Quality Management in Healthcare

Introduction

Managing quality is the fundamental requirement of the health and social care organisations where it is necessary for the health and social care service providers to improve the quality of treatment and care so that they can maximise the wellbeing of the individual by providing proper support and treatment where the individuals can overcome their health conditions and lead a normal life in the society (Smith et al., 2019). The aim of the report is to analyse the quality management practice in the health and social care context where the service provider can satisfy the service users in the health and social care context by delivering quality care and efficient treatment to all the individuals in the society. The study focuses on identifying the Care Quality Commission (CQC) report which has been conducted in the organisation named as Stretton Nursing Home (SNH). Through evaluating the report of the CQC. It is possible for the quality manager to assess the perspective of the nursing home to manage quality so that their aim of maximising patient’s safety and welfare can be achieved efficiently.

TASK 1: Discussing differing perspectives of quality in relation to health and social care services

1.1 Explaining perspectives that stakeholders in health and social care have regarding quality in Stretton Nursing Home

It is necessary for the health and social care organisation to identify the major stakeholders who are contributing to improve the organisational performance as a whole and meet the prespecified aim of the organisation successfully (Leyerle, 2016). In this regard, the stakeholders are in two types, one is external and other is internal. In the SNH, the internal stakeholders are such as the nurses, doctors, health and social care professionals including physicians and others in the nursing home as well as managers, employees, shareholders and suppliers. On the other hand, the extremal stakeholders of the SNH are such as government, CQC, social community and the customers who are also interrelated with the operational act5vitiies of the health and social care service in the nursing home. In this regard, it is necessary to develop strategic planning, so that all the stakeholder can work collaboratively to meet the aim of the nursing home which is to maintain quality in the SNH. It is the responsibility of the health care providers to reduce waiting times in the nursing home as well as maintain the criteria to serve the patient better care and management so that the individuals can get proper environment to improve their wellbeing (Nelson and Staggers, 2016). In addition to these, managing budget through cost control as well as managing staff members through providing monetary and non-monetary rewards.

The reputation of the SNH can also be managed by the service providers where they can improve their performance in providing better care and support to the service users in the society which in turn helps the SNH to establish the nursing home in the health and social care context. In addition to these, the service users or the individuals who receive health and social care service from the SNH is another important stakeholder who are also playing crucial role in improve the quality of the health and social care service. Managing waiting times, cooperating with the nurses and the doctors, sharing their views and opinion as well as personal information about their past treatment and other medical records and manage respect, integrity and dignity are also useful to promote quality in the SNH. Hereby, both the service users and the service providers are important stakeholders in the SNH to manage the quality and mitigate the issue of managing suitable environment and poor-quality care at the nursing home. In addition to these, the government and the other eternal agencies such as CQC and national health Service also provides proper guidelines about managing quality at the nursing home. In this regard, managing quality in the SNH depends on implementing the social care act and other legislative practice to provide better care and service to the users and in this regard, the government and other external agencies ensures proper implementation of the Health and Social care Act 2008 and Mental Capacity Act so that the SNH can manage the quality for believing proper treatment and care to the individuals admitted in the SNH (Care Quality Commission, 2018).

1.2 Analysing the role of external agencies in setting standards in Stretton Nursing Home

The external authorities also play an important role in promoting quality in the SNH sop that the major issues of lack of evidence-based practice, lack of data protection and patient management, lack of efficiency in the health and social care service and poor organisational environment can be managed (Ellner et al., 2015). The external regulatory authorities such as CQC and NHS aim to monitor the performance of each of the stakeholders and aim at maximising the quality of the care provided by the SNH. In this regard, CQC protects the interests of the individual by implementing Mental Health Act and in this regard, the regularity board ensures that, all the patients in the society can get equal service from the SNH. Proper registration of the patients, monitoring and inspecting all of them with better practice, and enhancing communication with them are effective for the SNH to promote quality and deliver quality service after acknowledging the actual needs and preferences of the service users. In addition to these, National Institute of health and Clinical Excellence (NICE) is also responsible for monitoring the quality of health and social care service by providing proper guidance and maintaining quality standard which further influence the SNH to provide quality care and better practice to the patients (Care Quality Commission, 2018).

