Introduction
Healthcare industry is increasingly facing a dynamic environment that requires constant quality improvement and management. In that respect, this report provides an overview of the need for quality management and the roles that different stakeholders play. In addition, the roles of different organizations and resources for QI are identified.
Analysis
- Purpose of quality management in the health care industry and the reason it is needed
Quality management for healthcare offers a framework that enables hospitals to organize, monitor, communicate as well as continuously improve their healthcare aspects. In addition, it is suitable given the current national healthcare environment that is highly structured and requires pursuit of quality. Further, the need to address industry competition through management of expenditures and service quality is a purpose served through quality management. (WHO, 2006) Other purposes that define why the quality management is needed include
- Enhance quality and cost effectiveness. Costs and quality can be adequately addressed through quality management. In that respect, quality management can manage and lower costs. That is provided through the rational system that quality management creates for cost containment. (WHO, 2006)
- Improve system synergy. With the increasing external pressure and costs, the various systems of the healthcare system including hospitals, physicians and insurers have been pursuing conflicting goals. That has led to increasing intra-industry friction as well as less than optimal capacity to address critical issues. Thus, embracing quality management can be a source of a common paradigm that can enhances capacity to address major issues. Further, it enhances partnership with stakeholders including practitioners, providers and payers as well as enhances service delivery. (Leape & Berwick, 2000)
- Reason various health care stakeholders define the quality of care differently
Various stakeholders have different needs and interests in the healthcare industry. In that respect, their views and perspective on quality differs depending on the crucial aspect of healthcare that their interest focus on. Key stakeholders in the industry would include service providers, patients, regulators, health workers, community leaders and financiers. Thus, stakeholders define healthcare quality differently in terms of effectiveness, efficiency, accessibility, acceptability and equity as well as safety depending on their focus. (WHO, 2006)
- Roles involved with QI
Quality improvement entails a call for management’s commitment to constant evaluation of organizational operations and innovation. In that respect, the central roles in the process include. (WHO, 2006)
- Setting specifications for healthcare processes.
- Monitoring performance against the set specifications.
- Determining the cause of inappropriate variations like low productivity and quality waste.
- Variation elimination that seeks to ensure that service delivery is in line with set standards.
- Setting higher expectations after achieving previously set standards. (Leape & Berwick, 2000)
- Areas that must be monitored for quality
Quality monitoring should focus on key areas that are crucial for service delivery. In that respect, the following areas should be focused on as a way of improving quality.
- Infrastructure
Infrastructure is crucial as suitable professional expertise and physical plant are necessary for enhancing delivery of high-quality services. (WHO, 2006)
- Treatment indications
Addressing the problem of varying utilization of treatments and particular procedures is crucial in enhancing quality service delivery. Thus, QI should focus on achieving consensus through monitoring treatments indications. (Leape & Berwick, 2000)
- Costs
There should be a focus on costs of treatments and service delivery. That is because costs determine accessibility as well as the ability to meet stakeholders’ needs through quality service delivery.
- Service delivery process
Service delivery is the primary activity through which healthcare system is engaged. In that respect, a focus on improving the process is crucial in improving healthcare quality.
- Providers (Physicians) outcomes
- Accrediting and regulatory organizations involved in QI and their roles
Various organizations are involved in enhancing quality improvement in the healthcare industry. They range from regulators who set guidelines and requirements to be met to the accrediting organizations. Accrediting organizations approve service delivery and ensure that standards, as well as guidelines, are followed through. That is achieved through provision of suitable reward systems for standards achievement. Such organizations and their roles include
- American Nurses Crediting Center
The organization is a subsidiary of the American Nurses Association and seeks to promote nursing and healthcare excellence through suitable accreditation of programs. Thus, through its practice of certifying as well as recognizing individual nurses in various specialties in addition to recognizing organizations that promote safety, it enhances quality improvement. Further, the organization seeks to promote positive work environments hence enhancing quality improvement. (ANCC, 2014)
- Accreditation Council for Pharmacy Education
It is the national body that is responsible for accrediting professional degree programs in pharmacy in addition to providing continuing pharmacy education. Thus, through accreditation of continuing pharmacy education providers, the organization aims at improving healthcare service delivery in the industry by ensuring that all personnel are fully qualified. The organization also serves the role of assisting stakeholders that are seeking guidance on quality assurance as well as advancement in pharmacy education. The organization plays a crucial role that has led to increased demand for its service by international stakeholders including professional organizations, governments and quality assurance bodies. (ACPE, 2014)
- Helpful resources and organizations affect QI
Quality improvement is subject to factors that influence its goals achievement. In that respect, resources’ availability and organizations’ participation in the process impacts on QI success. In that view, the following is a summary of resources and organizations that have an impact on QI.
- Centers for Disease Control and Prevention’s (CDC)
The organization shapes public health priorities that have a large scale impact on healthcare quality by setting suitable guidelines and strategies that enhance healthcare quality. (Institute, 2014)
- National public health improvement initiative (NPHII)
The initiative supports local, tribal, territorial health departments with preventive as well as public health fund that make crucial changes and enhancements in organizations. In that respect, it supports the implementation of practices that seek to improve healthcare service delivery. (Institute, 2014)
- The National public health Performance Standards Program (NPHPSP)
The program provides guidelines on performance standards that leverage on state, national and local partnerships that promote continuous QI and healthcare preparedness.
- Public Health Accreditation Board (PHAB)
It is a non-profit making organization that seeks to improve healthcare quality by advancing performance and quality of territorial, state and local health departments. Thus, it is among the institutions that define and influence quality standards in the industry. (Institute, 2014)
Conclusion
In view of the industry’s standards review regarding quality management and improvement, it has been identified that organizations need to manage quality for various purposes. Those purposes include the needs to manage costs and achieve system synergy. In respect to the varying definition of health quality by different stakeholders, it has been explained that each stakeholder defines quality in view of their interests ranging from safety, efficiency, acceptability and accessibility to equity. Further, the areas that need a focus on quality management and improvement have been identified to include infrastructure, service delivery, costs, treatment indications and the physicians’ outcomes. On the other hand, the roles of QI have been identified as including specifications setting, monitoring processes, variations identification and elimination as well as setting higher targets. In addition, the industry has regulators that influence QI hence a need to consider them in the organization’s effort to manage quality. They include ANCC and ACPE among others. Finally, in a bid to achieve quality improvement, it has also been identified that the organization needs to consider the possible effects of various organizations and resources that have an impact and can help with QI. Those organizations and resources can be useful guides for quality management and improvement and include CDC, PHAB, NPHII and NPHPSP. Thus, the organization can focus on the noted quality management purposes and areas as well as utilize the identified resources for Quality improvement.
References
ACCME. (2014). Other regulators. Retrieved from, http://www.accme.org/about-
us/collaboration/other-regulatory-bodies
ACPE. (2014). About Accreditation Council for Pharmacy Education. Retrieved from,
https://www.acpe-accredit.org/about/default.asp
ANCC. (2014). About American Nurses Credentialing Center. Retrieved from,
http://www.nursecredentialing.org/
Improvement. Retrieved from, http://www.ihi.org/resources/Pages/Tools/ResourcesforPublicHealth.aspx
Leape L. L. & Berwick D. M. (2000). Safe Health Care. BMJ. 320, 725-726.
WHO. (2006). Quality of Care: A process of making strategic choices in health systems.
Retrieved from, http://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf
