Can someone please complete this discussion board due on 4/23/17?
Current and Emerging Trends in Healthcare
Topic Research/Selection and Literature Review
Bettina Casimir
Colorado Technical University
Dr. Mountasser Kadrie
Part 1: Topic Research and Selection
There are a number of things that health cares are doing in order to increase profitability. What most organizations have found to be effective is the introduction of quality improvement program. Organizations have succeeded in improving their performance through the use of effective quality improvement program. Organizations are seen with clinical and service quality improvement activities due to this program.
Having quality improvement program with all the basic elements work properly in assisting organization attain its goals, such as those directed towards increasing profitability and reducing costs. Below are the basic elements of quality improvement program:
Description of organizational objectives, program goals, and mission
Definition and explanation of major quality concepts and terms
Explanation of how quality improvement program is selected, managed, monitored
Explanation regarding training as well as support for people who will take part in the quality improvement process
Explanation of quality methodology, (such as Six Sigma) and quality techniques that will be utilized
Description of communication plan that will be employed and the manner in which updates will be communicated.
Explanation of measurement as well as analysis, and how the analysis will assist in defining future quality improvement activities.
Part 2: Literature Review
According to Swensen and colleagues, quality improvement program is very important since it is tightly coupled and intrinsically interlocked with cost, quality, trust, speed, and value. Quality improvement program has not yet spread so much throughout medical centers and hospital. The reason behind this is because it is not very clear to many hospitals and health care centers how quality improvement program directly benefits the financial status of the institutions far beyond the needs of society and that of patients. Most health care institutions have not embraced the idea and concept of quality improvement program. The management of most health care institutions has not realized that there is a relation between the business management strategy for fiscal well-being and achievement of optimal quality and improved patient outcomes (Swensen, Dilling, Mc Carty, Bolton, & Harper Jr, 2016). The major source of financial benefit or return seen by an organization will come from disciplined removal of waste with advanced techniques, such as systems engineering techniques. There are three major types of provider-related health-care waste. These are preventable harm, overuse, and inefficiencies. A lot of health care dollar spent by health care organizations is wasted. This is estimated to be about 40 percent. It is possible to design patient-centered care in a way that it can be provided or delivered with negligible wasted. Driving waste out of the organizations will reduce waste, which is possible through the implementation and use of quality improvement program. It will be possible to enhance employee engagement and build higher reputation high reliability performance. The satisfaction of patients will be increased through higher employee engagement. This will help drive the financial performance of health care organizations. Many people believe that quality improvement expenses and linked with accreditation and regulatory agencies. Due to this, people view this expense as those with little or no return on investment. Management of some health care organization argues that they are costs that have to be incurred in the process of doing business. They do not know that these costs can be reduced or avoided so as to make operations of a health care organization to be profitable.
As per Community Health Group (2016), the implementation of quality improvement program has enabled the organization provide quality health to its member for a longer period. Now, members are able to access quality, fairly priced, and exceptional services. Authority and accountability is being practiced throughout different levels of the organization. This has been through creation of Community Health Group’s (CHG) Board of Directors (Board) that has played a significant role when it comes to the designing, implementing, and monitoring quality improvement program of the Community Health Group. “The quality improvement program provides a formal process to objectively and systematically monitor and evaluate the quality, appropriateness, efficiency, safety, improve returns, and effectiveness of care and service utilizing a multidimensional approach” (Community Health Group, 2016, p. 102). Due to all these, the organization has succeeded in directing attention towards opportunities that improve its operational processes together with health outcome to patients and the society. Also, it has been able to attain satisfaction on practitioners/providers and members through the use of its quality improvement program. Another thing that is promoted by quality improvement program is the culture of accountability and quality to affiliated health personnel and workers to offer quality care as well as services to members. As per the managements of Community Health Group, the quality improvement program used on the organization has incorporated continuous quality improvement methodology, which directed attention to specific needs of all stakeholders, that is, health care provider, members, and community agencies.
Operations and financial performance of organization can be achieved through having a good work plan created by quality improvement program (HRSA, 2016). The quality improvement programs used by most organizations, among them a few health systems centers have important information relating to the manner in which the organization will deploy, manage, and review quality throughout the entire organization. Most quality programs are created by clinical leadership and executive. This has to be approved by the governing body of organization, which is usually composed of a board of directors. Once created, it has to be updated regularly. Regular update helps to ensure that the program reflects what an organization is doing with regards to improving quality and returns. Specific clinical area will be reflected properly through having an effective quality improvement plan. Focus area for current and subsequent calendar years will be reflected by the program. Management should not rush into creating a quality improvement plan. One has to establish an understanding of current status of an organization regarding quality improvement. This means that assessment of current activities of an organization have to be performed. The good thing with carrying out the assessment is that it makes it easy to know the weaknesses and strength of an organization. Also barriers to sustaining or maintaining quality improvement program can become clear (HRSA, 2017). There are some common barriers when comes to quality improvement projects that have been identified. Some of these barriers are: lack of enough resources, lack of good quality management organizational structure to support the process of improvement overtime, lack of proper communication and feedback to staff and providers, lack of periodic feedback and monitoring, lack of interest as well as changing priorities, and changing staff and not integrating sufficient training to staff that is in existence.
