quality improvement

QUALITY IMPROVEMENT

Running Head : Quality Improvement

QUALITY IMPROVEMENT

In APA Style

(name

(university

Quality Improvement

Berwicks Theory and Deming 's Obstacles

Self-assessment programs generally complimented the Berwicks theory of continuous improvement . It is a well-recognized guide to a better working environment . The Berwicks theory stated that the key to improvement lies within the efforts of evolving and improving the process of a work design , instead of demanding staffs with things they cannot do . In this particular case , Berwicks would say that the key to better services

in health care is to improve the process of health services and how each staff is positioned within the service (Wiederholt , 2002

The details of the application of the concept will be elaborated in the next chapter , but overall , the Berwicks could have prevented many mistakes or lack of sensitiveness from happening within the health care process in the clinic . There were several errors that occur because the system does not provide methods to overcome such issues . We could have stated that there are some identifiable `leaks ' within the system

The mistakes and error that took place is related to some of the Deming 's Obstacles . Deming stated four obstacles to quality three of them match the case , which are : Neglecting long range planning , relying to technology to solve problems and seeking examples to follow rather than developing a solution . I will provide detail elaboration about how Deming 's obstacles fit into the case in the next chapters

Organizational Culture

The organizational culture describes some of the concerns expressed within the Berwicks theory . The staff seems to have adequate commitment to provide patients with the best care . However , the clinic seems to have an intense working environment that implied to the existence of `strong ' evaluation systems . Unfortunately , these strict evaluations might not have been accompanied by sound process management . The staff seems to be so busy that they are having a hard time answering all the patient 's calls . They might have been given the responsibility or the workload that exceeds their capacity as individuals . Furthermore , some of the process allows mistakes that lead to several unrecognized negligence of patients

Unintended Outcomes and Their Prevention

There are several identifiable outcomes that should not be allowed within the clinic . They are : slow buzzer response , catheter incident losing patient 's chart , interrupted therapy due to unavailable resources , confusion of the best treatment and medications for the patient , slippery floor . Berwicks theory stated that most of the errors in workplaces are not caused by lack of motivation or `bad ' staff members , but to an insufficient or inappropriate process designs According to that statement , then the clinic should evaluate the system and discover which design that leads to mistakes and errors , prior to evaluating staffs and their mistakes (Wiederholt , 2002

The slow buzzer response issue is caused by constantly busy staff members . This is a matter of poor work design . The staffs were having too many responsibilities that prevented them from attending to patients in a quick manner . The poor work design might also contributes to the lost of patients chart , the catheter incident and the slippery floor Management should evaluate the system for `leaks , and change the workload of each staff if necessary , but management must not neglect evaluation of staff members

Some of the problems were also related to the Deming 's obstacles to success . For instance , the catheter incident might indicate an over-reliance on technology . On the other hand , lacking the necessary resources in time of a patient 's care describe the lack of long term planning in management of the clinic . There should be a system that monitors the clinic 's supply level to prevent such incident from ever happening . Furthermore , the doubt concerning which treatment and medications are the best for patients indicate a lack of professionalism in the job . Rather than being confused and looking for examples to follow , the decision-maker staff should develop the best solution for the patient according to their qualified medical knowledge and proper consensus among the clinic 's professionals

Process Improvement Model

In to improve the processes within the clinic , management could use Deming 's 14 key principles to increase effectiveness within an organization . They are

Creating a constancy of purpose for improvement of service

Acknowledge a philosophy of cooperation in which everybody (including staffs and employee ) win

Do not depend on mass evaluations to reduce mistakes . It is more effective to improve the process which will lead to better performance in the first place

Design a loyalty-based supplier relationship

Acknowledge the culture of constant improvement

Institute every type of trainings that would enhance skills and performance

Improving the leadership capability of the management team

Do not make evaluations that develop fear among staff . Instead , build trust where everyone could work more effectively

Get rid of barriers among departments and develop a win-win system of cooperation within the organization

Eliminate slogans of zero defects or new levels of productivity because they result only adversarial instead of real relationship among staff members

Use better leadership techniques rather than numerical goals and quotas

Design a work system that allow staff to take joy in getting the job done

Use a good program of education and self-improvement for the clinic staff

Makes sure that all staff members are on board of the change mechanism

(Haller , 1993

V . The Role of Clinical Governance and Quality Improvement Strategies

Beside Deming 's key principle of an effective organization , there are other concepts which might help to enhance the quality of services in the clinic . One of them is the concept of Clinical Governance . It has been recognized that the concept of Clinical Governance has a considerable role in designing a better system for the clinic . According to the Clinical Governance concept , a sound medical service would have been established using the following considerations

Education and training

The continuing professional development of clinicians has been the responsibility of health care management

Clinical audit

It is the review of clinical performance using agreed and predetermined standards , which should be a part of good clinical practice

Clinical effectiveness

It is the measure of the extent to which a particular intervention works , with regards to the concept of value for money , cost and benefits

Research and Development

The process management in clinical services must undergo constant development guided by research and development

Openness

A good clinical facility must be open to the public scrutiny but remain discrete regarding patient 's and practitioner 's confidentiality

Risk Management

A good clinical service considers three types of risks , risks to patients , risk to practitioners and risk to the organization , in to design work process and prevent poor service quality

(Scally , 1998 Starey , n .d

Bibliography

Haller , Harold S . 1993 . Managing with profound knowledge : A management process based on the Deming management theory . Harold S . Haller Company . ASIN : B0006R22PS

Scally , G . Donaldson , L J . 1998 . ` 'Clinical governance and the drive for quality improvement in the new NHS in England ' BMJ . 61-65

Starey , N . n .d . `What is clinical governance . Evidence-based medicine Hayward Medical Communications

Wiederholt , Joseph B . 2002 . `Wisconsin pharmacy self-inspection project An application of Berwick 's Theory of Continuous Improvement TheAmerican Journal of Pharmaceutical Education

PAGE 1

PAGE 5 ...