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Quality improvement

Diana Velez

Phoenix University

March 7, 2016

Quality improvement involves continuous and systematic actions carried out by measuring improvements in healthcare services and health status of targeted groups of patients (McLaughlin & Kaluzny, 2006). This paper aims at evaluating quality improvements concerning patient safety at Davis Health Care. Patient safety can be described as the freedom from accidental injury. In quality improvement(QI), the management of data is a significant part of improving the performance of a healthcare organization. It involves the collection, tracking, analysis, interpretation and taking appropriate actions on organizational data for specific measures such as patient safety.

Measuring the inputs, processes and outcomes of a health system is a proactive and systematic approach to practice-level decisions for delivery systems and patient care. data management involves a continuous measuring and monitoring, and it enables an organization's quality improvement team to identify and implement available opportunities for improving its existing care delivery systems such as patient safety and monitor progress. Data needed for monitoring improvement in patient safety include information on evidence-based care provided, systems that affect patient access to quality care, the safety of the patients, support for patient engagement, cultural competence and coordination of medical care with other components of the healthcare organization. Tools that can be used for collecting performance information in relation to patient safety include benchmarking, brainstorming and surveys.

Benchmarking in Healthcare can be defined as a collaborative and continuous discipline used in measuring and comparing results of key work processes such as patient safety initiatives with those of best performers in measuring the organizational performance (Joint Commission Resources, Inc.; Joint Commission International, 2012). There are two different types of benchmarking that can be applied in measuring patient safety and quality performance. Internal benchmarking is used in identifying best practices inside an organization for comparing best practices within the organization and the current practice over time. The information gathered can be plotted on a control chart using statistically derived lower and upper limits. However, the use of internal benchmarking alone cannot yield information or results that are fully representative of the best practices. External or competitive benchmarking involves the use of comparative data between healthcare organizations to evaluate performance and identify patient safety improvements that have been successful in other organizations.

Brainstorming is a technique used for generating lots of ideas regarding a particular problem. It encourages creativity and incites enthusiasm. Common brainstorming techniques are unstructured, structured and silent brainstorming (Kelly, 2010). In a structured brainstorming, the group leader gathers ideas group members of the group one at a time and participants may skip contributing if they don't have an idea. This technique is advantageous since it offers equal opportunities for every member of the group to participate and contribute their ideas, but it disadvantage is that it is somehow restrictive. Unstructured brainstorming is free-form in which the participants contribute ideas freely as they come into mind, it is advantageous since the participants are free to build their ideas in a relaxed atmosphere. Its disadvantage is that it the tendency of being less assertive and the lower-ranking participants may not contribute. The silent brainstorming involves the collection of written ideas from the participants. It is advantageous since everyone's contribution is captured and disadvantageous since the group does not have the opportunity of building synergy of an open session.

Surveys are instruments used for gathering data that can either be qualitative or quantitative. There are different types of the survey including interviews and questionnaires (Kelly, 2010). Interviews are conducted with the participant responding in a face to face conversation or over the phone. Documentation of the respondent's comments is done by the interviewer. Questionnaires, on the other hand, involves gathering information from the respondents through electronic or paper instruments that are completed by the respondent independently. Quality improvement teams usually use questionnaires for collecting information relating to patient safety regarding their satisfaction with the services or processes. It can be a useful tool for gathering information, opinions and perceptions from individuals who are not members of the quality improvement team.

Similarities between benchmarking, brainstorming and surveys are that they are all used in gathering qualitative data that can be used for decision making in relation to the implementation of quality improvement measures for enhancing the safety of the patient in a health system. The difference between benchmarking and brainstorming is that in benchmarking, an organization gathers data by comparing its performance with other best-performing organizations in order to implement the overall best measures. On the other hand, brainstorming involves gathering data from the quality improvement team on the best measures that can be executed to improve the patient safety. Brainstorming and survey method differs in that as the brainstorming approach involves the collection of data from members of the organization, survey involves the gathering of the same data but from external sources that is individuals who are not members of the quality improvement team.

Efforts for measuring quality and patient safety need to be measured for demonstrating whether the quality improvement efforts are leading to change and the desired results, contribute to the expected results or require additional efforts for bringing an initiative back into acceptable ranges. The rationale for measuring quality improvement is the notion that good performance is a reflection of good quality practice, and the comparison of performance with other care providers and organizations can encourage better and improved performance.

Tools that can be used for measuring and displaying quality information in relation to patient safety include common formats, consumer assessment of healthcare providers and systems, patient safety indicators and quality indicators. Common formats are specifications that are normally used for collecting patient safety information in a standard approach, using common definitions, language and technical requirements for electronic reporting and implementation. They can be used for collection of data on all types of near misses, adverse events and unsafe conditions in healthcare organizations or settings, nursing homes and other institutions (Tweedy, 2014).

Consumer assessment of healthcare providers and systems is a range of surveys designed for measuring the experiences of patients in terms of care, communication with care providers, the responsiveness of medical staff and other indicators of high-quality and safe care (Tweedy, 2014). Quality indicators help in highlighting the potential quality concerns by identifying areas that require further study and investigation. Patient safety indicator is a data collection tool that reflects the quality of care within health systems (Tweedy, 2014). It provides different indicators for collecting performance information such as prevention quality indicator, inpatient quality indicators, and the pediatric quality indicators.

Similarities between common formats, consumer assessment of healthcare providers and systems and quality indicators is that they are all used in measuring quality in terms of performance of a given healthcare initiative such as patient safety and satisfaction. Differences between them are that they use different approaches to estimating and measuring performance. From the definition, common formats collect information relating to patient safety in a standard format. On the other hand, consumer assessment of healthcare providers and systems gathers similar information but from the perspective of the patient in terms of his/her satisfaction with the services provided by a particular healthcare system.

References

Joint Commission Resources, Inc.; Joint Commission International. (2012). Benchmarking in health care. Oakbrook Terrace, lL: Joint Commission Resources : Joint Commission International.

Kelly, P. (2010). Essentials of nursing leadership & management. Clifton Park, NY: Delmar Cengage Learning.

McLaughlin, C. P., & Kaluzny, A. D. (2006). Continuous quality improvement in health care. Sudbury, Mass: Toronto : Jones and Bartlett.

Tweedy, J. T. (2014). Healthcare Hazard Control and Safety Management (Third edition ed.). CRC Press.

Tweedy, J. T. (2014). Healthcare Safety for Nursing Personnel: An Organizational Guide to Achieving Results. CRC Press.