Quality Management Assessment Summary
Quality Management Assessment Summary Stephanie Webb University of Phoenix March 8, 2011 HCS/451 Quality Management Assessment Summary Quality management is a systematic and continuous process that organizations use to deliver products and services that meet or exceed customer expectations (McLaughlin, & Kaluzny, 2006). Quality management in healthcare has evolved over the year to address increased demands from consumers related to the quality of care and services, as well as to address problems in patients’ outcomes (McLaughlin, & Kaluzny, 2006).
Stephanie Webb Management will assess quality management in long-term care facilities (LTC). This assessment will address the definition of quality care, and describe key concepts of quality management. This assessment will set short-term and long-term goals of LTC facilities, and describe the internal and external factors that may affect these goals. This assessment will also recommend quality management policy that will facilitate the reaching of those goals. A single definition of quality is elusive because quality is different for every individual.
According to the U. S. Office 0f Technology Assessment, the broad definition of quality is the degree to which the process of care increases the probability of outcomes desired by the patient, and reduces the probability of undesired outcomes, given the state of medical knowledge (McLaughlin, & Kaluzny, 2006). Since the 1960s, LTC quality has been conceived by using the Donabedian’s framework that associates quality with structures, processes and outcomes of care (Capitman, Leutz, Bishop, Casler, & Schneider, 2005).
The focus of quality has changed over time from concern with basic structural factors, such as fire hazards in facility construction to process of care indicators. Process of care indicators includes the use of physical and chemical restraints. Quality in LTC facilities has also changed from process of care indicators to outcome of care indicators, such indicators are changes in functional status (Capitman, et al, 2005). The health care quality framework is based upon some basic principles.
The principles are closely interrelated, which is quality planning (QP), quality control (QC), and quality improvement (QI) (Capitman et al, 2005). QP is the identifying and tracking customers’ needs and expectations. QP also includes identifying process issues critical to effective outcomes, and setting quality improvement goals (Capitman, et al, 2005). QC is measuring the extent to which an organization and individuals achieve, and maintain desired outcomes, and measuring current performance, and its variance from expected performance. QC also measures key processes and outcomes, and prerequisites for QI and/ or QP (Capitman, 2005).
QI is using collaborative efforts and terms to study, and improve specific existing processes at all levels in the organization, analyzing causes of existing process failure, dysfunction, and/or inefficiency. QI also includes systematically instituting optimal solutions to chronic problems, frequently analyzing and disseminating positive variance and/or best practice information to patients, and families through education, as well as to staff, and using the scientific problem solving method to improve process performance and achieve goals (Capitman, et al, 2005).
Since the health care quality umbrella framework is based upon these basic principles, health care uses Total Quality Management (TQM) philosophy and a continuous quality improvement approach. The quality management of LTC facilities will use the term TQM, because it enhances and benefits the organization and all people associated with it, by utilizing processes, which continuously improve the quality of all products, services, and information (Capitman, et al, 2005). Implementing TQM will increase customer satisfaction, increased productivity, i8ncreased profits, and decreased cost (Capitman, et al, 2005).
Implementing the concepts of TQM would allow a LTC facility to reach its short-term and long-term goals. Some short-term goals for LTC facilities are to reduce high-risk pressure ulcers, reduce the use of daily physical and chemical restraints, improving pain management, and increasing staff retention. Some long-term goals quality improvement goals are to improve clinical quality, improve patient and family satisfaction, and improve overall patient outcomes and quality of life (Advancing Excellence in America’s Nursing Homes, 2011). Several internal and external factors can affect the LTC facility’s ability to reach quality improvement goals.
Some internal factors are staffing levels and staff characteristics (Institute of Medicine, 2001). Some other internal factors that can affect quality improvement goals are environmental conditions, management, and organizational capacity. If a facility does not have the numbers, skill, training, and positive management, no matter what policy and procedures that is put in place positive outcomes cannot be reached (Institute of Medicine, 2001). Some external factors that could affect the reaching of quality management goals are resources for providers.
Substantial improvements in LTC quality are not positive without increased resources (Institute of Medicine, 2001). Government policies of reimbursing, and research has an effect on the improvement of quality. The amounts and ways we pay for LTC are inadequate to support a workforce sufficient in numbers, skills, and commitment to provide adequate clinical, and personal services to residents and those in need of LTC (Institute of Medicine, 2001). Research is lacking in understanding the effect of changes in payment policies on providers, on accessibility of services, and on quality of care.
