Enhancing Patient Care through Quality Management

Introduction

The significance of quality management in the health and social care service provisioning mechanisms is paramount since the efficacy of such quality management could ensure the delivery of standardised, effectual and constructive care to the patients which could be suitable and beneficial to their health needs.

Explain perspectives that stakeholders in health and social care have regarding Quality

Stakeholder perspectives

The profile of stakeholders includes the patients, suppliers and service providing personnel in the care centres. It is necessary to consider the attitudes and behavioural perspectives of these personnel while formulating quality management decisions so as to avoid conflict in the future.

Perspective of service users

The primary necessities of the service subscribers are required to be fulfilled through adequate quality provisioning at the care facilities. Any shortcoming in this respect is needed to be addressed through careful analysis of the underlying rationale.

Perspective of workers or staff members

The health professionals and staff members of the care facilities are required to fulfil the responsibility as well as the liability of maintaining the quality maintenance aspect in the administered health services. Motivation is key to efficiently practice such activities.

Perspective of legal bodies

Legal bodies such as the Care Quality Commission (CQC), National Institute Of Clinical Excellence (NICE) and the health service commissioners generally formulate the benchmarks regarding quality of healthcare services. Disciplinary actions could be taken by these legal bodies while the contravention of the healthcare regulations could be detected.

examples from case studies

Case study based examples could be drawn from incidents such as shortcomings in manual handling, dressing and meal serving to the patients. The necessary work approaches have to be synergistic enough so as to formulate effective care environment for the care service subscribers.

Analyse the role of external agencies in setting standards

CQC – Care Quality Commission

According to Bergeron (2017), Care Quality Commission (CQC) performs the role of an independent regulation authority for registration of all of the providers of the social and healthcare services within the territory of UK as well as the inspection of such care services to ensure the adherence of the health and adult social care standards. Under the legal auspices of the Health and Social Care Act (2008), the CQC was established to be the singular regulator of all of such adult social care and health services within the national territory of the United Kingdom. As has been observed by Ferrand, et al (2016), the previously mentioned act is the legislative source of all of the authorities and powers of enforcement of health standard maintenance related policy decisions of the CQC within the national perspectives of the UK.

National Institute Of Clinical Excellence (NICE)

The role of the NICE is to provide advisories and recommendations regarding the provisioning of appropriate care and medical treatment for the general patient populace based on the formulated clinical guidelines by the National Health Service within England and Wales. The objective of this agency is to improve the standard of quality of available healthcare through introduction of necessary changes in the health services so as to enhance the opportunity of the patient populace to access qualitative healthcare when required (Valentine, Nembhard and Edmondson, 2015).

Example of external agencies and their roles in setting standards

According to Frank, Glazer and McGuire (2017), several external agencies perform the regulation of the health and adult social care services within the UK and most of these are adjuvants to the national government and the rest are voluntary or private institutes. Furnival, Boaden and Walshe (2018) have outlined that it is necessary to maintain the standarof quality which could be essential regarding the healthcare services so as to effectively provide the patients with adequate and beneficial medical treatment. The role of the various agencies is thus centred on the core aspect of inspection and evaluation of the health and social care provisioning centres such as day care homes and hospitals in terms of measuring of the standards of quality which could be related to the services provided at these care facilities. Furnival, Boaden and Walshe (2018) have specified that the prime responsibility of these healthcare regulatory agencies to ensure that the existing regulations are adhered to and the pre-specified standards of quality could be observed consistently by such healthcare facilities. Furnival, Walshe and Boaden (2017) have suggested that ensuring of the compliance of the existing healthcare facilities regarding the accepted qualitative standards of practice of care is fundamental to the overall roles and responsibilities of the external regulatory agencies.

The roles of each agency and their significance in setting standard

According to Gopee and Galloway (2017), the National Institute Of Clinical Excellence performs the recommendation provisions for the care improvement and sustained qualitative standardisation of the medical treatment processes in the hospitals and nursing homes of England and Wales. Such recommendations are utilised by the health professionals to formulate effective policies of qualitative care standards maintenance and regarding training and educational endeavours to enhance the skills of healthcare service providers. Such recommendations are formulated with the perspective of enabling the patients to make decisions which could be better informed and more efficacious communication measures could be developed between the health professionals and the patients. According to Haigh and Garside (2019), the roles of the CQC regarding health standards setting could be comprehended as multifarious in nature. These could be understood to be the fundamental duties of registration of the care of the health service providers, monitoring and inspection of the services as well as the rating of the same depending upon the outcomes of such monitoring, ensuring the protection of the healthcare service users, reporting the most significant quality related issues in the health and adult social care and finally, the addressing of the problems faced by the vulnerable patients such as the personnel who could be categorised under the legal perspectives of the Mental Health Act. Co-ordinating with the other institutions and public health organisations is another of the prerogatives of the CQC.

