bring difficult situations and one needs to be able to
meet the needs of patients, ethically, "an ethically difficult situation is defined as one in which
values, principles and interests' conflict and it is difficult to judge what is right and good in the
specific instance" (p.1). "Communication between the patient, family, and clinicians is a critical
component of high-quality, safe care and the foundation of partnerships between the patient,
family, and clinicians." (ahrq.gov) Clinical communication on ethical issues can "promote good,
person-centered care and prevent moral distress"(p. 1)
Kaplan, H. C., Provost, L. P., Froehle, C. M., & Margolis, P. A. (2011). The Model for
Understanding Success in Quality (MUSIQ): building a theory of context in healthcare
quality improvement. BMJ Quality & Safety, 21 (1), 13-20. https://doi.org/10.1136/bmjqs-
2011-000010
The authors in this article focus on quality improvement studies that show modest improvements
and failures in healthcare, they focus from these studies to the studies determining why, when,
and where these aimed studies worked most effectively. The authors describe these studies as
"The Model for Understanding Success in Quality, MUSIQ", trying to understand the deeper
roots in the success of quality improvement.
The authors in this article list several contextual factors that are included in MUSIQ, external
environment/motivators, project sponsorship, and organization/QI leadership, senior leader
project sponsor culture supportive of QI, maturity of organizational QI physician payment
structure QI support and capacity data infrastructure, resource availability, workforce focus on
QI, microsystem QI leadership, culture supportive of QI, capability for improvement motivation
to change, QI team diversity, physician involvement subject matter expert, team tenure prior QI
experience team leadership, team decision-making process team norms, team QI skill
miscellaneous trigger, and task strategic importance to the organization. All of these factors have
influences on QI.
Niñerola, A., Sánchez-Rebull, M. V., & Hernández-Lara, A. B. (2020). Quality
improvement in healthcare: Six Sigma systematic review. Health Policy, 124 (4), 438-445.
https://doi.org/10.1016/j.healthpol.2020.01.002
As discussed in a previous article a six sigma is an improvement methodology similar to the
Lean methods, these methods date back decades to the auto industry. "Six Sigma is a
management system that seeks to improve the efficiency of processes, reducing defects [1] to
achieve improved quality and customer satisfaction" (p. 438). This system was extended into
healthcare after its continued success in industrial quality. Utilizing the Six Sigma has a strong
impact on healthcare as it has been proven to have improved medical procedures, among many
other situations in healthcare. The author's main purpose for this article is breaking down the
"Six Sigma literature", while applying it to the healthcare sector.
Pannick, S., Sevdalis, N., & Athanasiou, T. (2015). Beyond clinical engagement: a
pragmatic model for quality improvement interventions, aligning clinical and managerial
priorities. BMJ Quality & Safety, 25 (9), 716-725. https://doi.org/10.1136/bmjqs-2015-
004453
The authors here describe the realistic way for healthcare to improve quality in the medical
system. They discuss the assumptions that management plays an important role in quality
improvement as this is not proven, the comparison between management and frontline workers
are explored to see the levels of participation of quality. The authors further discuss the roles in
management and staff and their clinical involvement in quality improvement. The theory behind
the support between management and frontline staff in healthcare have previously been explored,
this article dives deeper into these relationships. There is also the question that quality
improvement is, or should be, common sense.
Reese, D., Dolansky, M. A., Moore, S. M., Bolden, H., & Singh, M. K. (2021). Quality
improvement education innovation: evaluation of Coursera MOOC 'Take the Lead on
Healthcare Quality Improvement. ‘Journal of Research in Nursing, 26 (1-2), 62-78.
https://doi.org/10.1177/1744987120982644
The world health organization speaks on the gaps in healthcare quality and safety and that they
are a critical national and international problem, and these gaps that often result in death. (2003)
Quality improvements are methods to improve and address these gaps. This article focuses on
the "massive open online courses" (MOOC), "Take the Lead on Healthcare Quality, and the
circulation of quality improvement learning globally. The purpose of this article is to find the
effectiveness and satisfaction of the MOOC and what can be added for improvement. These
studies with MOOC had gains in learner outcomes, along with; QI knowledge, attitude, self-
efficacy and systems thinking. This model, MOOC is an effective way to provide a QI
curriculum globally to frontline workers, and those that participated in the MOOC had
improvements in knowledge, attitude, self-efficacy and systems thinking.
