Quality Improvement Safety in Care

Define Quality Improvement and consider the elements associated with it in relation to health and social care.

According to Johnson and Sollecito (2018), Quality Improvement (QI), in the context of health and social care services, could be recognised to be the framework through which systematic improvement could be performed in delivering of appropriate care to the patients. The entire systematic process is primarily formulated with the objective of measuring, analysing and controlling the various elements which constitute the entire process.

According to Renedo et al (2015), the QI framework constituent elements entail the investment of persistent efforts by the health and social care service providers to attain predictable, suitable and stabilised outcomes in terms of service delivery. This could be better explained as the effort towards curtailment of variation of the care delivery processes and achievement of outcome improvement involving both the patients and the care organisations.

According to Dixon-Woods and Martin (2016), the core constituent elements of QI could be identified as focus on efficacy of the care delivery systems, the recognition errors, emphasis on teamwork, attaching of value to peer reviews, reduction of the per capita healthcare expenditure and improvement of patient experiences through utilisation of errors as opportunities for learning experience development. Achievement of QI efficacy involves the sustained commitment of the entire working architecture and human resource capital of respective care delivery organisations, including the higher management echelons.


Critically explore the factors that have led to a greater international emphasis on quality measurement and improvement in health and social care.

According to Srinivas and Raju (2017), the previous decades have witnessed the expansion of global health contingencies and associated priorities. Such contingencies have culminated in the utilization of QI based approaches for redressing such problems in the health and social care services. Vindrola-Padros et al (2017) have stated that prevalence of Anti-Microbial Resistance (AMR) has proven to be the most intractable emerging healthcare issue.

To this effect, significant emphasis has been concentrated on the improvement of healthcare services through which the AMR could be tackled. In this context, the development of the dual process of effective quality control and care planning could be perceived to be able to address this problem related to AMR. The prime objective of such QI mechanisms implemented globally could be considered to be the enhancement of effectiveness in supervising the healthcare facilities through which the health hazard posed by AMR could be successfully managed.

According to D'Lima et al (2016), this format of QI based approach has been effective regarding development of credible control and supervisory mechanisms through which the administrative initiatives in addressing AMR related problems could be brought to success. Some instances of such administrative mechanisms could be stated as implementing stringent schedules for monitoring, administering antibiotic consumption prescriptions which could benefit the patients as per their health conditions since such antibiotic administering schedules are calibrated and well balanced and, development of task checklists through which healthcare efficiency management could be optimized at the levels of individual practitioners as well as care facilities.

Carinci et al (2015) have observed that adherence to the International Health Regulation (IHR) of the WHO by different countries is premised upon the efficacy achieved in public healthcare system surveillance. Such healthcare surveillance could be implemented at the national and sub-national levels so that threat reporting mechanisms at such levels and at the global level could be optimized.

According to Carvalho, Jun and Mitchell (2017), resource limitations in most of the countries generally constrain them from achieving such efficiency. The reason is that such countries, mostly situated at Sub-Saharan Africa and at some sections of Southern America and Asia, are confronted with various problems. Some of these problems are recognizable in the form of dearth of equipment and improper systems of early warning of possible pandemics and improperly qualified and trained healthcare professionals.

According to Gadolin and Andersson (2017), one of the direct outcomes of such constraints could be understood as the Ebola outbreak of 2014-15 due to the deficient health surveillance implementation systems at the small villages of Guinea in West Africa. Apart from this, the outbreak of Zika virus in the Southern American countries has also brought forth the realization that dependence on individual national and localized disease surveillance and security are paramount in terms of prevention of such epidemics of infectious ailments. The emphasis has to be on the enhancement of measures of access of individuals to available healthcare facilities and effective disease prevention technologies. Delivery of proper and essential care services (such as affordable medications and vaccines to the affected populace) in tandem with the protection from differential risks has to be considered.

According to Momani, Hirzallah and Mumani (2017), the considerable intensification of international migration propensities, with an approximation of 250 million personnel (including the 21 million international refugees, 40 million internally displaced personnel and 3% asylum seeking personnel globally), has been another factor of concern for the health operational agencies at the international levels to emphasize on the application of comprehensive QI. According to Barnard et al (2016), the Sustainable Development Goals, the under the purview of Universal Health Care principles, could remain to be unfulfilled since, the majority of such migrant population, does not have the means to accessing effective healthcare services at the host nations.