Implementation of fundamental health care policy would allow LTC providers to gain a more quality-oriented facility. Key quality management policies are communicating a quality focused mission statement, conducting customer (residents/family) satisfaction surveys, conducting employee satisfaction surveys, gathering and analyzing performance data, and recording and acting on customers concerns (Quality First, 2011). The existence of a quality focused mission statement, and a description of the facilities process for systematically communicating the mission to staff, residents, family, and other stakeholders sets the tone for quality care.
The existence of the customer survey allows management to know, analyze, and change any dissatisfaction of the customer. The existence of an employee survey will allow management to receive and improve staff dissatisfaction, and receive ideas on how to make improvements. The gather of data will allow management to adjust and improve any key processes and organizational measures. Recording and responding to customer concerns is a policy, which allows management to communicate regularly with the residents, family, employees, and other stakeholders on how their concerns are investigated and handled in a confidential manner (Quality First, 2011).
Executive Summary The purpose of this summary is to inform long-term care facilities about quality, and quality management. This summary will also give recommendations from Stephanie Webb Management. QUALITY The term quality is elusive because quality means different things to every individual. Quality in long-term health care is the degree to which the process of care increases the probability of outcomes desired by the patients and reduces the probability of undesired outcomes, given the state of medical knowledge.
QUALITY MANAGEMENT Quality management is the systematic and continuous process that organizations use to deliver products and services that meet or exceed customer’s expectation. Quality management is based on three principles, which are closely interrelated: * Quality Planning * Quality Control * Quality Improvement Quality planning is identifying, tracking customers, and their needs and expectations. Planning also includes identifying process issues critical to effective outcomes, and setting quality improvement goals.
Quality control is measuring the extent to which an organization and individuals achieve, and maintain desired outcomes, and measuring current performance and its variance from expected performance. Quality control also measures key processes and outcomes, and prerequisites for quality improvements and/or quality planning. Quality improvements are collaborative efforts and teams to study and improve existing process failures, dysfunction, and/or inefficiency. Quality improvements also include instituting optimal solutions to chronic problems.
Implementing these principles would allow long-term care facilities to reach short-term goals as well as long-term goals. SHORT-TERM GOALS * Reduce high-risk pressure ulcers * Reduce the daily use of physical and chemical restraints * Improving pain management * Increasing staff retention LONG-TERM GOALS * Improve clinical quality * Improve patient and family satisfaction * Improve overall patient outcomes * Improve quality of life Having short-term and long-term goals in place long-term care facilities can implement some quality management policies, which will aid in the reaching of those goals. FUNDAMENTAL LONG-TERM CARE POLICIES Communicating a quality focused mission statement * Conducting customer satisfaction surveys * Conducting employee satisfaction surveys * Gathering and analyzing performance data * Recording and acting on customers concerns The existence of these policies will allow long-term care facilities to communicate systematically its goals and mission to the residents, family, staff, and other stakeholders. These policies will also allow management to receive input from the resident as well as the staff, and record and respond to patient concerns in a confidential matter about how these concerns are investigated and handled.
Stephanie Webb management recommends that long-term care facilities uses these quality management principles and implement these quality management policies because the implementation and use of these principles, and policies will improve the quality of Long-term care facilities, as well as reducing risk. References Advancing Excellence in America’s Nursing Homes (2011). Retrieved from www. qualidgm. org March 6, 2010 Capitman, J. , PhD, Leutz, N. , PhD, Bishop, C. , PhD, & Casler, R. (2005) Long-Term Care Quality: Historical Overview and Current Initiatives.
Report for the National Commission for Quality for Quality Long-Term. Retrieved from www. qualitylongtermcommission. org March 6, 2011 Institute of Medicine (2001). Improving the Quality of Long-Term Care. Retrieved From www. iom. edu Retrieved on March 9, 2011 McLaughlin, C. , & Kaluzny, A. [Eds]. (2006). Continuous quality Improvement in Health Care (3rd ed). Sudbury, MA: Jones and Barlett Quality First. (2011). Guidelines for Developing a Quality management system for Long-Term Care Providers. Retrieved from www. ahchncal. org March 6, 2011
