Continuous Quality improvement(CQI) in healthcare

  Continuous Quality Improvement in Healthcare Name Institution Affiliation   Continuous Quality Improvement in Healthcare  Introduction Continuous quality improvement (CQI) refers to a strategy used by organizations to minimize wastes and enhance efficiency in a bid to increase the satisfaction of both the employees and clients (Lorch & Pollak, 2014). In other words, it is a process designed to ensure that all stakeholders are satisfied with the operations carried out in a particular organization. There is a misconception that when a problem arises, it is a consequence of unclear instructions, failure of the management team or a poor work design and cannot be attributed to individuals performing the process. However, problems can also stem from individual employees for failure to follow instructions from management or to apply the suitable techniques to perform a certain task (Lorch & Pollak, 2014). The principle behind CQI is that regardless of the utmost care, systems and processes can never be designed to be perfect and the fact that several changes occur every day in the business world. Therefore, it is necessary to adopt an evolutionary process that helps to detect changes and implement the suitable corrective actions (Lorch & Pollak, 2014). In the field of healthcare, CQI has been proven to be an effective strategy in improving care for patients, clients, and residents as well as improving the welfare of the staff (Sollecito & Johnson, 2012).  The healthcare sector has plenty of opportunities to streamline, develop, optimize and test processes and CQI should be an integral part of all individuals irrespective of the position or the role they play within the organization. To even achieve a higher level of effectiveness, any health care system should integrate all of its parts in a bid to offer high-quality care to the patients. For any organization to offer high-quality care, it must possess high-level of safety, should be accessible to all, must be effective, equitability, high efficiency, be appropriately resourced, focused on population and integrated (Sollecito & Johnson, 2012). Quality improvement is largely based on having a clear understanding of the entire system, the complexity of dealing with individuals, different outcomes resulting from the system and application of knowledge to alter some of these outcomes. Generally, quality improvement programs are designed and applied by leaders and local staff who are experts at solving problems and managing group dynamics (Sollecito & Johnson, 2012). However, they involve various stakeholders such as government, patients, community and suppliers in the implementation of these programs. CQI initiatives are made up of various teams that play different roles to achieve a particular objective (National Learning Consortium, 2013). They contain a local interdisciplinary team whose main function is setting different goals for improvement. The second team has a responsibility to identify barriers to quality, sources of the problems or system flaws that hinder the delivery of quality care. The team is mandated with formulating and executing various ideas to improve care delivery and finally the fourth group tests the effectiveness of different actions in solving system problems that prevent the provision of quality care. The fourth group performs quality measurement techniques in a manner that will give them instant feedback to determine whether the applied ideas are working accordingly (National Learning Consortium, 2013). Therefore, just like any other project, quality improvement has three main parts: beginning, middle, and the end. The quality improvement team has a clear objective, collects relevant data and formulates and tests the impact as they work towards executing successful improvements. Therefore, for any healthcare organization that anticipates to continuously offer high-level care, it must strive to implement continuous quality improvement (National Learning Consortium, 2013).      Integrated Healthcare In the recent past, there used to be paintings of the image of a solitary family doctor in most of the rooms in healthcare organizations. The image depicted a vigilant, concerned, thoughtful physician attending to a desperately ill patient. The purpose of hanging these paintings in many of the waiting rooms was to communicate to the public that doctor was a very important person in the society as far as treatment of diseases was concerned. Such image did not bear any resemblance to the modern healthcare systems, although this does not mean that the private doctor system is outdated. Contemporary healthcare entails complex, rapidly evolving intervention and treatment plans as well as activities of several people, institutions, and disciplines (Karam et al., 2017). Effective health care system requires continual evaluation and restructuring to continue improving the quality of care depending on emerging issues. This does not only concern the sick patients, but also the healthy individuals who require some services such as cancer screening or help with obesity and smoking or a certain portion of the population struggling with one or more chronic diseases. Quality and effective care do not happen by simply working harder, but requires the coordinated and concerted activities of multiple individuals, including medical and non-medical professionals as well as a variety of institutions and disciplines and a delivery system configured to facilitate the execution of the services  (Karam et al., 2017). The team with the ability to blend a variety of perspectives and skills towards the shared goal is crucial in both the delivery of high-quality care and the evolution of the practices to support it. The Outcome Model of Quality One of the models used to evaluate the health services and assess the quality of care is the outcome model of quality. The model was originally developed