Assess the Impact of poor service quality on health and social care stakeholders

Underlying quality issues causing poor impact NHS

According to Halcomb et al (2016), the report of the CQC during the financial year of 2017-18 outlined the extensive sequences of quality related issues which have been imparting a negative impact on the policies formulated by the NHS. One of such issues has been the shortcomings of in excess to 10% of the NHS hospitals in making the dignity and respect maintenance of their patients the primary priority of theirs. The research of Harvey and Kitson (2015) has demonstrated that the most frequently emerging failures have been the dearth of ensuring proper privacy, improper communication in between the patients and their care personnel and the incremental tendency of the staff to be condescending in their behaviour towards the patients. Furthermore, the decline in the qualitative measure of care for a prolonged duration has been another significant quality related issue which has contributed in the avoidable mortification of certain number of patients. Hignett et al (2015) have drawn thte example of absence of adequate care provisions at various sections of the Staffordshire NHS foundation during the period of 2015 to 2017.

Why monitoring is required at RUH

According to Johnson and Sollecito (2018), the customary formal cautioning notification issued by the CQC to the Royal United Hospital has been based on the outcome of the inspection based assessment which had been performed without previously notifying the RUH management committee. This outlined the failure of the RUH to put into practice the recommended procedures which had been specified by the February based previous inspection. The latest assessment and inspection undertaken during June, 2017 involved four days of consecutive inspection conducted by the CQC at the RUH and visitations to the wards of the geriatric patients had been undertaken. This involved the examination of the emergency and intensive care units, operations and surgery theatre and the patient recovery sections of the hospital. The most glaring deficiencies could be detected within the following segments of operations concerning the maintenance of proper standards of care:

1: Ensuring the proper measure of respect for the patients and their representatives.

2: Properly executing the standardised care responsibilities regarding implementation of the policies of care welfare involving the patients.

3: Accomplishing the targets of safeguarding of the patients from abuse

4: Most significantly, the maintaining of proper records and information preservation regarding the clinical treatment service history of critically ill patients.

Consummate failure in the above mentioned responsibility measures has made it imperative for improvement of monitoring of the health service quality standards at the RUH.

2.0 Explain the standards that exist in health and social care for measuring quality

The standards of quality management within the services of health and social care could be considered to be equally significant for the large and relatively smaller sized healthcare facilities including the hospitals, nursing homes, critical care centres, recovery facilities and maternity and geriatric care homes. According to Kristensen (2015), greater emphasis on the improvement of the care services and procedures is required and this is indicative of the consistent utilisation of integrative approaches within the working architectures of the existing healthcare organisations. Various such approaches and standards, through which the quality of the healthcare and social service could be measured, include the responsibility management efforts regarding effective and qualitative provision of homecare involving the service subscribers, initial and middle level teamwork based leadership improvement, flexibility enhancement of services and skill sets of the staff members, implementation of technological innovations regarding development of standard medical care treatment based solutions to health issues of the patients and betterment of interpersonal communication regarding care plan formulation (van Schoten et al. 2016). Apart from these, the additional measures of quality assessment are safeguarding of the patients and healthcare service seeking personnel and avoidance of wastage of resources and judicious utilisation of machinery and medical equipment within the hospital and care home facilities such as within the RUH. According to Meesala and Paul (2018), the evaluation and measuring authority of the standards of quality could be understood to be the Regulation and Quality Improvement Authority (RQIA).

2.1 Evaluate different approaches to implementing quality systems

As per the observations of Mohammed et al (2016), the implementation of the approach of Total Quality Management (TQM) since this could contribute in the quality management and maintenance of assuring standards of service quality in the existing working structures of the RUH. The implementation of such an approach could effectively enable the RUH management to concentrate on various care quality regulation associated shortcomings and issues such as the documentation and record preservation problems involving the care service subscribers. Employee management with the objective of safeguarding policy implementation to shield the critically ill patients from abuse could be also ensured through concerted application of TQM at all of the working levels of the RUH. Morris, Chawla and Francis (2019) have opined that extensive and in-depth analysis of the quality standards could be made possible through the application of TQM at the RUH.

