Organizational Improvement Plan - Research Paper Example

? Quality Improvement Plan 3 G.V. (Sonny) Montgomery VA Medical Center Helen Taylor Quality Improvement Plan 3 G.V. (Sonny) Montgomery VA Medical Center Introduction Although patient fall is a common accident occurring in medical centers, it is preventable and centers should strive to reach a percentage of patient fall rate as close as possible to zero. With that philosophy on mind, the Montgomery VA Medical Center aims to achieve the lowest rate possible in patient fall. In 2010, the hospital’s patient fall rate was 3.19% while in nursing home was 5.33%. Taking into consideration the promise of giving excellent service to the customers, Montgomery VA Medical Center considers such rates too high and plans to reduce it to 2.8% or less. This paper will look into the institution’s measures to reduce the fall rates by integrating quality improvement strategies in performance measures, applying information technology, and involving benchmark and milestones. Methodologies for Integrating Quality Improvement in Performance Measurement Quality improvement strategies achieve their full potential when they are part of the performance measurement. This plan tries to avoid duplicating ideas in the methods of integration to prevent “unnecessary confusion on providers and confusion among consumers” (Board on Healthcare Services, 2006, p. 83) present in other medical institutions’ plans. In doing so, the plan will focus on the most important elements identified to decrease patient fall rates and achieve the hospital’s ideal rate. Three quality improvement strategies, audit and feedback, patient education, and provider education, can be beneficial when used in performance measurements such as process measures and outcome measures. Process measures are useful to “quantify the delivery of recommended procedures or service” (Institute of Medicine et al., 2003, p. 82 to achieve the desired outcome, while outcome measures “are used to capture the effect of an intervention”( p. 82) on the patient, or in other words, the assessment of the patient to the kind of care he received. Smith, Mossailos, and Papanicolas (2008) cited methods to integrate quality improvement strategies in performance measurements. The authors contended that there should be a robust conceptual framework of the process on what the institution is trying to reach. For instance, provider education is a priority when the center wants to transfer efficiency to patient education as part of the process measures. An advantage of having a framework is that it lessens duplicating quality of the aims; however, it has less to do with the actual performance of methodology. Public reporting is another method to improve the plan’s decrease of patient fall rate. This method “sought to inform consumer choice and stimulate provider improvement” (Smith, Mossailos, & Papanicolas, 2008, p. 10). The method requires full participation of the consumers to have adequate data to assess the provider. However, the reports proved to have “very little impact on the behavior of practitioners or organizations” (Smith, Mossailos, & Papanicolas, 2008, p. 11) when the practitioners are unaware of how the initiative goes and there is little or no financial incentive attached to it, which in turn, would make the method useless and a waste of effort. Using information systems or data gathering is the initial process of quality improvement (Smith, Mossailos, & Papanicolas, 2008). Through it, providers would have an overview on which aspect they have to improve. This is beneficial because it improves the institution as a whole, using technology. However, technology is rapidly advancing and keeping with the latest developments would mean a large sum of investment (Smith, Mossailos, & Papanicolas, 2008). Financial budgeting would be a problem, if not shouldered by a bigger organization or the government. These methodologies are interconnected and all include information dissemination and organized practice. Taking into consideration this institution organizational environment, public reporting will be the best one to use in this plan. The implementation of an efficient public reporting would inform both practitioners and customers about the risks, susceptibility, and hazards of patient falls. The use of valid and reliable information increases the probability of reducing patient fall rate. Information Technology Application Technology has an important role on the medical field specifically improving medical care. It has lead to the development of treatments of some diseases thought previously to be incurable. In healthcare, information technology can “decrease human error, standardize medication concentration, assist caregivers...[by] using alerts and reminders, improve medication safety, and track performance” (Hughes, 2008, p.11). Ortiz and Clancy (2003) studied the uses of technology in healthcare in the fields of Clinical informatics to promote patient safety, Small business innovative research program, and Practice-based research networks. Clinical informatics aims to reduce the number of medical errors every year (Ortiz and Clancy, 2003). Training and education in healthcare using technology is likely to reduce medical error. The application of technology in education is beneficial. However, instruction would not be enough to reduce medical error that results in patient fall. There is no pattern of the manner of patient fall. Therefore, extensive training and not just lectures would be preferable to reduce the risk for patient fall. Small Business Innovative Research Program aims to give capital to small businesses pertaining to healthcare (Ortiz and Clancy, 2003). Primarily, it “helps small businesses develop innovative technology that will lead to