Other // Risk and Quality
RISK AND QUALITY
This paper will explain the basic concepts of quality improvement, risk and quality management in the health care industry. The author will also analyze the information needed for decision-making processes in the industry of health care. In order to provide more information of this research, risk and quality management will be analyzed by considering tools used, purpose of each tool, advantages and disadvantages of the tools selected and the challenges in making risk and quality management decisions in the health care industry. Four peer reviewed scholarly journals will be the foundation of this paper.
Alam (2016) defined risk as “a probability/threat of damage, injury, liability loss that is caused by vulnerabilities and that may be avoided through pre-emptive action/s”. Allah added that the “interaction of humans with health systems pose a threat to them mainly because of the complex technology, intensely complex procedures, high demand on services, time pressure, high expectations from the service users, hierarchical by nature of training and responsibilities.” (p.1). By this definition, the concept of quality improvement, risk and quality management comes in due to the fact that patients are treated inside hospital and sometimes they are being injured inside hospital care. Some threats or harms are triggered by hospital acquired conditions like falls and infections. Another is medical errors as the third leading cause of death in the U.S. The causes of medical errors are communication problem, wrong information flow, staffing, lack of policies or technical capability. This is the reason why there is a need for a firm decision making and analysis on how the administrators of medical related institutions improve quality management. Therefore, quality and safety cannot be compromised.
There have been many research, studies and programs by different healthcare organizations to manage risks and improve quality and safety of patients. Healthcare institutions apply different strategies because of different sets of culture, policies and procedures to be complied with. External regulators or government standard or protocols are being followed by medical organizations for safety program. Every administrator or clinics and hospitals are working together with their department especially to the quality and risk management for assistance in improving the practice and system of their organization. The pressures being received by those regulators, people and other concerned entities are working together in order to promote the quality and safety programs by risk and analysis as professional practice. According to Curell (2010), “many national organizations, such as the Agency for Healthcare Research and Quality Forum (NQF), have specifically focused on projects that demonstrate continued focus on patient safety and quality. Since 2003, The Joint Commission (TJC) has endorsed many specific safe practices (such as use of patient identifiers, use of standardized abbreviations, and improving and standardizing handoff communications) as further defined under their National Patient Safety Goals program and has incorporated them into their accreditation process. TJC continues to expand its requirements related to quality and now also includes broader physician competency and credentialing criteria under its agenda”. (2010, p.13).
In lieu to accrediting companies like TJC, external compliance requirements are being valuable to peer review analysis and quality improvement that risk and quality managers in the organizations are visible in every aspect of efficient and effective professional health care and safety for patients. As Curell (2010) explained in her book entitled “Integrating Risk Management, Quality Management, and Patient Safety into the Organization”, the peer-review’s rationale is for the states to improve the healthcare systems and provide recommendations for patients’ care protection and promotion. The peer-review process will also have documents and safety review with quality assurance members. To foster the nature of this study, Kovac (2014) made a research to ensure efficient health care, high quality health services with a requirement to develop quality in healthcare across the Croatian territory. Like for example, aside from accreditation, there is a legal requirement to introduce quality management system into healthcare institutions in other EU countries. Possessing quality certification for both healthcare facilities and business processes is also necessary to guarantee safe medical practice. This is to establish that their products and services have met the criteria in a relevant standardization document. Civic further discussed that all patients have the universal and equal right to obtain quality healthcare services with professional standards. In Croatia, some healthcare institutions have failed to recognize quality management system in public health facilities. The researcher used St. Catherine Specialty Hospital for Orthopedics, Surgery, Neurology and Physical Medicine and Rehabilitation in Zabok which need to employ quality management system. Kovac (2014) put his statement “considering that the potential of this hospital extends beyond the boundaries of the Croatian market, a plan has been made to introduce it into the medical tourism. Therefore it was necessary to set up a quality management system as a preparatory step on the way achieving international accreditation, and the fact that European market has become open to cross-border healthcare services has only further emphasized the need to do so”. (p.678). They even followed a standard surgical checklist introduced by WHO to reduce number of surgical deaths because of errors and omissions in operating rooms. In 2013, the hospital already obtained its certification for diagnostics, treatment and rehabilitation with quality systems in compliance to the ISO 9001:2008 standard for quality improvement goals and quality indicators.
There are quality and safety tools studied by the Health Evidence Network. The institution reported the advantages and limitations of different quality and safety tools for health care. These tools are considered systems, methods or diagnostics to help quality or risk management departments for decision-making. These tools are not only for quality improvement but also for problem solving on some instances. It found out that quality tools or simple tools that are mostly being utilized are brainstorming, control charts, pareto diagrams, run charts, scatter diagrams, checklists, tablets, and counts. Advantages of these tools are: safe, timely, effective, equitable, patient centered, and efficient. These and other tools are used for quality assurance or audit frameworks. Other complex tools like the use of systematic “approaches” are the “continuous quality improvement plan-do-check-act (CQI PDCA) cycle, the Langley model, the team quality improvement sequence (TQIS), and different versions of the audit cycle and of patient pathway frameworks. There is evidence that statistical process control and quality costing methods are effective, but that the time and skills necessary to use them properly are greater than for many other tools. Both are disadvantaged in health care by the lack of quality data”. (2005, p.4). The above tools need regular checking and evaluation for analysis. Health care should be taken seriously and it is critical for staffs to deliver an efficient and high quality care and services. New standards, measures and procedures are changing and compliance with regulations within the organization is an everyday challenge.
References
Alam, A. (2016). Steps in the Process of Risk Management in Healthcare. Journal Of Epidemiology And Preventive Medicine, 02(02), 1-5. doi: 10.19104/jepm.2016.118
Curell, K. (2011). Integrating Risk Management, Quality Management, and Patient Safety into the Organization. In B. Youngberg, Principles of Risk Management and Patient Safety (p. 13). Illinois: Jones & Bartlett Learning. Retrieved from http://samples.jbpub.com/9780763774059/74059_ch00_fm_i_xvi.pdf
Kovač, N. (2014). Quality Management in Health Care – Contributing to Patient Safety Sand Efficiency of Business Operation, 670-678. Retrieved from http://www.efos.unios.hr/repec/osi/journl/PDF/InterdisciplinaryManagementResearchX/IMR10a50.pdf
Øvretveit J (2005). What are the advantages and limitations of different quality and safety tools for health care? Copenhagen, WHO Regional Office for Europe (Health Evidence Network report; http://www.euro.who.int/document/e87577.pdf, accessed [09012019]).
2019/5526
