Quality Improvement and Risk Management in Health Care
A health care system is an institution or organization of people using resources to deliver health care services to meet the target population's health needs. There are many health systems worldwide with many organizational structures and histories. Different countries have various systems that support their health system planning such as trade unions, governments, market participants, charities and religious co-ordinate bodies who deliver health care services that are planned and evolutionary. Risk management entails the proper strategies that reduce possibilities of specific losses in health organizations (Spath, 2009).
The systematic utilization and gathering of data are very important to the practice and concept. The programs of risk management consist of both reactive and proactive components. The reactive components include the actions, which are in response to adverse occurrences while proactive components include those activities done to prevent adverse occurrences such as losses. In both reactive and proactive, the process followed includes diagnosis, assessment, prognosis and management. Diagnosis means the process of identifying the risk or potential of the adverse effects. Assessment means the calculation of the possibility of the adverse effects that can be a result of the risk situation (Spath, 2009).
Prognosis means the estimation of the impact that the adverse effect may have in the institution. Management means the exercises taken to control the risks from taking place. All health institutions and organization need to address their particular risks. Risk management techniques are vital in an institution because they help reduce the possibilities of adverse effects results and improve the quality of patient care in the practice of medicine. The key goal in risk management is to reduce the risk of liability exposure of health care providers, harm to patients and financial loss to the organizations and institutions (Marco, 2011).
Quality improvement on the other hand is mainly necessary to help improve the clinical, financial and operational outcomes, which are all interrelated. For example, quality improvement involves receivable accounts collected in a consistent organized manner and at the right time. This means also investing on well trained and highly paid staff, which in return serves to improve on the care given to patients and performance of caregivers; also referred to as patient flow efficiency or operational outcome and clinical outcome. A well-organized and professionally run organization will encourage a wide variety of informal and formal quality improvement practices and efforts that will address both small and large matters (Barry, 2002).
Quality improvement majorly focuses on processing issues because a bigger percentage of the errors and inefficiencies in institutional and organizational settings are caused by the failure in processes. These failed processes are identified then corrected more positively in institutions and organizations that work hard towards empowering their staff. While employees ought to understand that they are accountable for every process that they implement, managers need to be able to provide their workers with the right resources needed to fulfill the responsibilities assigned to them. They also need to learn to exercise the authority to address arising issues in the organizations (Marco, 2011).
For example, the processes involved include medication administration programs, medical record documentation, and utilization of clinical protocols, patient education and patient admission. The efforts applied in quality improvement involve monitoring every process to predict the outcome, identify the challenges and develop new solution that will encourage improved performance. When these processes are improved, there is prevention of adverse occurrences through the development and practice of quantifiable indicators, or precautions. This will gauge the effectiveness and identify potential problems in terms of medical care (Barry, 2002).
Quality and important risk indicators should be developed in the outpatient setting because it will help monitor the performance of caregivers. These indicators should not be limited to patient's serious medical conditions or death, adverse reaction to drugs, failure to document or report test results, failure to perform tests and unplanned visits to hospitals. Caregivers ought to be encouraged to analyze the processes implemented during medication and identify any flaws when the indicators are triggered. This will provide them with chances to identify constructive changes and quality care practices that can be implemented to also ensure the efficiency of the institutions and organizations (Marco, 2011).
In addition to this, an important diagnostic tool such as a pictorial, flow chart or diagram which are designed in a designated sequence are necessary for the continuous monitoring of performance and growth of organizations. This is because by using a diagram to identify flaws, caregivers and the management can redesign faulty processes. They can also learn to minimize any profanities of future potential and actual problems and errors occurring. For example, if a diagram or flowchart is identified with a trend of excessive waiting times for incoming patients, another processed flowchart can be taken from the patient's entry point through discharge, which may help to identify inconveniencing situations and provide possible solutions (Barry, 2002).
Quality improvement and risk management are aligned in their focus on identifying potential errors and problems and developing corrective strategies. Implementing and improving the two programs may strengthen workers and administrators' abilities to minimize occurrences of any errors, improve the care given and enhance efficiency. Improvement strategies and programs should also be created and documented in a plan provided to all workers. This entails efforts towards making patient results better. It should provide a detailed explanation of people's roles and workability (Shaw, 2009).
It should also include the objectives of the program and provide accountability that will enforce implementation. Most importantly, the plan should generally address the identification of problems, analys, monitor the process, finally evaluate, and implement any improvement efforts. In order to supervise the program successfully and involve cooperate efforts from everyone, the organization management should establish a committee that includes representatives and meet on regular basis. This way, through committee minutes, action plans can be issued and the decisions made by the committee can be promulgated throughout the entire organization (Shaw, 2009).
In addition to this, the committee can facilitate a follow through mini-program regarding the identified and adverse problems and trends. Integrating quality improvement and risk management will produce a safer caregiver, visitor and patient friendly environment for all facilities. The key elements coalescence will also assist in providing a legal defense posture that is stronger and adverse the occurrence of events. Even though this may take a lot of effort and time to develop, refining an integrated quality improvement and risk management program is an effective way to ensuring patients are well cared for and organizations are well maintained (Shaw, 2009).
The program benefits such as more efficient operations reduced error rates and decreased litigation risk. It makes it a worthwhile investment for the most specialized and smallest healthcare organizations. Through all these, there are factors that if not properly handled may still cause a negative effect in the organizations and harm patients. These include social, political and cultural influences, which have a massive impact on health care organizations. Social and cultural inequality may be detrimental to any society or countries' health. When a country or society is diverse, overpopulated and multicultural there is likely to be unequal rapid economic growth (Shaw, 2009).
The effects of such inequality influence the population and healthcare systems either negatively or positively. The impacts of cultural and social factors are well understood and recognized by health and social care institutions and are often assessed to ensure needs are met. Well being strategies built meet basic factors such as housing, economic, education and transport. Meanwhile there are other factors such as refuse disposal. Street cleaning and building regulation affect the health of the society. These strategies prioritize key factors that are significantly influential (Schulz, 2005).
Healthcare standards reflect on the cultural, social and political well being of the society. A society with poor and multicultural practices may influence the people's attitude towards receiving healthcare services. Meaning there are societies that do not believe in healthcare services but prefer traditional ways of maintaining their health and staying alive. For this reason, reaching out to the members becomes a struggle because their cultural beliefs are contrary to the healthcare services provided. On the other hand, there are those cultures that believe in their religious practices that do not allow them to seek healthcare services but instead contact their religious leaders when they are in need of healthcare services (Kavaler, 2003).
In other countries and societies, population and politics are barriers to receiving quality healthcare services. When a country has history of poor political exercises, the economical stability is likely to go down hence causing poor living conditions that may bring about disease outbreak. Healthy living conditions enable citizens and members of a society to access quality healthcare and basic human rights. It also enables them to have essential prerequisites for economical, cultural and social developments. From political histories of many countries, it is evident that any inequality in social and political contexts can have a big impact on the health conditions of…