Health systems are often on the lookout for the best strategies that would help to strategize and improve the quality of service delivery. However, research, including (Mayberry, Nicewander, Qin, and Ballard, 2006) reveal that a huge percentage of their strategies become a failure. Such evidence depicts the challenging nature of successful improvements in healthcare. Nonetheless, there are numerous practices that have become increasingly efficient as health practitioners learn from each other’s successes and failures. This paper discusses such effective strategies ideal in the improvement of healthcare and the nursing practice environment as follows.
The first strategic move is the acknowledgment of the importance of adaptive governance, leadership and culture in healthcare. Individuals within the nursing practice environment may have the dedication and competence needed to make quality decisions. In the absence of adaptive leadership, however, their efforts may fail to depict sustained and prioritized improvements. Such initiatives, therefore, require an adaptive culture to help drive quality and sustained service delivery for both nursing and health care practice environments (Bailey, et al., 2012).
The second essential strategy involves the use of analytics for informed decision-making. The HRSA (2011) advice on analytics as an essential integration mechanism in healthcare for sustained QI. The practice has an important part of play in the planning, implementation, and action phases of any QI process to enhance quality delivery. Nurses can use analytics to measure baselines, understand clinical issues, as well as determine the implications of a clinical change. Ideally, the process offers the checkpoints required for strategic improvement in healthcare.
Also connected to the above strategy is the use of EBP in enhancing service delivery. Reviewers focus on the research design, inclusion and exclusion criterion, results, and conclusions drawn from every model under analysis. Such practices are the platform upon which nurses and healthcare systems establish their QI initiatives. Development agents in healthcare use care delivery models, for instance, to integrate EBP into practice. They also require peer-reviews to help in measuring the consistency in individual models. Such approaches serve as a primary factor in outlining growths and improvements as applied to nursing practice (HRSA, 2011).
The measurement and identification of readmission is a perfect example of a quality issue in healthcare. Wang et al. (2014), for instance, show how nurses can apply the LACE index in measuring and controlling readmissions. The authors show that the index is ideal for the identification of patients at risk of readmission. In addition to this index, other appropriate predictors include the determination of the previous number of emergency room visits and history of disease reoccurrence. In essence, nurses that can appropriately use such EBPs and tools can achieve ultimate results in QI in the nursing practice environment.
Furthermore, organizations could strategize their practice through the use of educational interventions at clinical and community environments. This strategy involves the actual distribution of material meant to educate patients, healthcare practitioners, and the community. Althabe et al. (2011) note that it plays a vital role with the wake of emergent and stubborn clinical issues. For instance, the active distribution of printed and visual educational content on Zika virus in Florida could help both nurses and the community to prevent further infections. Hospitals and local stakeholders could also increase their active engagements in the community by inviting federal officials for educational outreach.
Lastly, it would be ideal for healthcare organizations to consider routine audits and feedback. An insight from Althabe et al. (2011) shows that audit controls can help in summarizing the outcomes of new and existing interventions over time. Such evidence requires suggestions of maintenance and sustained improvements for enhanced service provision. Now, the best audits and feedback surveys come from both internal and external environments. Nurses and patients, for instance, play a perfect role in the provision of feedback on new practices, as well as offering recommendations for service improvement. Independent auditors can also look at the extent to which the organization adheres to local and federal regulations.
References
Althabe, F., Bergel, E., Cafferata, L., Gibbons, L., Ciapponi, A., Aleman, A., . . . Palacios, R. (2011). Strategies for Improving the Quality of Healthcare in Maternal and Child Health in Low and Middle Income Countries: Overview of Systematic Reviews . Buenos Aires, ARG: Institute for Clinical Effectiveness and Policy .
Bailey, J. D., Docherty, S., Adams, J., Carthron, D., Corazzini, K., Day, J., . . . Anderson, R. (2012). Studying the clinical encounter with the Adaptive Leadership framework. Journal of Healthcare Leadership, 2012 (4). doi:10.2147/JHL.S32686
HRSA. (2011). Quality Improvement. Washington, DC: Department of Health and Human Services Health Resources and Services Administration.
Mayberry, R., Nicewander, D., Qin, H., & Ballard, D. J. (2006). Improving quality and reducing inequities: a challenge in achieving best care. Baylor University Medical Center Proceedings, 19(2), 103–118.
Wang, H., Robinson, R., Johnson, C., Zenarosa, N., Jayswal, R., Keithley, J., & Delaney, K. (2014). Using the LACE index to predict hospital readmissions in congestive heart failure patients. BMC Cardiovascular Disorders, 14 (97). doi:10.1186/1471-2261-14-97
