Quality Insurance

Quality Improvement Plan: Part III - Managing and Improving Quality In today’s health care environment, competition remains high and many organizations are seeking new ways to improve their quality of care, as well as remain competitive with other health care organizations in the process. Various methods exist today for organizations to integrate quality improvement strategies to help in the measurement of performance improvements.

This paper will discuss:1) several methodologies, the pros and cons that exist with these methods, 2) describe information technology applications, how they may be used to improve patient falls, 3)discuss how benchmarking and milestones are involved in managing the use of quality indicators, and finally,4) describe how performance and quality measures are aligned to an organization’s mission, vision, and strategic plan, and how these measurements align with Self-Regional Hospital’s mission, vision, and strategic plan for improvement. Methods for Quality Improvement Strategies

Accidental Falls have become the most commonly reported incident in hospitals today, and Self-Regional Hospital is no exception. Recently, Self-Regional researched and gathered specific fall data that included “mobility/gait, lower-extremity strength, history in fractures, visual, or auditory impairments, dizziness, dehydration, depression, stroke, ischemic attacks, and cardiac arrhythmias” and the role they play with patient falls in the organization (The Joint Commission, 2007, p. 26). They are now in the process of researching various methodologies to help manage and improve this area of concern.

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Several concepts that concern total quality management (TQM), and quality improvement (QI) are offering health care organizations and their administrators the opportunity to decide which methodology would be most successful in improving quality care for their patients. There are three methodologies Self-Regional is considering: 1) Six Sigma, 2) Lean, and 3) Customer Inspired Quality (CIQ). “One of the key components of quality improvement is the technology that gathers and compares the data that the quality improvement measure produces” (Dlugacz, 2006).

Once this information has been gathered, the organization can benchmark with other comparable organizations. The Six Sigma model, pioneered by Motorola, is used to improve the quality of process outputs by identifying, and removing defects through a problem-solving approach that works to improve quality outputs. The Six Sigma methodology achieves this by using a process known as the DMAIC process (define, measure, analyze, improve, and control), for existing quality processes that are below specifications, and are in need of improvement in increments.

There are features with Six Sigma that separates it from other initiatives of quality improvement: * Clear focus on achieving measurable and quantifiable financial returns * Increased emphasis on strong leadership and support * Special Infrastructure of “Champions,” to lead and implement the Six Sigma approach * Clear commitment to making decisions based on verifiable data, rather than assuming or guess work (Harry, 2000). The second model is Lean, which played a key role for Toyota’s success.

This method is used to help reduce or alleviate waste, while working to improve an organization’s performance through their workflow processes. Organization’s that use Lean have a clear understanding of consumer value, and continuously will focus on the key processes to improve it. Their goal is to provide excellent value to the consumer, by developing an excellent value process that has zero waste. Lean offers the organization the opportunity to identify steps in a quality improvement process, and then identify the steps that are valuable and non-valuable.

Once the non-valued steps have been identified they will be removed to prevent waste in the process (Lean Enterprise Institute, 2009). The Customer Inspired Quality method is the last method for quality improvement that Self-Regional is considering. In 1992, Shaw Resources patented this methodology to focus on work processes that have direct impact on the care and services that hospitals provide. The Customer Inspired Quality methodology identifies, defines, analyzes, and improves the quality and effectiveness of processes in the health care environment with an emphasis on the following work process evaluating components: Integrates department services that are related to defined systems concerning care * Improves productivity and efficiency, while reducing unneeded work processes and costs * Can be implemented as short-term or long-term quality improvement processes * Patient loyalty and satisfaction is enhanced (Shaw Resources, n. d. ). Pros and Cons of Quality Improvement Methodologies There are always pros and cons to any quality improvement methodology. For instance, the pros of Six Sigma tend to place extreme importance on leadership and its support for the success of the project.

Another pro is the integration of different human elements, which include cultural change, and focus on the customer and their needs. “By using the concept of statistical thinking, Six Sigma encourages applications of statistical tools and techniques that reduce variability” (Harry, 2000). The cons of Six Sigma include, not having the quality data available, especially when a new process has been implemented without having the data available. Often the solutions that Six Sigma proposes can be costly and only a small portion of the solution can be implemented.

