QUALITY IMPROVEMENT IN HEALTHCARE FACILITIES

Quality Improvement in Healthcare Facilities

Quality Improvement in Healthcare Facilities

Introduction

Quality is a most ambiguous word. It means different things to different people. It means different things to the same person at different times and in different circumstances. So quality is difficult to define and understand, and difficult to examine and evaluate. Barton (1998) mentions it is typically in the eye of the recipient. When it comes to service quality in the health care sector, the examination of quality would explore such areas as the effectiveness of an intervention, the appropriateness of a particular intervention and under what circumstances, and determining whether its benefits exceed its costs (Barton, 1998). Even this explanation is limited in scope. To consider an additional definition and broaden the understanding about quality, it might be described as that kind of care that is expected to maximize an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts.

A Discussion of the Quality Improvement Process

Quality improvement should be a major focus in any organization and requires four basic steps: “…specify the requirements, design the product, create the product, and examine the product.” Each process must be completed in order as each is important. Once requirements and specifications have been determined, resources and standards can be evaluated to create and test the product. The means of creation will be different in various organizations but the process remains the same (Griffith, 1998).

During every part of each process, flow charts can be analyzed to make proper decisions; strategic plans must be considered; impact on all stakeholders must be evaluated; and appropriate quality management tools must be determined.

Quality management holds that every product, service, and patient outcome is the output of a process. Thus, if the quality of the process output is deficient on some dimension (such as time, cost, clinical outcome, or patient satisfaction), then the process must be improved (Griffith, 1998). Further, in a dynamic world of emerging technologies, shifting patient and employer expectations, regulatory change, and competitive developments, processes must be continuously improved. W. Edwards Deming's famous chain reaction illustrated that process improvements (reductions in rework, scrap, and errors) lead to improved efficiency and decreased costs. The initial emphasis of industrial quality control was largely directed toward these ends. The quality gurus offered rather uniform prescriptions to enhance process improvement. These included an emphasis on teamwork so that complex and cross-functional processes could be addressed; the injunction to “drive out fear/blame” so that the problem of false data could be minimized; and the study of variation because of the information it furnishes on the state of the process.

An organization's processes are especially improved when the organization uses a systematic effort rather than haphazard change directed by hunches and intuition (Cudney and Reinbold, 2002). To promote effective process change, organizations need to use a structured approach or template to guide each improvement ...