Introduction
Continuous quality improvement is vital in health care due to the profession’s nature. I have decided to evaluate interventional radiology and its areas that can be improved. Quality improvement in the area primarily focuses on removal of waste, delays, errors, and unnecessary costs. In this essay, I will review some of the methods and their relation to my practice, as I have not been involved in any MSN-level quality improvement initiatives.
Standards and My Role
For this essay, I have selected three standards which should be implemented in interventional radiology. Ogrinc et al. (2015) describe a general pattern for quality improvement reporting named SQUIRE 2.0, which is essential for defining and evaluating changes. Kelly and Cronin (2015) propose practical methods for the improvement, such as lean management, kaizen, or the Six Sigma method. Lastly, Villarreal, Rostad, Wright, and Applegate (2015) describe an initiative that allowed them to improve starting times for the procedure and reduce delays. In the situation, I view myself as an employee that would have to implement the new standards in my work.
The Relevance of the Standards
Quality improvement is always a relevant topic, as implementing it means critically reviewing one’s performance, determining weaknesses, and addressing them. The ideas proposed by Kelly and Cronin (2015) provide a robust framework for the achievement of that goal, as they describe methods that have proven themselves highly successful in other industries, and applying them would likely be beneficial both immediately and in the long run. Furthermore, the guidelines provided by the article concern all employees of an enterprise, which would make them relevant to me.
The other two standards offer more concrete advice on procedure performance and information management. Villarreal et al. (2015) describe a set of measures they took to analyze the reasons for delays and late procedure starts and eliminate those issues, which is a process any organization is capable of repeating. Ogrinc et al. (2015) provide a unified and convenient system for reporting quality improvements that can then be used by other specialists in the field. As such, the two standards described here detail practices that can and should be applied to the functioning of any health care organization and are therefore always relevant.
Standards in My Practice
I believe that the guidelines by Kelly and Cronin (2015) are mostly implemented in my practice, although it would be prudent to review it and make a more informed statement. However, the guidelines by Villarreal et al. (2015) and Ogrinc et al. (2015) are not being used. Delays occasionally happen in the performance of the procedures, and no tangible steps are being taken toward the elimination of the issue. Furthermore, SQUIRE reporting forms are not used in my practice, and reports on quality improvement initiatives are performed in a free format.
Necessary Improvements
To implement the standards that are not followed in my workplace, it would be necessary to create a team that would investigate issues that are present, and enforcement of reporting guidelines would be needed. This would mean monitoring the performance of the department and documenting events that lead to delays as well spreading awareness of the SQUIRE 2.0 standard among employees. The result would most likely be a more streamlined experience where patients would receive care that is more efficient and does not waste time, and an effective method of evaluating future quality improvement initiatives as well as an opportunity to examine the approaches taken by other institutions and implement them if necessary.
Evolution of Practice Change
Over the first 12 months of quality improvement, the practice will move to the new standards. At first, information about the SQUIRE 2.0 system will be circulated among the practitioners along with the suggestion that it should be used for reports. At the same time, a team will be formed to monitor the performance of the department, in particular, the scheduling of the procedures. After some time, the use of the SQUIRE system will be made mandatory, and the changes determined to be necessary by the team will begin. After the implementation of the new policies and the transition to SQUIRE are complete, the proposed standards will be in effect.
Areas That Cannot Be Changed
Part of the reason for the delays in procedure performance involves patients being late. As there is no practical way to enforce punctuality among patients while still providing reasonably quick access to the procedures to the people who need them, this issue cannot be resolved at present. As such, delays can be reduced, but not eliminated, and considerations on how to address the concern should be left to future quality improvement initiatives.
Conclusion
My practice does not entirely follow any of the standards presented in this essay. However, they can mostly be implemented within 12 months through a team-based study of the delays and their causes as well as the introduction of a new reporting format. A part of the delay-related concerns cannot be resolved with current methods, so alternatives have to be found, and the issue will persist until a way to remove it is found. Generally, however, my practice consistently follows quality improvement standards that are not related to reporting, even if there is room for improvement.
References
Kelly, A. M., & Cronin, P. (2015). Practical approaches to quality improvement for radiologists. Radiographics, 35(6), 1630-1642.
Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2015). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. The Journal of Continuing Education in Nursing, 46(11), 501-507.
Villarreal, M. C., Rostad, B. S., Wright, R., & Applegate, K. E. (2015). Improving procedure start times and decreasing delays in interventional radiology: A department’s quality improvement initiative. Academic Radiology, 22(12), 1579-1586.