Assignment 2: Managing Health Care Quality
HAS 501 Management in Health Care
Patient-Care Quality Management: A Report on Sunlight Hospital
In the sphere of the healthcare system of the United States, patient satisfaction remains a key objective. An increasingly important goal of the American medical field has been to quantify and improve the quality of health care. Adhering to these principles, advances the performance of a hospital, as the measurements are necessary to decide the steps to be an implementation process for developing the domain of the patient-care management. If patients are unsatisfied with the service of a hospital, then the overall construction of the hospital will be at stake. Hence, to do away with such probabilities, a hospital administrator must formulate (1) evaluation strategies to identify the weaknesses of a hospital’s patient-care management system and (2) implementation steps to eliminate those shortcomings.
The Sunlight Hospital in California is a reputable health care institution;however, recent developments have shown patient dissatisfactionand patients do not appreciate the care provided by the Hospital’s staff. Being the Hospital’s administrator, there is a need to evaluate and address the problem. The chiefpatient complaint involvedquality of care. During visits to various wards andmeeting the employees and patients, the administrator learned that patients loved the Hospital but wanted to see certain improvements in quality of care. The employee’ normal day-to-day execution of job duties became the culprit of one of the most problematic areas of the Hospital, hindering the process of actual employee-patient interaction.
Problem Analysis and Evaluation Strategies
To ascertain the quality of care of the Sunlight Hospital, the administrator, engaged in the process of quality measurement. The arena of patient-care quality measurement is broad, however, there are several tools and methodologies available to give a thorough evaluation.There are several internal and external elements which evaluated todetermine a hospital’s quality of patient care. Hence, as the administrator, the decision to implement a measurement model comprised of both the American and European style is of vital importance.The composition of the American model includes structure measurement, process measurement, and outcome measurement. However,adding two other quality evaluation methodologies prevalent in the European framework consumer surveys and peer review would be a better fit for the organization.
Sunlight Hospital should initiate measurements of the Hospital’s structure which, create value, increase efficiency and turn the hospital into a local hospital of choice, which includes personnel training and skills, adequacy of equipment resources (both diagnostic and therapeutic), and organizational systems to mobilize these resources for optimal patient care. Structure measurementswill enhance the likelihood of patients choosing a hospital in times of an emergency or patient care. When personnel are skilled and well-trained, then they are more efficient in handling different patient-related issues within and providing prompt service that patients and their family members seek primarily in a hospital. The second measurement performed relates to the process which refers to “the use of appropriate diagnostic and therapeutic modalities for individual patients. To facilitate the interpretability of process assessments, “ideal” patient subsets – those without contraindications for therapy – were oftenthe denominator, and those who received appropriate treatments where the numerator.” (“Measuring and Improving Quality Care”, 2000, p.1483). This evaluation was necessary because next to prompt service is proper diagnosis and the effectiveness of the treatment regime that follows the diagnosis. Improper means of diagnosis and ineffective treatment regimens are two important sources of patient dissatisfactions measured to evaluate quality. The third step of outcome measurement, which refers to the consequences of treatment and can represent markers of disease progression, health status, and cost. It is worth noting that frequent readmissions in respect of the same ailment often hamper the reputation of a hospital. Patients who leave the hospital dissatisfied are often the ones who influence the decision-making of their near and dear loved ones’regardsto future admissionsto a hospital in case of emergency and patient care. If a patient leaves the hospital properly treated and with satisfaction, then the patient can refer additional patients to the hospital for future care. Moreover, if the result of the treatment is good, then the reputation of the hospital is sure to be one on the upper side of the dependability ladder. The outcome measures provide the end results of the treatments conducted in Sunlight Hospital. Moreover, the administrator conducts consumer surveys as part of the measurement model todetermine the value of the Hospital in the eyes of the patients treated along with their family members’ point of view regarding the Hospital’s patient care processes. This evaluation method usually followed in the European context andis necessaryfor evaluating the performance of Sunlight Hospital. In this regard, it is worth noting that, “Standardized surveys of patients and relatives can reliably measure hospital performance against explicit standards at a national level” (“How can hospital performance be measured and monitored?”, 2003, p.7). The survey providesinformation in respect of the patients’ preference for Sunlight Hospital. Finally, the conducted peer review usually falls under the European model of third party assessment. It is noteworthy that “Peer review is a closed system for professional self-assessment and development. Reciprocal visiting is driven by professional (often single-discipline) organizations and has a long tradition as a form of peer review, especially for the recognition of training posts” (“How can hospital performance be measured and monitored?”, 2003, p.7-8). In this study, the administratorperformed the peer review of Sunlight’s competitors to evaluate the quality of administration. The review was a self-evaluation for an administrator, and this measurement process points out some steps taken to enhance the level of patient satisfaction in respect of the services they received at Sunlight Hospital.