The Ontario’s Health Care Organization has seen better performance due to its quality improvement plan (Ontario, 2016). This health care organization has directed much attention on making sure that it provides high quality and integrated care to all its patients, residents, and clients. This is through making sure that each and every person working for the organization and in the organization has shared objective, which is providing quality care. Provision of quality care will increase the satisfaction of residents and patients when it comes to the services of the organization’s services. The organization tries to act as per the principles that are found in the Excellent Care for All Act (ECFAA), which are related to the provision of integrated and quality care. Furthermore, this is shared within broader system initiative and priorities. Due to the Excellent Care for All Act (ECFAA), the quality improvement plan for Ontario’s Health Care Organization has created better foundation for the health care system when it comes to commitment in improving the quality of care Ontarians receive, transparency, accountability, and directing focus to patient-centered activities. The quality improvement plan for Ontario’s Health Care Organization is a document that has information regarding quality commitment that is in line with provincial and system priorities (Ontario, 2016). The organization makes these priorities to its patients and the society at large. As a result of this, improving quality is made easier due to focused actions and targets. Also, it becomes easier for the government to monitor plans of various organizations when it comes to achieving some defined targets through going through quality improvement plans. Most organizations have quality improvement plans that are almost similar. Even with similarity, they have succeeded in attaining better performance due to their quality improvement plans.
Ogrinc and colleagues (2016) directed much of their attention to quality improvement program development process in their research titled “for Quality Improvement Reporting Excellence.” Many organizations have seen better performance due to the used of an effective quality improvement program. The use of a good development process while designing quality improvement program is very important. There are some organizations that have not been successful while using their programs. A number of stakeholders should be involved in the development process of an effective quality improvement program. Some of stakeholders to be involved are the board of directors for an organization, patients/ clients/residents, clinicians, senior management, and other staff. The senior management as well as the board of directors should make sure that the organization is meeting targets that have been set out in the quality improvement program. The performance improvement of an organization will be supported by a good quality improvement program. Due to this, goals of an organization become very easy to attain, where the major goal revolves around getting better returns or good profitability. The development of quality improvement program should be driven by system-level priorities. To be specific, these are metrics that direct attention to integrated care across patient care settings and across sectors. These have to be prioritized so as to come up with quality improvement program that touches on the functional integration efforts of the entire health care system (Ogrinc et al., 2016). The needs of the patients, clients and residents have to be taken into consideration while creating quality improvement plan. This is because their health care experience is what should be the top priority of health care organization. This should be properly incorporated in the quality improvement plan of an organization. The management and other people designing the quality improvement program should move even further to come up ways through which the needs of customers can be enhanced in a way that the organization was not performing earlier. It is possible to achieve this through surveys or directly involving patients, residents, and clients in the process of developing quality improvement program. There should be incorporation of other system priorities. This will be directed towards optimal alignment across the region.
According to research carried out by Meehan and colleagues, there certain steps that can be followed so as to develop a good quality improvement program. The first step is to use organizational-level data. Doing this will meant to determine the current performance of an organization or coming up with baseline for the priority indicators. Organizations that are not having baseline should ensure that they begin the process of gathering data deemed necessary in the process. The second thing to do is to review the priority indicators for the organization. Once reviewed, those that are relevant should be determined. Reviewing the current performance of an organization against theoretical best for all priority indicators or provincial benchmarks will help support this process. If the management decides not to include a priority indicator in the quality improvement program (for instance, due to performance that is already good, that is, exceeding the theoretical best or benchmark), they should write down the reason in the comment section of the quality improvement plan (Meehan, Loose, Bell, Partridge, Nelson, & Goates, 2016).. Any other indicator that is important to the quality improvement program of the organization should be included. The third thing is to use the guidance that is provided to create a program so as to address each and every system level priorities that were identified for improvement. The fourth process in developing quality improvement program is to complete the Narrative to use to communicate the priorities that have been created. Another thing to be completed in this process is the progress report. The final step is sign-off. Sign-off entails approving of the quality improvement programs by parties that are involved, among them key senior leadership, the Quality Committee (if applicable), and the board of directors.
