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Organizational Quality Improvement Plan


General overview

As the major issue concerning the managed care related to Veterans Affairs deals with the quality of services provided by the organization, it is necessary to analyze and evaluate the quality of services after the introduction and implementation of the managed care program to ensure that all veterans are treated according to their needs within Veteran Affairs hospitals contrasted to the situation when these institutions failed to provide veterans with appropriate services in the VA hospitals.

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The Quality Improvement Cycle

Aim and scope. The plan aims to trace the improvement of the organizational quality in terms of services provided t veterans in VA hospitals. So, the quality improvement cycle reflects the stages of the plan. This means that we should set goals and collect data for a plan, test the plan and revise it, analyze data and make a decision of further actions, and implement the plan into action about the next stage and necessary plan for its organization and implementation. In this respect, it is necessary to trace the organizational quality improvement with the help of the proposed plan.

Study Measures (Weiner, Shortell, and Alexander. 1997, p.500)
Figure 2. Study Measures (Weiner, Shortell, and Alexander. 1997, p.500)

Theoretical Background

Type of care the organization provides

The VA hospitals are health care institutions that are aimed at providing. The importance of reports and assessment of data that can be used to improve the quality of services provided to patients was reported by Ransom et al. (2008, p. 4). The VA hospitals should improve the quality of services provided to customers to develop their reputation among customers. As VA hospitals should provide veterans with appropriate health care services, the quality of these services should be assessed. Thus, the plan for quality improvement should be designed, implemented as a pilot version that would enable the managerial of the organization to make certain changes if some discrepancies occur in the process of testing it. Moreover, the patients can be surveyed about their attitude to changes and possible improvements that are observable in treatment, testing, and overall attitude.

Organization’s mission and QI goals

The organization’s mission includes the improvement of the quality of services provided to customers to enable them to receive adequate treatment in VA hospitals instead of addressing public community hospitals. The quality improvement goals include improvement of responsiveness assessed via evaluation of nurses’ attitude toward patients; it is also necessary to improve the quality of health care services including treatment and methods used to diagnose, treat, and observe the patient. Another quality improvement goal is to develop the image of the institution in terms of reputation about the quality of services, attitude of personnel, insurance issues, treatment and medication systems, and other aspects that seem to be influential for the reputation of an organization. Assessment of patients’ attitudes can present a set of information to rely on to improve the quality of the services provided.

Role of the consumers in the organization’s QI

The consumers in the area of health care are patients and their relatives that encounter difficulties related to finding an institution that would provide them with adequate treatment. Veterans at VA hospitals are claimed to receive more appropriate health care services due to the implementation of managed care which is aimed at monitoring and controlling the costs spent in every case and their adequacy to the real needs of the patients and potential outcomes of some tests and operations. In this respect, the consumers can be considered an integral part of the process of quality improvement. Besides, it is preferable to take into account issues reported by patients with the help of a survey to improve the overall performance of the organization.

Three External Indicators

Brief overview

“Case management has been advocated as a strategy to decrease the unmet need for supportive services” (Katz et al., 2001, p. 557). The quality improvement plan should be based on the real needs of the patients and the organization. As the major activity of VA hospitals includes treatment of veterans, it is necessary to conduct research on the needs and expectations of veterans in terms of expenses, treatment methods, special programs for disabled veterans, and overall attitude of the organization’s personnel to the patients. External indicators include political power (governmental organizations) and private organizations, media, and public pressure (Dlugacz, 2006). In this respect, it is necessary to plan the organizational quality improvement strategy about the possible reaction from government and private agencies, media, and the public sector.

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Utilization of indicators by customers as part of QI process. As reported by Weiner, Shortell, and Alexander (1997), “Total quality management (TQM) is defined as a structured process for creating organization-wide participation in planning and implementing continuous improvement” (p. 493). As the quality of the services influences greatly the image of the institution, it is necessary to trace changes and assess the quality. Thus, the customers should be the primary concern for the organization that plans to implement a quality improvement plan. So, the category of customers is presented by patients and by the public sector as one of the influential external indicators of the quality improvement strategies.

Utilization of stakeholder feedback in the QI process

As stakeholders can be considered an internal indicator of the quality improvement plan, it is necessary to create the plan with regard to the stakeholders’ vision of this plan and changes that may affect the organization and other parties concerned. As suggested by Dlugacz (2006), the stakeholders should formulate their expectations and possible restrictions to be imposed with the help of the plan (p. 76). In other words, stakeholders as the primary source of decisions can affect the plan and its parts in order to make the implementation of this quality improvement plan more effective.

Association of Case Management with Unmet Need for Supportive Services and Utilization of Medical Services and Medications (Katz et al.,
Figure 3: Association of Case Management with Unmet Need for Supportive Services and Utilization of Medical Services and Medications (Katz et al.,)


All changes that are sure to affect the organization in case of implementation of the quality improvement plan can be either positive or negative. In this respect, it is necessary to take into account all parties concerned so that there were no gaps in providing health care services to certain categories of the population such as VA hospitals that are aimed at providing veterans with adequate health care services. Every external indicator of changes can react in a different way. So, it is necessary to plan the quality improvement in terms of media, public sector, governmental and private agencies. Surveys aimed at collecting the opinions of patients can be really effective while organizing the plan to improve the quality of services provided by the organization.

Reference List

Dlugacz,.D. (2006). Measuring health care: Using quality data for operational, financial and clinical improvement. San Francisco, CA: Jossey Bass.

Katz, M. H, et al. (2001). Effect of case management on unmet needs and utilization of medical care and medications among HIV-infected persons. Annals of Internal Medicine, 135 (8), 557-565.

Ransom, E. R., Joshi, M. S., Nash, D. B., and Ransom, S. B. (2008). The healthcare quality book: Vision, strategy, and tools (2nd ed.). Chicago, IL: Health Administration Press.

Weiner, B. J., Shortell, S. M., and Alexander, J. (1997). Promoting clinical involvement in hospital quality improvement efforts: The effects of top management, board, and physician leadership. HSR: Health Services Research, 32(4), 491-510.

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