2.3 Analyse potential barriers to delivery of quality health and social care services (mention aspect of contract law and negligence in business assignment)

Avery (2016) has suggested that the delivery barriers of qualitative services of care are dual folds, namely the Internal and the External barriers. Internal barriers could be understood as the dearth of technological exposure and skill to operate complicated medical equipment by the RUH staff members as well as shortcomings in the internal communication systems through which co-ordinated care delivery planning at the team levels could be made possible. External barriers are palpable in the form of deficiency in the form of financing mechanisms, health insurance services and either the absence or the inadequacy of social support services for the patients who could be released from the care home such as the RUH. According to Hall et al (2018) the offer of care services by the RUH facility and the acceptance of the same by the healthcare subscribers could be defined under the provisions of the Contract Law in which the involved parties are the patients and the hospital authority. The aspect of Intent, as has been enshrined under the Contract Law of the UK, could be considered to be the potential internal barrier since the mutual agreement clauses, in terms of the legal parlance, are not legally enforceable involving these two parties. Furthermore, it is the non-utilisation of the ability of the staff of RUH rather than the absence of it which precludes any attempt regarding the formulation of any effective contract on part of the hospital authorities and the patients to administer qualitative care.

On the other hand, the research of Coulter (2017) suggests that the RUH deficiencies in operational policies could be termed as negligence of business since there have been ample evidence of the hospital staff failing to perform their respective duties under the reasonable circumstances of duty.

3.0 Evaluate the effectiveness of systems, policies and procedures in a health and social care setting in achieving quality in the service offered

The responsibility to provide palliative care for the elderly patients and critically ill personnel as well as general care rests upon the RUH service staff such as nurses and professional physicians. The institutional care structure has been integrated within the administering of services mechanism at the RUH. The utilisation of severe disease prevention and care programs, improvement in the care quality and safety assurance for the patients and proper benefit and incentive provisioning for the hospital staff and health professionals are all included in the systematic policies and procedures of the RUH. Some other aspects are performance dependent remuneration scales and various non-monetary rewards and recognition of outstanding performance of the staff (Vincent and Amalberti, 2015).

3.2 Analyse other factors that influence the achievement of quality in the health and social care service

The quality achievement and efficiency management influents at the RUH could be understood as the effort to enhance the integrity of services to administer qualitative and standardised care to the patients and providing adequate benefits to all of the stakeholders of the facility. Apart from these, greater emphasis on the appropriate measure of outstanding performance achievement on part of the nursing staff could be considered to be another factor which influences the quality management at the RUH.

4.0 Evaluate methods for evaluating health and social care service quality with regard to external and internal perspectives

The operational procedures and contributions of the CQC are essential in terms of the evaluation of external and internal perspective based quality assessment at the RUH. Nicolaou and Kentas (2017) are of the opinion that the enlistment of the external factors which influence the functional abilities of the RUH could be derived from the reports of the RUH. On the other hand, the process of TQM could outline the internal factors of influence of quality maintenance such as the leadership efficacy and documentation processes, administrative supervision of care policies and staff behavioural management and flexibility of communication between the physicians and the patients and their representatives. Another method has been the quality assurance mechanisms which emphasise on staff sensitisation towards the needs of quality maintenance and professional capability enhancement of the same.

4.1 Discuss the impact of the involving service users in the evaluation process on the quality of service delivered.

Fostering of innovations and creativity through involving service users within the quality management in health could be a definite possibility since the patients could bring in their experiences to be contributed in the care planning scenario and this can effectively broaden the perspective of the hospital staff. Other than this, involvement of service subscribers could effectively ensure the supervision based efficacy to ensure quality through appropriate care policy related decisions.

Conclusion

The preceding study has considered the different dimensions of qualitative healthcare provisioning mechanism which have been embedded within the hospital based care service mechanisms. Focus has been concentrated on the principles and impacts of systems, procedures and policies formulated by various healthcare regulating organisations within the United Kingdom on the health service provisioning practices. Apart from these, external factors and agencies which influence the entire set of healthcare structural activities within the UK national perspective, have also been discussed.

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