in 1966 by a University of Michigan physician and healthcare service researcher called Avedis Donabedian, the reason why it is also referred to as Donabedian model (DesHarnais & McLaughlin, 2011). It defines health care quality using three main terms, which include structure, process, and outcomes. Under the structure category, quality of care is described in terms of the context in which medical care is delivered using factors such as staff, financing, hospital buildings, and equipment. Other factors considered include human resources and payment methods. Together, these factors influence the manner in which patients and providers act and are indicators of the average quality of health care within a system or facility. Generally, it is easier to make an observation and measurement as far as structure is concerned compared with the other two components of the model (DesHarnais & McLaughlin, 2011). On the other hand, the process represents the transactions that occur between care providers and patients as well as other involved parties. It represents all operations carried out in healthcare settings such as diagnosis, treatment, patient education and preventive care, but can also cover other actions taken by patients and their families or friends. Moreover, the process may be categorized further as interpersonal and technical processes, and all these encompass the manner in which medical care is delivered. As Donabedian indicated, measuring the process is practically equivalent to the quality measurement because the process involves all actions of health care delivery. Information about the process is available on the organization’s website, medical records and direct observation of hospital visits and interviews with patients. Finally, outcomes refer to the impact the healthcare has on the state of patients or population (DesHarnais & McLaughlin, 2011).  Some of the aspects used to gauge the quality of health care include health status, patient satisfaction, behavior and knowledge obtained from the interaction between providers and the clients. Outcomes sometimes are considered the most crucial indicators of care quality because improving the health status of patients is the main objective of health care. Nevertheless, measuring the outcomes accurately is sometimes very difficult. Establishing a connection between outcomes and process usually requires a large population sample, adjustments by case mix and prolonged follow-ups as the results often take a considerable amount of time to become observable (DesHarnais & McLaughlin, 2011). Working in Collaboration to Improve Structure Component To continuously improve the quality of health services, various stakeholders must work in collaboration to cater for the components of the outcome model of quality. Considering the structural component of Donabedian model, different parties in a health care system must work in close coordination to create a conducive environment that will enhance the delivery of quality care (Green & Johnson, 2015). Within the organization, different departments have duties to identify emerging issues and work cooperatively to bring about change that will improve care quality. For instance, innovation teams have to constantly evaluate building structures to identify ways in which they can be improved to increase efficiency in the provision of the services. However, they must alliance with other sectors such as management and financing to facilitate the implementation of their ideas (Green & Johnson, 2015). If the movement of disabled people is a problem within a particular healthcare facility, it is the work of the innovation team to identify possible solutions and alliance with management and other departments to execute the most feasible idea. In addition, the organization should contact construction companies and architectural designers who will help in the reconfiguration of hospital buildings to ease the movement of people with disabilities within the premises (Hibbard, 2004). Further, the diagnosis department must conduct continuous research on laboratory facilities to identify the ones that will increase the effectiveness of detection of illness. Here, various parties must also work together. Because it is management that sanctions the release of funds from the financing department to purchase the required equipment, the diagnosis team must convince management about the advantages of identified equipment and how they improve the quality of care. Also, the companies manufacturing such equipment have a responsibility of making products tailored to meet the current needs of the patients and have to work in collaboration with the healthcare organizations to identify the essentials of their clients (Hibbard, 2004). Having a team of highly competent medical professional translates to high-quality care (Richardson, 2009). However, recruiting such individuals is not an easy task, and it entails massive investment in terms of both resources and time. Patients’ needs are evolving as the time moves on and there is a need to hire candidates with suitable skills and competencies to match the emerging needs. For instance, cultural issues have plagued the healthcare sector for a long time now. Issues resulting from cultural differences have a greater impact on the medical outcomes, adherence and customer satisfaction (Richardson, 2009). Therefore, it is crucial for the human resource department to recruit the cultural sensitive professionals if they anticipate achieving a high level of satisfaction among the customers. Recruitment is a highly complex process that requires a high level of partnership within the organization. Human resource management must consult the physician on the requirements for a particular role because the healthcare field is evolving rapidly and credentials needed sometimes back may not be relevant today. For instance, in the 90s, physicians did not require to have much knowledge on informat...