improvements in health care quality in the United States” (Ortiz & Clancy, 2003, p. xiv ). This can effectively promote the proliferation of quality healthcare, but on the other hand, there is the possibility that people who go into small businesses may be amateurs, which puts quality healthcare into risk. Practice-based research networks are composed of experienced clinicians working together in a specific community to achieve medical development (Ortiz & Clancy, 2003). Through information technology, the program already has “36 networks and an increase in the FY 2003 budget to $3 million dollars” (Ortiz & Clancy, 2003, p. xvii). This is a promising leap for U.S. healthcare, but it has less to do with patient falls. It would not be as effective in this plan to promote the reduction of patient fall rates in VA hospital. In a way, the applications described above are similar since they promote action through researched information. For this initiative, clinical informatics could be the most relevant to patient fall prevention in combination with practice based-research networks. Clinical informatics concerns with informing practitioners and customers while the practice-based research network would be helpful to develop technology for patient fall prevention. Benchmark and Milestone in Quality Improvement Benchmarking and milestone in quality improvement are important in the VA hospital’s plan for quality improvement since it requires comparative data with other medical institutions. It is not a sort of competition, but merely a view of the hospital’s status in providing health care. Jantti and McGreggor (2007) asserted that benchmarking [and milestone], “is primarily a tool for measurement, learning, and improvement” (p. 7). In the plan’s benchmarking, the hospital considers three areas to assess: access to computing facilities, service quality, and service delivery. This is especially important in reducing patient fall rate since its success would require incorporating service-centered and patient-centered care. Knowing the data of the benchmarks mentioned, the hospital would be able to have an idea of which area they should concentrate. On the other hand, milestones are the result of the efforts on the quality improvement based on the benchmarks. For this plan, the hospital would like to achieve health care system integration, consumerism, and “active involvement and participation of staff and consumers” (Jantti & McGreggor, 2007, p. 9 ). The VA Montgomery Medical Center believes that the implementation of the plan is not a sole responsibility of the medical personnel, but more the efforts of the medical staff and the perseverance of the consumers and their families. Health care system integration within the different areas of health care processes, assisted with information technology would help maximize the plan’s purpose. Lighter and Fair (2000) stated that “consumers have an effect throughout the system” (p. 427). Consumerism is the proof that the VA hospital is dedicated in giving the best care to its consumers and assure them of convenience, hospitality, and accessibility while they are in the hospital’s premises. While consumers are “becoming increasingly interested in improving quality of life” (p. 427) especially in health and healthcare services, the plan will deliver what the patient wants and most especially, what the patient needs. Lastly, the idea of active involvement among people who are concerned is by far, the greatest milestone that the plan could achieve, because without full cooperation, it would be impossible for the rest of the processes to push through. There should be willingness and ability to act based on strategic planning. Conclusion To successfully decrease patient fall rate, the plan’s narrowed focus should come from the efforts of different health care sectors. Primarily, there should be proper planning and idealization of goals followed by proper implementation of the plan. Even if the hospital wants to follow strictly every step, the plan should also remain flexible and adapt according to the unpredictable events that may come as the plan progresses. The plan highlights education for both practitioners and customers. It recognizes the importance of knowledge on how to come about with an unstructured events and accidents such as patient falls. With the aid of technology, innovating tools to prevent patient falls can reduce its rate. Most important, the hospital should be measuring at all times the amount of improvement achieved, concentrating on the customer’s welfare. References Board on Healthcare Services. (2006). Medicare quality improvement organization program: Maximizing potential. Washington: National Academy of Sciences. Hughes, R.G. (2008). Patient safety and quality: An evidence-based handbook for nurses. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2682/pdf/ch44.pdf Jantti, M. H., & McGregor, F. (2007). Measurement and milestones- Sustaining improvement. Research Online. Retrieved from http://ro.uow.edu.au/cgi/viewcontent.cgi?article=1067&context=asdpapers Institue of Medicine (U.S.), Comitte on Enhancing Federal Healthcare Quality Programs, Corrigan, J., Eden, J., & Smith, B.M. (2003). Leadership by example: Coordinating government roles in improving health care quality. Washington: National Academies Press. Lighter, D. E., & Fair, D. C. (2000). Principles and methods of quality management in health care. Maryland: Aspen Publishers, Inc. Ortiz, E., & Clancy, C. M. (2003). Use of information technology to improve the quality of health care in the United States. Health Services Research, 38(2), xi-xii. Smith, P. C., Mossailos, E., & Papanicolas, I. (2008). Performance measurement for health system improvement: Experiences, challenges and prospects. Denmark: WHO. Read More