Organizational Quality Improvement Focus Area

Organizational Quality Improvement

Focus Area of Quality Improvement

In the health care sector in the United States, quality improvement is probably one of the most important paradigms to consider in terms of patient health and safety. This is particularly important of ensuring the financial and general well-being of the hospital as well, as inappropriate care could lead to law suits, or at least a very tarnished reputation. This is then also one of the ideas of the University of Kansas Center for Advanced Heart Care. The institutions is focused upon providing patients with the best of care not only during their stay at the hospital, but also during their follow-up visits to the hospital. Pre-, during and post-care are equally important in this regard, to ensure that patients receive the optimal amount of attention to promote their continued convalescence and health as a result of whatever procedure has been performed. To accomplish this, it is essential to create and maintain an accurate medical record of each patient that visits the hospital. As such, the proper and timely documentation of data such as vital signs, intake/output, nursing assessments, nursing notes, physician progress notes, and physician orders is of utmost importance not only to track patient progress, but also to reduce medical error. Reliable medical records will also provide organized clinical data points in order to generate possible diagnoses and suggest complementary investigations more easily. To help improve this element at the Center, it is important to consider certain tools and methodologies.

Methodologies

Dlugacz (2006, p. 74) suggests two possible methodologies that can help to improve the quality of the database design. These include the PDCA and Six Sigma methodologies. These, according to the author, can help analysts in the process of determining areas in need of improvement. Six Sigma is a tool whose design can be implemented to reduce negative economic impacts resulting from inefficient services. Where Six Sigma indicates the mean of any treatment methodology or outcome, a variation of three sigma form this mean is an indicator that the are needs attention.

One important limitation of this methodology is its focus on the financial application of determining quality. This is a somewhat narrow focus for the purpose of the Center's database, of which the primary purpose is to improve the quality and accuracy of the data collected. Hence one might conclude that this methodology is not entirely suitable for the purpose at hand.

A much broader quality focus is provided by the PDCA methodology (Dlugacz, 2006, p. 75). This methodology involves four cyclical actions: Plan, Do, Check and Act. According to Dlugacz, this cycle is particularly useful in the health care setting because of its wide applicability to a number of different actions and paradigms within this sector. This also extends to database accuracy. The cycle allows for any current performance shortcoming to be highlighted and remedied for the benefit of both the institution involved and the patients relying upon professionals to provide excellent care.

In addition, the cycle also allows the evaluation of outcomes after implementing necessary improvements. Knowledge acquired is systematically implemented and can therefore also be used to build up a database of improvements and requirements for maintaining quality. The systematic nature of the system then also allows for saving time and funding. When assessed in this manner, the wider application possibilities of this cyclical improvement methodology make it much more suitable to the quality improvement area selected for the Heart Center. The data obtained from measures can then be used to continuously evaluate improvement and determine whether there is any deviation from the standard. This creates a continuous loop of quality monitoring.

One possible disadvantage of this methodology is the fact that its implementation could create staff resistance and negativity. While the tool offers a measurement that holds staff and leadership accountable for continuous quality improvement, some may feel that it is a measure to "police" performance, which in turn could create feelings of resentment and negativity. In this regard, it is vitally important that leadership communicate effectively with staff, with particular focus on the fact that quality improvement in patient databases means improved quality in health care. This is good not only for patients, but also for the reputation of the Center, and by association for the staff working with patients as well.

In order to further increase the effectiveness of the PDCA model, the Hospital Corporation of America (Ransom et al., 2008, p. 69) went a step further in creating the FOCUS PDCA Model. This model involves the addition of five steps, as indicated by the FOCUS acronym: Find a process to improve; Organize a team that knows the process; Clarify current knowledge of the existing or redesigned process; Understand the variables and causes of process variation within the chosen process; and Select the process improvement and identify the potential action for improvement.

Because of its more detailed description and its flexible applicability to any business process, I would therefore opt for the FOCUS PDCA model in my final analysis.

The Role of Information Technology

Working with databases naturally implies the use of information technology (IT), especially in today's rapidly developing business and technological world. No business can survive without some sort of IT application to organize and continually improve its operations. The University of Kansas Center of Advanced Heart Care is no exception to this. At the Center, keeping an accurate database of patients for the purpose of improving the quality of care means the use and potential implementation of various online and database application.

The importance of the Internet for example cannot be overemphasized (Ransom et al., 2008, p. 273). As this vast research tool develops, its uses also increase exponentially. In terms of database construction, professionals at the center can research the Internet for a variety of related information for the specific conditions suffered by patients. This information can then be added to the database for easy access and in terms of improving the care the patient received by also applying it to similar future cases.