Regular quality improvement is a critical component of modern clinical practice, hence the importance of health facilities to develop methodologies aimed at implementing quality improvement initiatives and aligning them to the broader goals and objectives of the organization (Kahn & Fuchs, 2007). This paper looks into the authority, structure, and organization needed to implement quality improvement initiatives aimed at reducing medical errors and enhancing consistency in the standard of care in the health facility.
The authority structure of the health facility is critical in ensuring the effective implementation of quality improvement initiatives. According to Parker et al (1999), the extent to which top management, organizational culture, and other stakeholders becomes directly involved in quality improvement initiatives determines the degree of quality improvement implementation. In this perspective, the executive leadership, quality improvement committee and the medical staff will be jointly involved in implementing the quality improvement plan. The involvement of the executive leadership is instrumental in the creation of an organizational culture that will emphasize innovation and teamwork among the medical staff, enabling an environment that will provide a solid foundation for the implementation of the quality improvement initiative (Parker et al, 1999). The quality improvement committee will be responsible for designing benchmarks and communicating progress to other members that are directly or indirectly affected by the quality improvement initiative. The medical staff are at the core of any quality improvement initiative intended to reduce medical errors, thus their involvement is mandatory if the plan is to achieve the intended success (Kahn & Fuchs, 2007).
Constant communication is critical for effective implementation of a quality improvement initiative since the decisions made may affect multiple individuals and departments within the health facility (Kahn & Fuchs, 2007). According to these authors, constant communication assists to reduce incidences of resistance to the quality initiative which may arise due to misinformation or lack of adequate information. As such, the performance activity outcomes must be constantly communicated to the hospital’s Board of Directors, the executive leadership, managers and all employees affected by the initiative in the health facility. The coordinator of the quality improvement committee should be responsible for facilitating meetings, collecting and analyzing data, generating reports, and providing feedback about the progress and problem areas to the core leadership and members of staff.
It is the function of the quality improvement coordinator to ensure that members of staff are trained and educated about the quality improvement plan and performance measurement systems across the health facility to empower them and translate their expectations into program objectives and activities (Kahn & Fuchs, 2007). The staff can be educated by undertaking bi-monthly training programs where the improvement plan is discussed in detail and members asked to seek for clarifications and provide input on how the plan could be further improved. The organization’s intranet service could be used to orient members by posting plan details, progress notes, agenda and minutes of meetings, challenges presenting, useful websites and resources, and what members of staff are needed to do to make the plan a success (Quality Management Plan, 2006). Although such communication should target all employees, the quality improvement coordinator should focus on making sure that the clinical members of staff are well aware of the plan since they are directly involved in making decisions that may either inhibit or promote desirable clinical outcomes.
Quality improvement plans depend upon the capacity of health facilities to undertake continuous evaluation to test changes aimed at improving performance and, more importantly, identify areas that need to be revised to make the plan more effective (Parker et al, 1999). In the context of reducing medical errors and enhancing consistency in the standard of care, some elements of the plan that need to be annually evaluated for improvement include: needs and desires of patients, needs and expectations of clinicians, level of technology adoption in making clinical decisions, level of efficiency in service delivery, and the level of patient satisfaction. A successful improvement plan must be regularly monitored to establish whether the plan remains effective over time (Quality Management Plan, 2006; Al-Assaf & Schmele, 1993). Various tools such as the bar graphs and Six Sigma can be used to monitor the improvement plan by comparing the baseline process capability with the process competence some few months after the implementation of the improvement plan.
The quality and performance measure of the organization’s decision-making processes are likely to be affected by external influences coming from governmental agencies, professional and interest groups, and accrediting bodies, among others (Kahn & Fuchs, 2007). Government agencies have come up with various measures that health facilities can use to reduce medical errors, implying that a quality improvement plan intended to reduce medical errors must look for valuable insights from the findings of various government agencies regarding the issue. Some professional and interest groups are known to subscribe to some best practices regarding certain medical conditions and such practices may also influence the decisions made by this particular health facility in implementing their quality improvement plan (Al-Assaf & Schmele, 1993). Additionally, the implementers of the quality initiative may also be influenced by the rules and guidelines of various accrediting bodies to take a particular stand to meet the basic requirements set by these bodies even though such a stand may not be in the best interests of the quality improvement plan in question.
Reference List
Al-Assaf, A.F., & Schmele, J.A. (1993). The text of total quality in healthcare. New York, NY: St. Lucie Press
Kahn, J.M., & Fuchs, B.D. (2007). Identifying and implementing quality improvement measures in the intensive care unit. Current Opinion in Critical Care, 13(6), 709-713
Parker, V.A., Wubbenhorst, W.H., Young, G.J., Desai, K.R., & Charns, M.P. (1999). Implementing quality improvement in hospitals: The role of leadership and culture. American Journal of Medical Quality, 14(1), 64-69
Quality management plan. (2006). Web.