Analysis of QI methodologies and implementations for Dare Health Care  

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Improvement Methodologies

For the organisation, opportunities using quantitative and qualitative methods. One of the qualitative methods are the interviews, whereby the data is collected through formal interview techniques. The advantages of this approach is the exploration of the accurate and exact nature of the problem, courses of the events as well as eliciting the correct information about the patient safety and quality care aspects like the health status of the client, the decision-making with the clinical process that was made and executed treatment process (Curcin, Woodcock, Poots, Majeed & Bell, 2014).  Qualitative interviews can be useful in providing  insights as to why the medical staff or the health care management staff are engaging in particular processes, while also identifying health outcomes and indicators like uncertainty, stress, any stress, the status of the operating rooms, and how the critical care unit is being managed to ensure safety (Curcin, Woodcock, Poots, Majeed & Bell, 2014). However, a major disadvantage of the interviews is that it will not result in the proper or accurate provision about some elements like the cognitive processes that are driving the evident behaviors of the nurses.  In essence, interviews cannot help to provide data for understanding how the nurses or the healthcare professionals are engaging in such practices, the knowledge and skills, what drive them into completing complex tasks (Al-Abri & Al-Balushi, 2014). The implication is that through interviews, it will not be possible to offer a cognitive analysis such that the information can be presented in a useful format for improving the efficacy of the health care providers, especially the nurses in achieving the quality deliverables or benchmarks in health care management.

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The administrative system for collecting quantitative data can be a useful approach or elements of collecting the quantitative data in hospitals.  The survey method is effective because it provides the necessary and required data already processed in ‘report forms’ from different clinical locations (Al-Abri & Al-Balushi, 2014). The method is valid since the data is documented on reporting sheets containing some of the parameters of the clinical events contributing to the health care situations are well as the taken corrective measure. The quantitative methodology presents the advantage of exploring the health care management issues in details since they are inclusive of such elements like the regular care assessment surveys, the clinical surveillance systems as well as the reviews of the medical charts (Curcin et al., 2014).   

Nevertheless, the quantitative methodology is limited to the leadership influence because in some cases, the data is used for punitive measures like punishing the staff for poor performance (Al-Abri & Al-Balushi, 2014).  If implemented correctly, then the approach can be effective in overcoming issues with underreporting of the data within the system. Despite the challenges, the quantitative methodology is effective in that it provide information on some aspects of quality improvement including the administered drugs, the actions taken, and the time-trend parameters (Curcin et al., 2014).  In return, there is more emphasis on a physician-driven explanation of the causative factors but may face the disadvantage of the medical staff resisting to reveal some of the adverse events when using a quantitative approach of collecting data because the figures must be genuine. Different tools like check sheets for tracking and documenting data over time can be useful while control charts can quantify the information by recording in the form of a control chart to forecast on the possibility of the event occurring in future.

The chosen methodology: Qualitative interviews

Since the emphasis is on quality improvements, the nature of the patient care is sometimes easy to observe and make an inference from the engagement with the clients. Therefore, a qualitative methodology is the most effective because, through close engagement with the patients, it comes out clearly as to what they feel about the services, the professionals attending to them, their overall health status, comment on the services provided as well as providing recommendations for the necessary changes (Al-Abri & Al-Balushi, 2014). In fact, from the qualitative data, it is easy to provide analysis and quantify the events as they occur and as such, using them to improve the current level or extent of services provided in the health care setting or the organization. 

Information Technology

For the technology application, there is the need for the hospital to have a laid out plan for reporting systems that structures the processes that health care professionals can use in identifying the events as they occur within the health care setting. In this regard, the aim should be to develop and have an integrated reporting system that includes other technologies like emails and other electronic means of communicating and coordination within the health care setting (Free et al., 2013). One of the advantages of the system to quality improvement, in particular in the safety of the patients, is that it is all inclusive of those involved in care management including the executive management and the health care providers (Free et al., 2013).  An integrated reporting system ensures that there is an enhanced patient safety besides the quality of care as the relevant authorities and the health care staff make sure that proper systematic changes are adopted.

However, any application of information system into the management of data is challenged by such disadvantages as the issues or concerns with immunity, confidentiality and anonymity (Free et al., 2013). For instance, with the anonymous nature of the information system, it will not be possible to probe the person reporting or getting more of the necessary and required information for improving the care management through reporting of the actual events. On the other hand, if the reporting system with the health care system is not confidential, it discourages proper and accurate reporting of the events and as such, can be a compromise towards the concerted efforts towards improving quality within the organisation (Currow et al., 2015). 