There are a number of benefits that are attributed to quality improvement programs or plans (Aragona, Ponce-Rios, Garg, Aquino, Winer, & Schainker, 2016). Effective quality improvement program positively drives the quality improvement process and structure, which support continuous quality improvement, including re-measurement, intervention, analysis, trending, and measurement. Also, the quality improvement program plays a significant role in supporting practitioners when it comes to quality improvement initiative. Governing regulatory agencies have also seen some benefits due to quality improvement program. Creating of service and clinical indicators that show epidemiological and demographic characteristics have been easy with quality improvement program. Now, organizations are able to come up with good benchmarks and design performance goals for periodic or continuous evaluation and monitoring.
Quality improvement is the process of process management (Haughom, 2017). The use of quality improvement program entails incorporating modern quality improvement approach. Generally, this helps to come up with modern organizations that have the ability to deal with complex challenges that are emerging in the market, such as those relating to managing costs and improving profitability. The approaches involved in the quality improvement programs are very simple. However, they have the ability of dealing with extraordinarily powerful issues. Much of the fact about quality improvement program and plan is based on process management. Many industries in different parts of the world have seen drastic changes or transformation due to quality improvement techniques and concepts. The use of quality improvement program is now being embraced in most health care institution after seeing some resistance for a longer time. Its effectiveness in the health care industry will make other industries, such education to embrace it with time. Health care is now very complex. But there is no big difference between it and other industries. This is because health care has about a thousand interlinked processes that are interlinked to make it a complex system. It is possible to change the challenges that are facing health care through directing attention to these small interlinked processes. “Now, this may seem like a tall order, but Pareto’s principle tells us that there are probably 20% of those processes that will get us 80% of the impact, so the challenge of every organization is to identify that 20%, roll up their sleeves, and begin the important work of addressing those challenges” (Haughom, 2017, p. 9).
Rosenberg (2016) found quality improvement program to be effective in insulin pen safety. The program was meant for health care professionals. There have been reports of safety concerns of insulin pen. Others have been relating to commitment to continue insulin pen use as well as optimize safeguards. This has affected the performance of some health care when it comes to service provision and satisfaction of the needs of customers. Through the use of quality improvement program, staff education on insulin pen preparation together with injection technique and improvement opportunities in insulin pen best practices were properly identified and implemented. The major problem that was identified during the process is storage of insulin pens for people with contact isolation precautions. It was easier to devise a practical solution once the problem was identified. Other things that were carried out during the quality improvement program were putting into place of barcode medication administration, scanning of insulin pens designed for certain patients, and prevention sharing of pen among patients. Participation in the mentor quality improvement program made it possible for the health professions to improve their service delivery.
References
Aragona, E., Ponce-Rios, J., Garg, P., Aquino, J., Winer, J. C., & Schainker, E. (2016). A quality
Improvement project to increase nurse attendance on pediatric family centered rounds. Journal of pediatric nursing, 31(1), e3-e9.
Community Health Group (2016). Quality Improvement Program Description. Retrieved from
http://www.chgsd.com/documents/QIProgDesc.pdf
Haughom, J. (2017). Five Deming Principles That Help Healthcare Process Improvement.
Retrieved from https://www.healthcatalyst.com/5-Deming-Principles-For-Healthcare-Process-Improvement
HRSA. (2016). Developing and Implementing a Quality Improvement Plan. Retrieved from
https://www.hrsa.gov/quality/toolbox/methodology/developingandimplementingaqiplan/
HRSA. (2017). Quality Improvement. Retrieved from
https://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/
Meehan, A., Loose, C., Bell, J., Partridge, J., Nelson, J., & Goates, S. (2016). Health system
Quality improvement: impact of prompt nutrition care on patient outcomes and health care costs. Journal of nursing care quality, 31(3), 217-223.
Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016).
Standards for Quality Improvement Reporting Excellence 2.0: revised publication guidelines from a detailed consensus process. Journal of Surgical Research, 200(2), 676-682.
Ontario (2016). Quality Improvement Plan (QIP). Guidance Document for Ontario’s Health
Care Organizations, 132-237. http://www.health.gov.on.ca/en/pro/programs/ecfa/legislation/qualityimprove/qip_guide.pdf
Rosenberg, A. F. (2016). Participation in a mentored quality-improvement program for insulin
pen safety: Opportunity to augment internal evaluation and share with peers. American Journal of Health-System Pharmacy, 73(19 Supplement 5), S32-S37.
Swensen, S. J., Dilling, J. A., Mc Carty, P. M., Bolton, J. W., & Harper Jr, C. M. (2016). The
business case for health-care quality improvement. Journal of patient safety, 9(1), 44-52.
