High Quality Care for All

High Quality Care for All

Introduction

This paper intends to focus on the hight quality care for everyone for this purpose the paper will discusess that improvement in quality is going to be achieved principally through the publication of new comparable performance data, which will be used by clinicians to improve their practice and systems. Although Lord Darzi's report does not dismantle any of the existing market-inspired reform policies - indeed it continues to expand patient choice - it places a new emphasis on professionals' innate desire to improve services. Competition is secondary to professionalism and personalisation in the rhetoric of the report. In addition to this total quality management (TQM) is "a management approach of an organization, centered on quality, based on participation of all its members and aiming at long-run success through customer satisfaction, and benefits to all members of the organization and to society" (Hellsten & Klefsjo, 2000, p. 238). During the 80s, theories like Total Quality Management already used for some time in other areas began more frequently to be studied and used in health care. The concepts of TQM in "the reduction of variation in the production process through work standard-ization, and continuous improvements in outcomes rather than on identification and elimination of defects in production" led to studies of applicability in the nursing and medical area.

Analysis

The final national report of the year-long NHS review led by health minister and surgeon Lord Darzi was published on 30 June 2008 (Department of Health 2008b). High Quality Care for All confirms a shift in the government's approach to health policy: where previously the speed of care was the principal measure, 'quality' is now being broadened to encompass patient outcomes and experiences and clinical outcomes. The results of these works supported the utilization of TQM as a quality program by many provider organizations and accreditation institutions as the Joint Commission on Accreditation of Healthcare Organizations (Kinney, 2001). Laffel et al, in his article in 1989 also connecting the industrial experience in quality control and health care organizations, says that this approach "may well make important advances in the quality of care and service through the application of these principles and techniques" (p.1). The report also develops the government's plans to move away from centrally imposed

targets towards greater local flexibility in service delivery. A commitment to enable all trusts to become foundation trusts is reiterated, and the report promises there will be 'no additional top down' targets, although national 'minimum standards' will still be required and the distinction between these and targets is not clear. The report proposes giving the NHS greater local flexibility to modify existing financial incentives, including possibly for the Quality and Outcomes Framework and proposes new policies to reward good patient outcomes and to withhold funding for avoidable, adverse events in hospitals; the content of these policies can be tailored to reflect local priorities.

The emphasis changed to the whole health care organization, and the ideas of process efficiency, teamwork, employee commitment, all of ...