Think About And Do Some Independent Research On Recent Publications
Think about and do some independent research on recent publications that discuss quality improvement initiatives in healthcare settings that are having positive outcomes that are supported by data, benchmarks or staff/resident testimonies. Health care is a complex, ever-changing system that requires health care professionals to be well educated and up to date on current policy regulations or reforms, new emerging technology, and quality improvement approaches. There are many different approaches to improve quality and lower costs, but health care facilities should first identify what specific areas they need to focus on improving the most. Establishing effective and sustainable performance improvement initiatives can help health care professionals evaluate the current level of quality and the desired level of quality.
From there, they need to determine what quality improvement methodology to use. After doing much research, I found that the most common and productive quality improvement methodologies in health care are plan-do-study-act (PDSA) and six-sigma. The most commonly used approach in health care is the PDSA cycle. It involves a four-step process to test a change by planning the test, trying it out, analyzing the results, and acting on what is learned from the test. One case that proved the PDSA cycle to be an effective improvement initiative was conducted by Prathibha Varkey with the intentions of enhancing medication reconciliation to ensure complete and accurate lists of medications within the continuum of care.
The first cycle included creating a data collection form to assess patients medication use, then the second cycle was modified to prompt patient response to a list of medications from their most recent visit to the facility. The data collected by the end of the study proved that the use of the PDSA methodology decreased the average number of discrepancies from 5.24 to 2.46 (more than 50% less) and also increased the number of patient-reported medications from 47.3% to 92.6%. Six-sigma is a rigorous statistical methodology and another quality improvement initiative that is designed to reduce costs, decrease process variations, and eliminate any defects or errors in the system. It is achieved through defining, measuring, analyzing, improving, and controlling the project.
The first step includes defining the goals and scope of the project. A plan for data collection and measurement is then developed in the second step. The third step is when data analysis occurs. Implementation plans and solutions for improvement are developed in step four. In the final step, quality controls are developed to continuously monitor the new process.
The Charleston Area Medical Center utilized six-sigma to assess and improve its rate of colon and vascular surgical site infections, and the data from the project proved the methodology to decrease the surgical site infection rate at their facility by 91% (2.86 sigma) and saved them more than $1 million in annual savings.
2. Consider a situation where you are hired as manager of a healthcare facility with poor satisfaction ratings by staff and residents/patients. In addition, your quality indicators show you are below the national average. If I were hired as a manager of a healthcare facility that didn’t have good satisfaction ratings by staff members and patients and was ranked below the national average, I would implement the Plan-Do-Study-Act method as the main quality improvement initiative because it is a simple yet powerful tool for stimulating quality improvement.
To begin implementation of the PDSA cycle, you need to ask “What are we trying to accomplish?â€, “How can we determine that the change is an improvement?â€, and “What changes can we make that will result in improvement?†The answering of these questions allows healthcare professionals to break down the process into manageable steps, evaluate outcomes, make improvements, and test again. After 6 to 12 months of utilizing the PDSA cycle, healthcare facilities should have a continuous quality improvement process that they sustain and further develop. An example of this could be introducing patient and physician surveys to identify reasons for low ratings and ways to increase satisfaction.
One method to measure the success of these quality improvement initiatives would be to compare data from initial ratings to ratings after implemented changes, such as survey results or satisfaction scores. Quality impacts not only patient care but also organizational reputation and operational efficiency. As a healthcare manager, I would emphasize hiring qualified personnel and organizing regular training to boost service quality. Employees with the right skills and qualifications are essential for improving healthcare quality and ensuring resource optimization (World Health Organization, 2004).
Effective recruitment based on merit ensures that staff are competent, thereby preventing resource wastage and increasing patient satisfaction. Regular employee training updates staff on new procedures, technological advancements, and best practices, fostering continuous improvement. Well-trained staff are better equipped to meet patient needs and adhere to safety and quality standards. Additionally, motivating staff through incentives (monetary or non-monetary) is vital; motivated employees are more engaged, productive, and committed to organizational goals, which translates into higher quality services and improved patient outcomes (Gillam & Siriwardena, 2014).
Implementation of these initiatives involves conducting staff meetings to clarify job roles and assess qualification gaps. Underqualified staff may be reassigned or encouraged to pursue further training, while highly qualified staff are positioned in roles best suited to their expertise. Engaging employees in decision-making fosters ownership and cooperation, easing the transition during change. Training schedules should be designed based on staff availability, with ongoing assessments to refine approaches. Incentives and recognition further motivate staff, promoting a culture of continuous quality improvement. Monitoring progress involves collecting data through patient and staff surveys, performance metrics, and direct observations. Comparing pre- and post-intervention satisfaction scores provides tangible evidence of progress. Regular feedback sessions and performance reviews help identify areas needing further improvement. Success will manifest as enhanced patient satisfaction, efficient resource utilization, and staff engagement. A positive organizational climate, reflected in improved ratings and staff morale, signifies the effectiveness of these strategies. Continuous assessment and adaptation are crucial for sustainable quality enhancement (U.S. Agency for Healthcare Research and Quality, 2017).
References
Gillam, S., & Siriwardena, A. (2014). Motivating health care staff to improve quality: A review of the evidence. BMJ Qual Saf, 23(8), 639-649.
U.S. Agency for Healthcare Research and Quality. (2017). Developing a Culture of Quality Improvement. AHRQ Publication.
World Health Organization. (2004). The World Health Report 2004: Changing History. WHO.
Varkey, P. (Year). Enhancing medication reconciliation with the PDSA cycle. Journal of Healthcare Quality.
George, M. L., Rowlands, D., Price, M., & Maxey, J. (2005). The Lean Six Sigma Pocket Toolbook. McGraw-Hill.
Antony, J. (2006). Six sigma for Service Processes. Business Process Management Journal, 12(2), 234-255.
Benneyan, J. C., et al. (2003). Statistical methods for health care processes. Quality Management in Healthcare, 12(3), 133-146.
Langley, G. J., et al. (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. Jossey-Bass.
Leonard, M., & Maslin-Prothero, S. (2018). Quality Improvement Strategies in Healthcare. Healthcare Management Review, 43(2), 123-132.
Peters, M. D., et al. (2013). Effectiveness of Staff Training on Patient Satisfaction: A Systematic Review. Journal of Nursing Scholarship, 45(4), 341-356.