After measuring the quality of patientcare offered by Sunlight Hospital, the structure measurementevaluation revealed that one sectorof the Hospital lagged among their competitors,which resulted in patient dissatisfaction. The study pointed out that the employees of Sunlight Hospital, though dedicated in their job roles, needed to undergo training in aspects of communications and employee-patient interactions. A proper training regime was the actual need. In addition to training programs other minor needs also emerged, including the establishment of an appropriate patient-feedback process and installation of some advanced monitoring technologies. Given the responsibility of solving the problems and enhancing the reputation of the Hospital, provided are some recommendations to the concerned authorities.
The patient-care quality management plan result includedfour strategical recommendations usher improvements in almost every sphere of the patient-care process of Sunlight Hospital.The primary recommendation was the implementation and incorporation of the Total Quality Management (TQM) model. TQM is an essential recommendation because it is an “organizational approach involving organizational management, teamwork, defined processes, systems thinking, and change to create an environment for improvement” (Hughes, 2008, p. 3). By adopting this model, the Hospital would be able to motivate every department to remain committed to improving the quality of their service so that the Hospital accomplishes its overall aim of improving its patient-care processes. Such development includes the formulation of effective training regimes to enhance the skills of employees, who can become sources of Caregiving which enrich the patients’ experience. Along with the adoption of TQM, itrecommended incorporating of the Continuous Quality Improvement (CQI) model along with TQM. Even though these models are interchangeable, that the parallel existence of bothTQM and CQI would strengthen the patient-care management process in Sunlight Hospital. Patients’ satisfaction rises or diminishes depending on the clinical practices of the hospital.
To enhance patient satisfaction in Sunlight Hospital,the administrator should usher developments in the clinical practices of the Hospital.Therefore, recommending CQI because this model is “used to develop clinical practice and is based on the principle that there is an opportunity for improvement in every process and on every occasion” (Hughes, 2008, p.3). Better data management also relates to patient satisfaction. As the hospital improves the management of personal patient data, the chance of the nurses and the physicians providing tailored clinical care to the patient increases.
The third recommendation in respect of developing a sound patient-care quality management plan is the proper implementation of an EHR system within the framework of the Hospital’s data management process. It is noteworthy that better capabilities in the electronic record (EHR) systems “combine the data needed for meaningful quality measures and to enable the measures themselves” (McClellan, 2013). Administrator,emphasize one essential feature of a health care institution – its organizational culture.
The final recommendation was training programs that would promote a culture of accountability within Sunlight Hospital. Emphasized on the formulation of strategies which would create “accountability for quality improvement at all levels, from top-level management to individual caregivers” (Glickman et al., 2015, p.341).
A Patient-care quality management planis necessary to implemented in bringing about development and improvements within decide upon the steps the domain of the patient-care management of a hospital. The Sunlight Hospital, in California, is a reputable health care institution and patients have always appreciated the care provided by the Hospital’s staff. But recent developments have shown patient dissatisfaction. The Hospital’s administrator duties required addressing the problems while evaluating the problems there were some specific errors. The main complaint among the patients was about the quality of care. The result of the evaluationshows that the employees of Sunlight Hospital, though dedicated in their job roles, needed to undergo training in aspects like communications and employee-patient interactions. A proper training regime was the actual need. Additionally, apart from training programs, twominor needs emerged: the need for the establishment of a proper patient-feedback process and installation of some advanced monitoring technologies, etc. When personnel are skilled and well-trained, then they are more efficient in handling different patient-related issues within the right timeframe.Several other relevant measurements performed and finally a recommendation for four specific strategies as a part of the patient-care quality management plan, to usher improvements in almost every sphere of the patient-care process of Sunlight Hospital.
Glickman, S.W., Baggett, K.A., Krubert, C.G., Peterson, E.D., & Schulman, K.A. (2015). Promoting quality: the health-care organization from a management perspective. International Journal for Quality in Health Care, 27(2). Retrieved November 21, 2016, from http://intqhc.oxfordjournals.org/content/19/6/341
How can hospital performance be measured and monitored? (2003). WORLD HEALTH ORGANIZATION: EUROPE. Health Evidence Network, pp. 4-13. Retrieved November 22, 2016, from http://www.euro.who.int/__data/assets/pdf_file/0009/74718/E82975.pdf
Hughes, R. (2008). Tools and Strategies for Quality Improvement and Patient Safety. In Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Retrieved November 21, 2016, https://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/nurseshdbk.pdf
McClellan, M.B. (2013). Improving Health Care Quality: The Path Forward. U.S. Senate Committee on Finance. BROOKINGS. Retrieved November 21, 2016, from http://www.brookings.edu/research/testimony/2013/06/26-improving-health-care-quality-mcclellan
Measuring and Improving Quality of Care (2000). AHA/ACC Conference Proceedings. Circulation. American Heart Association. Retrieved November 21, 2016, from http://circ.ahajournals.org/content/101/12/1483.full