Benchmarking

One of the ways through which benchmarking will be applied in the management or achievement of the quality indicators is using the reporting system and connecting with other state and national health care organisations to see what they are doing as on different areas of health care management (Currow et al., 2015). For instance, the organization can refer to the number of mortalities, hospitalised infections, type of customer feedback, the standard processes applied within other organisations to see if the quality improvement incentives are achieving the stated quality deliverables. More so, the reporting system can be used to communicate in a two-way among the hospitals, more so the reputable ones, to compare their structures (of the health care environment) as concerning leadership, processes (health care management processes) and the outcomes(like patient safety, proper management of infections among others).

Benchmarking will also be done by comparing how the different units are fairing and using the results or outcomes to measure or compare against the good performers within the organisations (Currow et al., 2015).  To improve quality, benchmarking will be done with other sources like the local health care quality assurance, by looking at similar performance data and comparing with the milestone or advancement of the organisation. Resources like the community clinic associations, especially on how they manage conditions like infection control, asthma and other ailments can aid in improving quality within the organisation. Data reports from the Federal agencies and the Federally Qualified Health Centres can be helpful benchmarkers.  

Mission, Vision, Strategic, and Operational Plans

The mission of Davis Health Care Centre is on providing state-of-the-art care management and treatment using a highly trained staff.  The mission is to ensure proper service to the community and provides residents with exceptional care focused on quality outcomes.  Through appropriate and sound health care services to the community, it is the inherent aim of the organisation to become the choice for the community, as a such, grow to become a first class facility. To fulfil this objective, there has been the commitments to offering a wider health care services, through advanced technology to ensure convenient and comfortable patient experience. Besides, through the highly trained to help in ensuring that there is an endless focus on the healthcare quality as well as constant maintenance of the commitment to the well-being of the patients. 

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The current quality improvement plan aligns with the missions, visions and operational plans of the organisation. For instance, through the proper collection of data on the state of the health care management by looking at elements like infection control, patient satisfaction, feedback, among other quality deliverables, the data will be used to improve patient comfort and well-being. On the other hand, there is the benchmarking of the outcomes, especially measuring the processes, structure and the results of the standard health care practices of other organisations to provide services that surpass the competitors. For instance, the reporting system is recommending the use of technology applications that allow for easy communication among the different units of the organisation. Through such incentives, it will be possible to create an environment of easy coordination and cooperation thereby leading to a unified effort towards providing quality in health care management.

Barriers/Challenges

As stated before, barriers exist with the staff and their reluctance to adopt ways of sharing information and reporting on the processes, and outcomes. Quality improvement concerns organisational change, and with this, there is the basic concern with the leadership because if a proper structure of coordination, support and motivation is not laid out, then it will not be possible introducing or implementing the new approaches to quality improvement (Currow et al., 2015).  Another challenge is the engagement of the staff in implementing the necessarily recommended improvement plan. In most cases, the staff are ever afraid of the unintended consequences or uncertainty that comes with the new models of quality improvement. In this sense, the organisation will be forced to focus more on intrinsic motivation to get the staff engaged in implementing this plan (Curcin et al., 2014).

Successful Implementation

The best strategy for implementing the program is by having a plan for managing the care management process and not focusing on managing the nurses and physicians (Curcin et al., 2014). In this case, the quality improvement should be implemented from the process perspective and not focus on the human resource management element. Notably, the reporting system should be properly streamlined, with the incentives for ensuring that the structure (leadership structure) is redefined to ensure smooth adaptation of the QI plan. The quality improvement being recommended concerns the concerted efforts towards a proper collection of data to improve quality assurance. In this sense, it is imperative for the organisation to have real incentives for presenting the healthcare staff with the right data under the correct format as well as the right time. While doing so, the information should be provided to the right person. For this sense, the strategy should be to have the data delivered precisely to the staff or the clinicians involved in quality improvement. The approach also implies having the right people assigned the task of quality improvement, including monitoring and evaluation(Currow et al., 2015). Training is equally an important strategy, more so training the clinicians on the importance of quality improvement and how such will help in the realisation of the set goals and incentives of the organisation.   

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  1. Al-Abri, R., & Al-Balushi, A. (2014). Patient satisfaction survey as a tool towards quality improvement. Oman Medical Journal, 29(1), 3–7. 
  2. Curcin, V., Woodcock, T., Poots, A. J, Majeed, A & Bell, D. (2014). Model-driven approach to data collection and reporting for quality improvement. Journal of Biomedical Informatics, 52(1)151–162
  3. Currow, D. C., Allingham, S., Yates, P., Johnson, C., Clark, K., & Eagar, K. (2015). Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking. Supportive Care in Cancer, 23(2), 307-315.
  4. Free, C., Phillips, G., Watson, L., Galli, L., Felix, L., Edwards, P., … & Haines, A. (2013). The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med, 10(1), e1001363. 
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