Rubinelli, S., Silverman, J., Aelbrecht, K., Deveugele, M., Finset, A., Humphris, G., Martin,
P., Rosenbaum, M., van Dulmen, S., & van Weel-Baumgarten, E. (2019). Developing the
International Association for Communication in Healthcare (EACH) to address current
challenges of health communication. Patient Education and Counseling,102 (6), 1217-1221.
https://doi.org/10.1016/j.pec.2019.01.004
This article focuses on current challenges of health communication, Rubinelli et.al., discuss
EACH, formally known as "European Association for Communication in Healthcare", now
known as "International Association for Communication in Healthcare". "Effective
communication between patients, relatives, and healthcare practitioners is essential in achieving
better access to healthcare" (p. 1217). The authors discuss roles and positions, mission and
strategies, and the main developments in EACH world of healthcare and promotion of health
communication.
Siverbo, K., Eriksson, H., Raharjo, H., & Moonen, M. (2014). Attitudes toward quality
improvement among healthcare professionals. International Journal of Quality and Service
Sciences, 6 (2/3), 203-212. https://doi.org/10.1108/ijqss-02-2014-0017
The need for quality improvement is increasing due to the complexity of hospital organizations,
requiring "administrative and organizational support to meet the demands placed on them" (p.
204). With the growing rate of patients’ complexity and medical conditions, the previous
standards that were sufficient in providing quality care are no longer sufficient. This article
focuses on comprehensive training in quality improvement and encouraging the participants to
continue their efforts in using quality improvement processes. In providing and implementing
training and coursework on quality improvement patient care will increase, during these events
there is a communicative approach in introducing new ideas and support and updating existing
working strategies that should improve the course of healthcare.
Suliman, S., Hassan, R., Athamneh, K., Jenkins, M., & Bylund, C. (2018). Blended learning
in quality improvement training for healthcare professionals in Qatar. International
Journal of Medical Education, 9, 55-56. https://doi.org/10.5116/ijme.5a80.3d88
This article focuses on blended learning in quality improvement training for healthcare
professionals in Qatar (a country in western Asia). Like the US Qatar also shows an importance
in quality importance for both health care professionals and the organizations. The authors
discuss how patients have better outcomes in their care when healthcare providers incorporate QI
into their daily work. This article mentions the approach of blended learning (BL) , a
combination of classroom and online learning experience, focusing on self-directed learning
would result in a longer retention of knowledge learned.
ŽVanut, B., Burnik, M., Kolnik, T. T., & Pucer, P. (2020). The applicability of COBIT
processes representation structure for quality improvement in healthcare: a Delphi study.
International Journal for Quality in Health Care, 32(9), 577-584.
https://doi.org/10.1093/intqhc/mzaa096
This article discusses the applicability of COBIT (Control Objectives for Information and
Related Technologies), Quality improvement has a focus on safety and risks and the goals to
maintain them, COBIT is "a process-oriented framework for governance and management of IT
that helps in delivering value from IT and understanding and managing the risks associated with
IT" (p.578). Utilizing this process is another way to adopt and maintain QI, communicating
alternate ways to ensure the practice, processes and standards are met. The COBIT process is a
framework to help build upon quality improvement; they are the building blocks to higher levels
of quality in healthcare, to help develop and organize strategies around information management.
References
Actminds. (2020, September 23). Quality Assurance Methodology.
https://www.actminds.com/blog/the-role-of-communication-in-quality-assurance-and-
compliance-processes/
Quality Assurance vs Quality Control: Definitions & Differences | ASQ
. (n.d.). ASQ. Retrieved July 16, 2021, from https://asq.org/quality-resources/quality-assurance-
vs-control
