Managing Quality in HealthCare Final Background Quality management is one of the most studied topics in the service sector. Quality management in health care is paramount for the achievement of the best practice in the health industry and the best outcome for the patient (NCQA, 2007). It involves all the people that participate in the provision of health care including the practitioners such as the doctors and the nurses and the support staff. All the participants should acknowledge the importance of quality management so as to be committed to ensuring that they achieve it. Quality management should be patient-centric and then there should be adapted and implemented standards and tools to achieve the quality. In health care, a challenge is the need to reduce costs for enhanced access by the public and be able to maintain high-quality. Therefore, it is necessary to strategically manage the situation so as to achieve a balance which is only achieved through accurate definition, measurement, evaluation, and monitoring of the services delivered (Al-Ali, 2014). Concepts and Techniques Definition of quality Quality in health care is approached from six dimensions: Effectiveness- it implies the delivery of health care that adheres to evidence-base and leads to improved health care results for the individual patients and communities depending on their needs. Efficiency- it entails maximum utilization of resources and the avoidance of waste. Accessibility- it includes timeliness, geographical location near the consumers, and provision in a setting where skills and resources are appropriate to the medical needs. Acceptability- it involves consideration of the preferences and the choices of the service users and the cultural requirements of the communities to whom the services are aimed. Equitable- it refers to the delivery of uniform services that do not vary in quality due to differences such as race, gender, ethnicity, location, or socioeconomic status. Safe- the last dimension refers to the delivery of care services with minimum risks and harm to the users (Buttel, Hendler & Daley, 2007). Policy and strategy development It is the role of the national and regional authorities to establish the guidelines that govern the entire health system. The decision-makers seek to keep the whole system under review and to develop strategies that aim at enhancing the quality outcomes for the users of the system. Health Service Providers The providers vary from entire organizations, teams, or individual health workers. They have the role of ensuring that the services they provide to the patients are of the highest attainable standard and that they can meet the particular needs of the patients, families, and communities. Also, they are committed to the achievement of the broad aims of the quality policy for the entire system. However, each of the service providers in health care in their different capacities has varying responsibilities. Service Users Consumers of health care services ranges from individuals, to groups and even the whole community that are faced with a particular health challenge that calls for the intervention of the health providers. They are the co-producers of health as the target of the services. It is their needs and preferences that determine the type of health care services provided. In some circumstances, they also are critical in managing their own health with the help of the service providers (WHO, 2006). Quality Measurement Measurement is the assessment of the performance of the organization over a period. It involves the collection, storage, and analysis of the performance statistics. Measurement aims at the gathering of information to be used for differentiated types of analyses. Primarily, the information is used for performance assessment to determine if performance is acceptable. If it is, steps are undertaken to ensure that it is maintained. If the performance is below the target, strategies are laid to improve it through making changes to the operations process. In the service sector, measurement mainly involves the assessment of customer satisfaction (Spath, 2009). Key Points There is an extensive connection between the various factors that interact in health care. For example, the policy setters must involve the service providers, the users, and their communities during the formulation and implementation of new strategies. On the other hand, the providers need to understand their working environment and its inhabitants so as to serve them effectively. They need to establish relationships with the consumers so that they can readily accept them in their communities. Lastly, the communities have to be aware of their health needs and the available services so that they can be able to influence their delivery and the guiding policies. Therefore, the relationship is circular and complementing which makes every section crucial (WH0, 2006). Analysis of the Problem As a result of the interactional nature of the health care sector, the establishment of a quality enhancement program is a real challenge. All the groups have to be involved in the program at different times for specific purposes. The challenge of the process is the often shortage of resources due to lower budget allocation or extensive projects that should be funded. Also, the health sector, especially in the twenty-first century, is so dynamic so that there are reported deadly diseases and pandemics so often that the industry is finding it a challenge to cope. Such pandemics are so deadly so that if not timely contained, they lead to massive death. Therefore, the health care sector deals with quality management on a daily basis and massive scales involving numerous participants (Spath, 2009). Action Plan The study aims at proposing a quality strategy that aims at informed strategic interventions for a local community that will help to achieve predictable quality improvement. The first step is the determination of the target local population and their needs that are then taken through analysis, strategy, and implementation of the process. The three forms a cyclical process that is widely used in quality improvement that includes understanding the problem, planning, taking the action, studying the results, and planning new response actions. The local level forms the basis on which quality processes are formulated. The major implication of the proposed strategy is that it shows that quality management is not fixed. Response to quality improvement results requires the adaptation of some elements of the plan and to the approach for implementation. The proposed process is straight-forward as all the activities are familiar. It is also based on the experiences of health practitioners and organizations in the sector that can make informed choices. Solutions Analysis Stakeholder involvement The process involves identification of those involved in the process and the extent of their participation. At the local level, the major participants engage political and community leaders, the ministry of health, the service users and their advocates, delivery organizations, regulatory, and representative bodies for the health workers. The leaders of the quality processes handle different aspects of the process. The well-managed involvement could involve