Quality, Patient Safety, And Safety Culture In Healthcare

Defining Quality in Healthcare

1.Quality in health care can be defined as the process by which research analysts ensure that the medical health services provided by a health care organization is safe and at the same time yields positive patient outcomes (Bates et al., 2014). Problems associated with the minimal use, exploitation or misuse of medical resources are determined on the basis of the evaluation of the health care services offered by a particular health care organization (Chartier, 2014). It is also important to note here that by virtue of the iron triangle of health care, researchers can easily develop an overview to measure and correlate the existing relationship between health care service quality, cost effectiveness and accessibility of the resources (Clement, 2017). Five principal concepts are implied in the process of monitoring quality services and related outcomes in the health care services (Dumont et al., 2013). The first three concepts are synonymous to the principles of total quality management or TQM and focuses on the customer needs, extensive research and implementing improvement and participation and collective team work by all employees.  The fourth principle comprises of management commitment to improve service delivery and to maintain an approach so as to continuously provide better service delivery (Free et al., 2013). The TQM ensures total quality management in service delivery and is a continuous process. It majorly aims at incorporating a permanent change in the work culture of the organization. Total Quality Management heavily relies upon the quality assurance tools and ensure that the overall quality of the organization in association to the production is continuously improved (Gittell et al., 2013). It ensures positive employee performance through provision of adequate funding, staffing and training opportunities. On the other hand the CQI ensures that the quality of the service delivery is consistently enhanced with the use of latest technological innovation and infrastructure development. TQM and CQI approach vary for different service sectors. While the healthcare sector primarily focuses on improving the medical services with the changing trend in medical technology and innovation, other service sectors focus on the quality improvement of the related domain. The six sigma tool and the lean thinking or the balance scorecard are quality improvement tools that make use of a strong methodology to monitor the efficiency of the services being dispensed by the enterprise (Zornoza et al., 2017). It helps in making the best use of the empirical as well as the statistical methods to compare the process management, possible innovation and improvement outcome of every organization (Hunter et al., 2017). The balance scorecard on the other hand helps in maintaining an equilibrium between the operational strategies in practice, developing an improvement and aligning the adapted reforms with the vision of the organization.

2.As per the Australian patient safety foundation Shekelle et al. (2013), patient safety is defined as “the reduction and mitigation of unsafe practices within the healthcare system. The use of best practices have shown to yield optimal patient outcomes. Patient safety can be defined as all the measures undertaken in order to provide patients with safe and quality health services. Safety in health care can be defined as the stringent monitoring of the equipment used in order to promote service delivery in accordance with the NSQHS standards. It encompasses of the responsibility to cross check and double check the quality of the resources used such as checking the expiry date of the pharmaceutical drugs and detect any possibility of contamination or leakage and adopting necessary measures to replace such faulty products in order to maintain patient safety (Iacob & Constantin, 2014). Hence, it can be said that maintenance of stringent safety guidelines in the health care sector can effectively contribute to patient safety and improved quality outcome. Risk management in healthcare can be defined as the complete cycle of identifying, accessing and prioritizing risk factors associated with poor service delivery and adapt measures to mitigate the defined risk factors. The prioritization of risk plays an important role in ensuring patient safety. In this context, it can be said that ‘risk’ is an external factor that could be manifested due to an unprecedented mismanagement in handling a project, or due to inappropriate funding or due to disasters rising on account of manhandling and errors at the professional level (Iuga & McGuire, 2014). On account of each of the mentioned risks there is a high possibility of a fatal consequence (Wager et al., 2017). Hence, it should be ensured by the administration that the organization has appropriate mitigation measures to combat an unforeseen risk factor. While developing strategies to combat the negative effect of the risk factors it is pivotal to identify the root cause of the happening on a priority basis, following the procedure of identification, it is important to consider two aspects of policies. The first involving in strategies that would nullify the negative effect or reduce the adversity of the risk factor and the second strategy would aim at developing combat strategies in order to avoid such a scenario in future. In order to perform an effective risk analysis and adapt appropriate mitigation measures, it is important to correctly evaluate the possibilities of a risk occurrence. This step could be addressed by using the appropriate risk management analysis tools. The correct use of a risk management tool is based upon which risk factor is to be evaluated. A wide range of assessment tools for the evaluation of a diverse range of risk entities is available. Tools could effectively evaluate the risk factors associated with strategic analysis in order to measure the efficacy of the business objectives. The threat analysis, effectively analyses the risks associated with business security. The investment risk analysis accesses the risks pertaining to investment and returns and develops alternative strategies in order to address such risks effectively. The program risk management identifies the risks associated with the successful implementation of a program and also strategically plans an alternative in case of the failure of the project plan. The cost risk analysis helps in identifying the risk factors associated with the financial fluctuations and economic risks and accordingly adapt mitigating measures to combat such losses. Hence, it can be said that the quality of risk management primarily depends upon the identification of the risk factors followed by prioritization in order to proceed effectively with the mitigation plan.