When using Six Sigma the choosing of the right project is critical to its success. The pros for Lean include: * Minimizing overhead cost to thirty percent * Eliminates most waste, if not all * Can improve productivity by eighty percent * Eliminates negative behaviors and employees have a clear objective of the organization’s expectations The Lean methodology’s cons include: * Can be difficult to attain support from all employees, due to resistance of change * Personality clashes can occur if some individuals do not take orders well from their co-workers Lean training is ongoing and in the beginning is time-consuming (Businessknowledgesource. com, 2010). The pros of the Customer Inspired Quality methodology include: * Quality improvement efforts are prioritized based on the customer’s needs * Friendly and encourages input from employees The main con with the Customer Inspired Quality method is that is structured primarily for health care organizations. Information Technologies for Quality Improvements Information technology plays a major role when it comes to quality improvement methods used by health care organizations.

Self-Regional Hospital has implemented software known as Business Objects. The components of Business Objects “provide performance management, planning, reporting, query and analysis, and enterprise information management” (Sap. com, 2008). The Business Objects Enterprise offers the organization the ability to track report instances by triggering alerts. The reports have parameters that can be modified to perform analysis on the data and the organization also has the ability set alerts that trigger when certain conditions are met or not met.

The data can be customized to show in charts and can be customized to allow the organization the opportunity to drill down into the data. Information technology allows data to also be displayed in a dashboard or a scorecard. A dashboard is a tool that monitors the ongoing performance of a process and its data in real time. Whereas, scorecards report on past performances and generally focuses on outcomes rather than processes. All of these applications can be used by administrators to track quality improvement processes of the organization.

Administrators also have the ability to design the scorecards or dashboards to display only information that is pertinent to the process. These processes would also give Self-Regional the ability to examine data that pertains to patient falls within their organization. Benchmarks and Milestones Benchmarking is a process that gives an organization the ability to compare their performance metrics and processes to other organization’s best practices. In other words, benchmarking is the process of an organization comparing itself to their competitors and defines how the competition performs better.

In health care, when an organization has a clear understanding of how their competitor/s meets their standards, they can set goals for quality improvements within their own organization. Benchmarking is beneficial for improving customer satisfaction, as well as improve core measurements set by the Joint Commission. Self-Regional Hospital can use benchmarking as a means to compare how hospitals rate on patient falls and what processes they have set in place to improve in this area. The hospital would benefit by using the website “hospitalcompare. hs. gov to research on patient satisfaction, quality improvement outcomes, and where they rate in these areas as well. Potential benchmarks Self-regional will strive for improved core measures at 90% for patient falls. Another area the organization will strive for is to improve patient safety. In order for the hospital to do this they will need to continue to implement the processes that support the Joint Commission’s National Patient Safety Goals, and implement quality improvement processes that will involve the organization as a whole.

Self-Regional will also implement computerized provider order entry (CPOE), and will also begin the process of extending the goals to the emergency department and critical care areas. The third bench mark will be to enhance the patient’s experience by using the DMAIC model to understand and support the emotional, spiritual, and clinical needs of the patients. Self-Regional Hospital will use the Customer Inspired Quality Methodology for implementing their performance improvement processes with patient falls. Data will be comprised from Crystal reports to display balanced scorecards and dashboards.

The organization will divide the dashboards into the Extending Elements, team, clinical, service, market, and finance. This information will be used in conjunction with information from benchmarking data to monitor the quality improvement plan. Health care organization’s use performance and quality measures to align their products and service activities with their mission, vision, and strategic planning to help improve their internal and external communications, as well as monitor the organization performance against their strategic goals.

Self-Regional Hospital’s mission, vision, and strategic planning is aligned with their performance and quality measures to provide continuous advanced quality care that will improve their patient outcomes, while focusing on patient satisfaction in the process. APA References Dlugacz, Y. D. (2006). Measuring Health Care Using Data for Operational, Financial, and Clinical Improvement, San Francisco, CA: Josey-Bass Publications Harry, Mikel J. (2000). The Nature of Six Sigma Quality.

Rolling Meadows, Illinois: Motorola University Press. p. 25 Lean Enterprise Institute, (2009). What is Lean? Retrieved on September 26, 2011 from http://www. lean. org/WhatsLean/ Shaw Resources, (n. d. ). Customer Inspired Quality: Health Care Operational Improvements, Retrieved on September 26, 2011 from http://shawresources. com/ customer-inspired-quality-and-processes-improvement. htm Sap. com (2008). Retrieved on September 26, 2011, from http://www. sap. com/ solutions/sapbusinessobjects/index. epx

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