the establishment of a management board that constitutes a representation of all the stakeholders. They board provides the primary focus for accountability and advising as well as wider communication with the participants. It is also essential to establish clear terms of reference and the determination of responsibilities. Situational analysis The process involves evaluating the current health conditions of the target community that has been achieved by implementing the existing quality strategies and the health-system performance. A situational analysis is a mapping process that enables the establishment of a basis on which new quality policies can be established, or the existing ones can be modified. The processes also involve incorporating other sectors such as the distributors, and the security team that has the capacity to affect the performance of the health system. Confirmation of health goals The set goals help to inform the decisions that different stakeholders take. The setting of the goals brings together all the participants and policy-makers so that it is made as inclusive as possible. Adjustments are made where there are detected flaws and agreements are reached at that ensure that everyone is committed to the success of the system. The lack of clear and agreed health goals will affect the focus and purpose of any quality improvement interventions. The health goals could include reducing mortality, occurrence of a particular disease, improving the treatment outcomes, or making health care safer (WHO, 2007). Strategy Development of Quality Goals The quality goals are developed based on the understanding of the target population and the agreements of the stakeholders. The new goals will then determine the formulation of the interventions to achieve previously identified health goals. They aid in the achievement of the health goals by enhancing the process (NCQA, 2007). Choosing interventions for quality The process involves formulating solutions to the identified quality problems in the health care provision system in the target area. The widely applied six domains of quality interventions include the following steps: leadership, information, patient and population engagement, regulation and standards, organizational capacity, and models of care. Strong and consistent leadership provides supports during the implementation of the health quality intervention measures. Information is paramount for effective decision-making and planning. The information system should be consistent to ensure uniformity of results and assurance of progress during the implementation. There should also be equal access to the same information for all those involved. The local population should be extensively engaged as they are the one that directly and indirectly interact with the health conditions. Also, they are the arbiter who determines what is acceptable or not concerning the health system quality. Regulation and standards are also important in quality management (Buttel, Hendler & Daley, 2007). Inspection and accreditation at varying levels can be provided as appropriate to the resources present in the country. Setting standards and monitoring adherence to them are necessary for facilitating higher compliance with evidence. Different organization capacities exist on which they perform their various responsibilities. Lastly, a model of care involves the best practice frameworks for the delivery of health care that are widely used. Such could be aimed at specific groups such as a local population or patients suffering from the same illness. The models include practices in health promotion and protection for the improvement of the quality outcomes. New models are also developed to accommodate recent developments. In such a case, the new model incorporates the contributions and finding of various participants (WHO, 2007). Implementation Implementation process The process integrates most of the previously mentioned activities such as leadership and accountability, and others such as timescales and milestones, and the monitoring of progress. The implementation also majorly involves the sustenance of interest and commitment among the participants and the ability to make tactical decisions to modify activities to conform to the reported feedback. Sustainability is essential as the majority of the quality-improvement initiatives encounter gradually reducing results due to lack of sustained focus on implementation. The crucial steps during implementation involve adherence to timetables, move towards the achievement of targets, redirecting resources, reporting of the performance, achievement of milestones, and detecting of new developments and setting out to develop strategies that can deal with them. Monitoring progress Monitoring involves the assessment of the accomplishments and comparing them to the set targets. It thus helps to determine the improved outcomes and benefits of the quality strategies applied. If the outcomes are not those that had been projected, modifications are made so as to achieve better results. If the workers can achieve the outcomes they had anticipated, then their motivation and commitment to the project are boosted (WHO, 2007). The measurement of quality is unanimously agreed upon by all the stakeholders in the earlier processes during the setting of the other goals. The existing information source should enable the monitoring of progress and the outcomes. On the other hand, the implementation plan should incorporate arrangements for gathering of new data if necessary. Individuals are influenced by various factors to react differently to the measurement information they receive. The reaction is based on individual choices and also by external factors. There is the need for the information to be accurate for it to be trusted. To assess the accuracy and usefulness of the information, it should be readily interpretable and consistent. In the quality measurement, organizations evaluate costs, quality, efficiency, productivity, customer satisfaction among other such current performance indicators. References Al-Ali, M. (2014). Developing a total quality management framework for health care organizations. Proceedings of the 2014 International Conference on Industrial Engineering and Operations Management Bali, Indonesia, January 7 ?? 9, 2014. Retrieved from http://iieom.org/ieom2014/pdfs/193.pdf Buttell, P., Hendler, R. & Daley, J. (2007). Chapter 3 Quality in Health care: Concepts and Practice. Retrieved online from http://health carecollaboration.typepad.com/health care_collaboration_/files/quality_buttell.pdf National Committee for Quality Assurance. (2007). The essential guide to health care quality. Washington, DC. NCQA. Retrieved from http://www.ncqa.org/portals/0/publications/resource%20library/ncqa_primer_web.pdf Spath, P. (2009). Introduction to health care quality management. Washington, DC. Aupha Press. [Online] Retrieved from http://file.zums.ac.ir/ebook/391-IntroductiontoHealth careQualityManagement-PatriceSpath-1567933238-HealthAdministration.pdf WHO. (2006). Quality of Care: A process for making strategic choices in health systems. Geneva, Switzerland. Retrieved from http://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf
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