Fall Risk on Med/surgical Unit: A comparative Study of Using 5ps of Micro-system Framework to Deming Quality Improvement Theoretical Framework
Introduction
In the current health care environment, people are increasingly aware of the care quality of different health facilities. Therefore, hospitals and other health organizations take extensive efforts to enhance the quality of their overall health outcomes. In a medical/surgical unit, the issue of patient fall can adversely affect patient recovery, and hence, the overall health outcomes of the organization. This paper will compare fall risk on med/surgical unit using 5Ps of micro-system framework to Deming quality improvement theoretical framework.
The 5Ps of microsystem framework include purpose, patients, professionals, processes, and patterns (ASHP Foundation, 2011). The purpose of the microsystem simply reflects the culture, values, beliefs and aspirations of the people who constitute the microsystem. The purpose of the microsystem should be clearly understandable to the whole members of the system. In a microsystem, individual members are clearly informed of the patients they care for. A deep understanding of the patient population greatly assists the caregivers in this microsystem to improve their decision making abilities and the design of care and services. In a clinical microsystem, every member who contributes to patient care is known as a professional. Here, every person in every role is an integral part of the microsystem adding to the functionality of the system. Patient care is supported by numerous steps and processes in a microsystem, and most of the tasks in the system may be interrelated. Generally, professionals in the microsystem do not attempt to understand the whole processes involved in patient care. There will be a flow chart illustrating various processes in the system from start to end. Patterns exist in every microsystem though most of the people are unaware of this fact or simply ignore them. These patterns are really useful for analyzing the quality, cost, and overall performance of the microsystem over a particular period of time.
Deming Quality Improvement Theoretical Framework
Developed by Edwards Deming, the management philosophy known as the system of profound knowledge is based on the systems theory. This theory is based on the fundamental premise that every organization has a system of interrelated processes, and the organization’s human elements constitute the components of the system. The system of profound knowledge comprises four parts including appreciation of a system, knowledge of variation, theory of knowledge, and knowledge of psychology (Wilson, 2012, p.179). It is important to note that this theory revolves around a number of assumptions and philosophical underpinnings. The basic view of this theoretical framework is that an organization has to focus specifically on enhancing the efficiency of a process that leads to results. It postulates that an organization may use a sensible mix of intrinsic and extrinsic motivation to support its quality improvement efforts. The theorist adds that a total transformation of various systems and processes may be required to accomplish the desired quality improvement. Deming’s theory gives specific attention to the element of quality. According to this theoretical model, a manager will not be able to attain his maximum level of efficiency unless he maintains a clear understanding of the quality system. As per this model, the overall processes embrace events, patterns, and systems. This theory asserts that keeping people informed of the firm’s systems and processes is an important management role.
Critical Comparison
Patient falls have become a serious issue affecting the health outcomes of medical/surgical units. In order to compare the risk of patient falls in medical/surgical units using 5Ps of microsystem framework to Deming’s quality improvement theoretical framework, one has to understand how both the theories would evaluate the organization’s use of human resources, role of management, reduction of variation of patient care outcomes, and the methods employed to enhance the patient care quality.
Under the 5 Ps of microsystem framework, the organization really values its human resources and takes all possible efforts to promote the active participation of human elements in different organizational tasks ranging from learning to decision making. When it comes to a clinical microsystem, every person contributing to patient care is considered as a professional. This theoretical model suggests that every person, in every role, should be respected for what he/she adds to the overall performance enhancement of the microsystem. This approach can greatly assist the microsystem to increase the level of morale, self-esteem, and engagement of its workforce. This situation in turn would contribute enhanced patient care outcomes. To be more specific, when it comes to HR management, the 5 Ps framework’s approach is that no job is inferior in any organization, and each job should be performed well so as to ensure smooth functioning of the microsystem as a whole. Hence, in a medical/surgical unit, every staff member’s efforts are well appreciated and every member is considered an integral part of the microsystem. As a result, nurse staff and other members in the unit would take sincere efforts to avoid unwanted outcomes such as patient falls, and thereby enhance the overall health outcomes of the unit. Here, the role of the management is to keep track of the patterns relating to patient falls and hence to form a deep understanding of the issue and its vulnerabilities. The management has to promote effective communication within the medical/surgical unit to identify the situations leading to patient falls. It helps them take sensible responsive measures to address the issue. An effective understanding of patterns relating to patient falls can benefit the management to form clear strategies regarding the reduction of variation in patient care processes or outcomes. Under the 5 Ps of microsystem framework, managers may focus extensively on redesigning the processes, systems, and steps to minimize the risk of patient falls in the medical/surgical unit.
As discussed already, Deming’s quality improvement framework suggests managing the microsystem better by using a thoughtful mix of intrinsic and extrinsic motivation. Hence, the medical/surgical unit’s managers may rely on intrinsic rewards such recognition, task autonomy, and task engagement as well as extrinsic rewards like higher pay and other monetary benefits to influence its workforce and thereby improve the overall workforce performance. The use of intrinsic and extrinsic rewards would motivate the nurses and other support staff to take voluntary steps to reduce the risk of patients falls in the medical/surgical unit. Referring to this framework, the management’s role is to promote cooperative efforts within the unit thus leading to the accomplishment of enhanced patient outcomes (Gitlow, 2000, p. 62. Promoting shared efforts is a better way to improve staff cooperation and to ameliorate the patient fall rate significantly. One of the four major pillars of Deming’s model is ‘knowledge of variation’, which provides a great understanding of the causes of variation in quality (Black & Copsey, 2014). This knowledge can assist the medical/surgical unit’s managers to improve the variation in patient care processes or outcomes. In other words, this approach can benefit the unit to stabilize and improve the patient fall rate constantly. Under Deming’s model, managers would rely on the ‘Plan-Do-Study-Act’ approach to address the risk of patient falls and to enhance overall health outcomes of the medical/surgical unit.
Recommendation
Conclusion
References
ASHP Foundation. (2011). Assessing Your Microsystem with the 5 P's. Retrieved from http://www.ashpfoundation.org/lean/CMS9.html
Black, S. A & Copsey, J. A. (2014). Does Deming’s “System of Profound Knowledge” Apply to Leaders of Biodiversity Conservation? Open Journal of Leadership,3, 53-65. Retrieved from http://file.scirp.org/pdf/OJL_2014061716195503.pdf
Gitlow, H. S. (2000). Quality Management Systems: A Practical Guide. US: CRC Press.
Wilson, R. L. (2012). Exploring Great Leadership: A Practical Look from the Inside . iUniverse
