Enhancing Healthcare Quality

Identifying a service improvement situation impacting on patient care:

Service improvement in healthcare is nothing new, rather the concept of improving the quality as well as service of healthcare has been developed from the time when a systematic healthcare system was developed in the society (Portela et al. 2019). This study has selected one of the most important service improvement situations in healthcare, introduction of pharmacist-led Medication Therapy Management (MTM) in context of meeting health needs of patients suffering from Psychosis. Psychosis is the psychosis in which brain loses its capacity in processing roper information. in today's modern medical framework, the majority of health professionals prefer to include Medication Therapy Management (MTM) program into clinical; field, in terms of improvement of therapeutic outcomes of these patients with psychosis. This process maintains connection among pharmacist, doctors and patients that assist them to discuss about the overall medication process that is prescribed for treatment of psychosis. MTM is the drug review process led by pharmacist, in which pharmacists gather detailed information regarding medicines that are prescribed to patients suffering from psychosis, review the outcomes of drugs and give suitable recommendation to make betterment of entire drug therapy (Hohmeier et al. 2019). Through introducing this service management process into healthcare, five core aspects can be covered such as

Review of medication therapy

Personal medication record

Referral of intervention

Documentation

Follow up process (Lengel et al. 2018).

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Identifying main issues in service improvement situation:

Although MTM program is associated with in-depth review of medicines taken by patients with psychosis in terms of assisting them to understand that whether the prescribed medicines are effective as well as relevant to their health needs, there are some potential issues that can be caused in healthcare framework due to implementation of MTM service (Isetts, 2017). One of the most common as well as major issues occur due to implementation of MTM program in healthcare is conflict between pharmacists and doctors that interferes with the compassionate service delivery process (Baker et al. 2017). As in MTM process, patients are connected to pharmacists to get proper information regarding effectiveness of medicines prescribed by doctors it sometimes can put questions on integrity and efficiency of health professionals (Sutton Burke et al. 2016.). Another issue of MTM service is lack of proper information delivery system in healthcare organisations that make the pharmacists unable to develop proper interaction with patients that interferes with the success of overall drug-review process. Additionally, lack of knowledge and expertise of pharmacists who are involved in drug review process can raise the chances of inappropriate analysis as well as review of prescribed drugs thereby enhancing health risk for patients with psychosis.

Responsibility of the healthcare organisation as well as own responsibilities as a healthcare professional: 250

In terms of improving the overall service delivery process of healthcare, not only individual staffs such as doctors, nurse, midwife and ward befriender but also entire healthcare organisation is responsible (Gill et al. 2018). While implementing MTM service in healthcare to provide high-quality compassionate care to psychosis patients, healthcare organisation is responsible to maintain highly organised communication and information delivery system that can assist patients, doctors and pharmacists to stay connected to one another and get all important updates about the prescribed medication. As argued by Sutton Burke et al. (2016), overall service improvement in healthcare through introducing MTM program is not only associated with maintaining effective information system in healthcare but also associated with conducting effective health education and training program for patients with psychosis. Healthcare organisers will assure that all healthcare professionals and pharmacists would be provided with all valuables resources to run successful training programs (Baker et al. 2017). Healthcare organisations are also responsible to maintain proper medical records of each patient in which there are complete details of medicines prescribed for treatment of psychosis such as schizophrenia.

Being a healthcare worker, I work on determining health issues of patients suffering from psychosis due to inappropriate application of any medicine and maintain proper documentation as well as follow of each medicine. I also work closely with patients with psychosis in analysing the overall progress of patient's mental and physical health after applying for the medicines. I use to maintain healthy contact with pharmacist to provide them with the information regarding medicines that are prescribed by doctors and issues regarding management of these medicines throughout treatment of patients suffering from psychosis.

By reviewing my performance as well as my experiences that I gained throughout the MTM service delivery process assisted me to develop my professional standard being a healthcare staff I need to improve my self-confidence in providing compassionate care to patients with psychosis. Through using this service improvement process I learned about the management of multiple medicines to ensure that appropriate drugs are applied in patients with psychosis in terms of meeting their psychological as well as physical needs. Throughout the MTM program, I have learned about the side-effects and actions of different medicines that assist me to determine whether there is any positive health implication of these drugs on these patients suffering from psychosis. Thorough analysing my experiences, I can say that I have learned how to communicate with pharmacists to provide the proper information regarding management and application of prescribed drugs.

Explaining how self-review can guide on career progression:

The overall review of my experiences that I gained throughout the service improvement process in my workplace, assisted me to develop professional and personal skills that are important for developing a bright future career. This self-review makes me realise that I need to focus on my written communication skill which will assist me in my future workplace to make proper documentation of patient's health condition and prescribed drugs. Throughout the review, I have realised how important communication is in a healthcare organisation. During the implementation of the MTM process in healthcare, I have developed proper verbal and nonverbal communication skills, which will assist me to develop clear interaction with my peers and health professionals in my future workplace. The self-review assisted me to develop my understanding about importance of drug-review process and documentation of medical records in a systematic process. My experiences on drug-review will assist me to improve patient's knowledge on medicine management process and health implications of each medicine on them.

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Reference list:

Baathe, F., Rosta, J., Bringedal, B. and Rø, K.I., 2019. How do doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care? A qualitative study in a Norwegian hospital. BMJ open, 9(5), p.e026971.

Baker, D.E., Behm, C.J., Feldmann, B., Flikkema, J. and Franz, T.T., 2017. Patients’ Perceptions of Pharmacist Intervention Through Pre-Screened Medication Therapy Management Service.

Brook, O.R., Siewert, B., Weinstein, J., Ahmed, M. and Kruskal, J., 2017. Measuring and improving the patient experience in radiology. Abdominal Radiology, 42(4), pp.1259-1267.

Gill, C., Triebwasser, C., Perlman, E., Xu, L., Kiptanui, Z., Johnson, K. and Harris, I., 2018. Capturing enhanced MTM services through development of encounter data and quality indicator measures. Research in Social and Administrative Pharmacy, 14(5), p.e15.

Greenhalgh, J., Dalkin, S., Gooding, K., Gibbons, E., Wright, J., Meads, D., Black, N., Valderas, J.M. and Pawson, R., 2017. Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care. Health Services and Delivery Research, 5(2), pp.1-280.

Hohmeier, K.C., Wheeler, J.S., Turner, K., Vick, J.S., Marchetti, M.L., Crain, J. and Brookhart, A., 2019. Targeting adaptability to improve Medication Therapy Management (MTM) implementation in community pharmacy. Implementation Science, 14(1), p.99.

Isetts, B., 2017. Integrating medication therapy management (MTM) services provided by community pharmacists into a community-based accountable care organization (ACO). Pharmacy, 5(4), p.56.

Lengel, M., Kuhn, C.H., Worley, M., Wehr, A.M. and McAuley, J.W., 2018. Pharmacy technician involvement in community pharmacy medication therapy management. Journal of the American Pharmacists Association, 58(2), pp.179-185.

Portela, M.R., Zarra, I.F., Esteban, H.C., Souto, M.P. and Núñez, E.M., 2019. Strategies to improve the quality of care in the chronic patient on multiple medications. Journal of healthcare quality research.

Sutton Burke, E., Niles, K., DiNicolantonio, J., Gardiner, C. and Conn, K., 2016. Effectiveness of a Centralized Medication Therapy Management Team to Improve Medication Outcomes.

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