Principles of Total Quality Management and Continuous Quality Improvement

3.The concept of safety culture for healthcare is determined as a positive thinking and perception of the workers about their physical and psychological safety, teamwork and leadership related safety. Further, they are comfortable to discuss the flaws of the system and possess a collective and cumulative thinking about the loopholes and the frontline workers take responsibility of change so that safety can be ensured again. High reliability organizations possess positive safety culture however, when the suggestions of workers are not included for safety betterment, a lack of self-satisfaction and a constant concern about safety is built into the organization that affects the fabric of it. It has been noted through healthcare practices that culture influences safety in healthcare, however little research has been conducted to determine this concept. Hence, it cannot be said with the help of research evidence that culture of any organization will help increasing positive outcomes for patients, but healthcare professionals and their culturally compliance care process helps  and contributes in safety for patients and professionals safety in healthcare organizations.

Shekelle et al. (2013) suggests that culture can never be described or measured, but it can be manifested. As a healthcare organization is cumulative result of many thoughts and beliefs, all these different elements it is quite difficult to measure the beliefs which contributes in effective safety culture and others that imparts poor and negative or unsafe culture. Therefore, measurements are made by sharing the staff and patient’s stories about their safety culture related feedback for the organization and fostering the right environment to create a positive and developed safety culture. This will help to create an environment where sharing of information is done based on their job satisfaction and reporting rates and an improved methodology is found. Further () mentions another way to create an environment of measurement of safety culture for patients and staff and this is demonstrated by allotting a day in month, when all the staff and patients of the health care facility will come together and will share their fundamental, emotional and social challenges they had to face while working and receiving care respectively.

However, there are several models of safely culture evaluation and depending upon the research theories, the measurement of safety culture depending evaluation towards the ultimate completion and on the evaluation through phase, and depend on the models these examples should be mentioned such as:

In which through pathological, reactive calculative proactive and generative steps, the informed care related and trust related values and safety culture are increased and measured.

This model is defoined as

This model is defined as the stop, connects, report and finally carries out the innovation so that the measurement can be carried out. In this process, workers, supervisors, managers, physicians. Nursing pro9fessionals patients and CEO is involved and their cumulative effect brings a0out the changes after measurement is done successfully.

References:

Bates, D. W., Saria, S., Ohno-Machado, L., Shah, A., & Escobar, G. (2014). Big data in health care: using analytics to identify and manage high-risk and high-cost patients. Health Affairs, 33(7), 1123-1131.

Chartier, Y. (Ed.). (2014). Safe management of wastes from health-care activities. World Health Organization.

Clement, S. A. (2017). Feasibility of Remote Management of Uncomplicated Urinary Tract Infection: A Quality Improvement Project.

Dumont, A., Fournier, P., Abrahamowicz, M., Traoré, M., Haddad, S., Fraser, W. D., & QUARITE Research Group. (2013). Quality of care, risk management, and technology in obstetrics to reduce hospital-based maternal mortality in Senegal and Mali (QUARITE): a cluster-randomised trial. The Lancet, 382(9887), 146-157.

Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., … & Haines, A. (2013). The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS medicine, 10(1), e1001362.

Gittell, J. H., Godfrey, M., & Thistlethwaite, J. (2013). Interprofessional collaborative practice and relational coordination: improving healthcare through relationships.

Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2017). Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention. American Psychological Association.

Iacob, C., & Constantin, C. (2014). Correlation Analysis of the quality of medical quality economic and financial management using correlation coefficients based on nonparametric data.

Iuga, A. O., & McGuire, M. J. (2014). Adherence and health care costs. Risk management and healthcare policy, 7, 35.

Shekelle, P. G., Wachter, R. M., Pronovost, P. J., Schoelles, K., McDonald, K. M., Dy, S. M., … & Larkin, J. W. (2013). Making health care safer II: an updated critical analysis of the evidence for patient safety practices. Evidence report/technology assessment, (211), 1.

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: a practical approach for health care management. John Wiley & Sons,pp 245

Zornoza, R., Acosta, J. A., Bastida, F., Domínguez, S. G., Toledo, D. M., & Faz, A. (2015). Identification of sensitive indicators to assess the interrelationship between soil quality, management practices and human health. Soil, 1(1), 173-185.