In this context, according to Melo (2016), the significance of QI application could become apparent concerning the healthcare service impartation domains related to equitable service delivery which have, so far been the neglected ones in terms of international health improvement initiatives. According to Renedo et al (2015), such considerations involve the entire spectrum of health and social care services including preventive treatment, affordable medication and services, palliative and rehabilitative services and promotion of general health consciousness. Such services could be facilitated through application of effective mechanisms of service control and quality enhancement planning with the objective of achievement of mitigation of all of the risks which could be generated through inequities in service delivery within the migrant populations.

Consider how globalisation affects the organisation you work in as it tries to achieve quality.

Various challenges are experienced by the healthcare organisation in the process of achievement of necessary quality in service delivery. The most significant challenge is expansion of in-patient facilities. Another of such challenges is the maintaining of effective balance between patients and medically qualified operational care staff. The overcoming of this challenge could ensure that QI based betterment of medical services, for diseases such as AMR, could become successful.

The most significant ones are the necessity of enhancement of in-patient facilities and to maintain the balance since these are fundamental to the improvement of quality under the purview of QI. The primary concern is the resource crunch which affects the organisation. The resources are mostly identifiable as financial, human resources and material resources. These are vital for the implementation of the practices of QI so as to enhance the existing quality up to the globalised standards which could be acknowledged by the Joint Commission International (JCI) which is the body of accreditation of the Joint Commission on the Accreditation of Healthcare Organisations, IIME and the World Federation for Medical Education. The gross expenditure necessary to elevate the existing services as per the globally acknowledged standards has been prohibitive and this has contributed to the care distribution problems. The outcome has been that the patients within the UK are increasingly lodging complaints about having to pay considerably greater costs for even essential services. In the UK, such a scenario contributes for the increase in the medical insurance expenditures for the patients since they have to pay greater premiums.

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Reference List

Barnard, C., Woods, D., Noskin, G., Kricke, G. and Cella, D., 2016. Patient Perspectives on Healthcare Quality: Implications for Measurement and Improvement. An Innovative RAPPORTS Model of Patient-Centered Quality, p.92.

Carinci, F., Van Gool, K., Mainz, J., Veillard, J., Pichora, E.C., Januel, J.M., Arispe, I., Kim, S.M., Klazinga, N.S., OECD Health Care Quality Indicators Expert Group and Haelterman, M., 2015. Towards actionable international comparisons of health system performance: expert revision of the OECD framework and quality indicators. International Journal for Quality in Health Care, 27(2), pp.137-146.

Carvalho, F., Jun, G.T. and Mitchell, V., 2017. Participatory design for behaviour change: An integrative approach to healthcare quality improvement.

Dixon-Woods, M. and Martin, G.P., 2016. Does quality improvement improve quality?. Future Hospital Journal, 3(3), pp.191-194.

D'Lima, D., Bottle, A., Benn, J. and Thibaut, B., 2016. Effective use of feedback for professional behaviour change and quality improvement in healthcare. European Health Psychologist, 18(S), p.964.

Gadolin, C. and Andersson, T., 2017. Healthcare quality improvement work: a professional employee perspective. International journal of health care quality assurance, 30(5), pp.410-423.

Johnson, J.K. and Sollecito, W.A., 2018. McLaughlin & Kaluzny's Continuous Quality Improvement in Health Care. Jones & Bartlett Learning.

Melo, S., 2016. The impact of accreditation on healthcare quality improvement: a qualitative case study. Journal of health organization and management, 30(8), pp.1242-1258.

Momani, A., Hirzallah, M.A. and Mumani, A., 2017. Improving Employees' Safety Awareness in Healthcare Organizations Using the DMAIC Quality Improvement Approach. The Journal for Healthcare Quality (JHQ), 39(1), pp.54-63.

Renedo, A., Marston, C.A., Spyridonidis, D. and Barlow, J., 2015. Patient and Public Involvement in Healthcare Quality Improvement: How organizations can help patients and professionals to collaborate. Public Management Review, 17(1), pp.17-34.

Srinivas, T.V. and Raju, T.V., 2017. Quality Improvement in Healthcare-A Diagnostic Study. DHARANA-Bhavan's International Journal of Business, 10(2), pp.42-51.

Vindrola-Padros, C., Pape, T., Utley, M. and Fulop, N.J., 2017. The role of embedded research in quality improvement: a narrative review. BMJ Qual Saf, 26(1), pp.70-80.

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