1.3 Assessing the impact of poor service quality on health and social care stakeholders in Stretton Nursing Home

The major reasons for the poor quality service in the SNH are such as the services are not always safe in the nursing home, lack of effectiveness to serve the patients in the care home, services are not always effective, lack of management in the nursing home environment and lack of data protection in the care home for which the managers and the service care providers aim to meet the quality standard set by the CQC in the nursing home. The major impacts of such poor-quality health and social acre service are on the service users which are not satisfied, and it further deteriorates the health condition of the service users (Dill, 2017). In addition to these, the needs and preferences of the patients cannot be met in the nursing home for such poor performance as well as lack of data protection in the nursing home reduce trust and loyalty among the individuals. In addition to these, the service providers are also affected for such poor-quality management in the SNH where the staff members and doctors are demotivated, and they increase self-esteem and become depressed. They also lose confidence and fail to meet the requirements of the patients so that it is possible to enhance the wellbeing of the individual. Poor performance and lack of quality further deteriorate the team performance where the staff members also become depressed as they fail to meet their responsibilities in the SNH (Care Quality Commission, 2018).

TASK 2: Exploring strategies for achieving quality in health and social care services

2.1 Explaining the standards that exist in health and social care for measuring quality in Stretton Nursing Home

Developing quality standard in the SNH requires proper guidelines by CQC as well as NHS and NICE which indicates that it is the primary aim of the nursing home to promote quality health outcome and patient care. As per the guidelines of quality management in the health and social care by CQC, it is necessary to increase patient’s safety and security in the nursing home and carte suitable organisational environment so that the individuals can stay safely. Managing patient’s data and information is also necessary as well as showing respect and integrity working practice needs to be developed in order to maintain quality standard in the nursing home. Respecting the patients and involving them in the care plan are also important for managing quality as well as it is necessary for the health and social care providers to implement policies of Health and social Care Act 2008 and mental Health Act so that they can provide better treatment and quality car to each of the patients (Maybin, Charles and Honeyman, 2016). In addition to these, quality standard is crucial where the efficiency of the nurses and clinical expertise among them are required for managing the quality of care and treatment in the SNH and apart form that, it is necessary for the SNH to provide effective care after proper diagnosis and screening of the patients so that they can access the right treatment ad medication as well as quality care from the service providers in the SNH.

2.2 Evaluating different approaches to implement quality systems in Stretton Nursing Home

Though Total Quality Management (TQM), it is possible to manage the quality of the SNH where the there are eight activities which help the nursing home to manage their quality. The activities are such as focusing on customer’s needs, leadership, improving involvement with the people, process, system approach to management, continual improvement, approach decision making and mutually beneficial supplier relationship (Waring et al., 2016). It is necessary to improve leadership and manage the workforce in the SNH so that it is possible for the health and social care providers to manage their quality and maximise the patient’s care successfully. Respecting the patients, managing integrity and empowering the patient’s in the care plan are effective leadership approach through which the SNH can maximise their quality to serve the patients with better care and practice. In addition to these, it is necessary to develop appropriate decision to manage the health and safety of the patients as well as contribute in developing suitable environment in the SNH so that the leaders and the managers can maximise the quality of care in the nursing home where the patients can get better environment to stay safely as well as they can share their past records and own experience with security where the staff members And the managers need to ensure that the patient’s data will be safe through the computerised data in the care home (Care Quality Commission, 2018). On the other hand, Continuous Quality improvement (CQI) is another approach which is also effective for the healthy and social service providers to develop proper planning after monitoring and evaluating the organisational present practice in the SNH. In this regard, PDSA (Plan, Do, Study, Act) is important to analyse the existing environment in the SNH (Qose et al., 2018). As per the report by CQC, it has been explored that, there is lack of quality management, poor efficiency in managing the patients, poor data protection ad lack of suitable environment for the patients for which, the quality of the care in SNH cannot be maintained properly. In this regard, the managers and the leaders focus on CQI through developing proper environment with safety and security as well as infection control system and managing hygiene factors so that the patients would be feeling safe and secured in staying in the nursing home. In addition to these, implementing mental capacity Act and introducing new computerised system for data protection as well as empowering the patients in developing proper decision to provide treatment and care are also helpful and these are major contributing factors to enhance quality management in the SNH (Care Quality Commission, 2018).

2.3 Analysing potential barriers to delivery of quality health and social care services in Stretton Nursing Home

In order to serve the patients better care and efficient treatment by implementing above mentioned strategies, there are certain barriers for which, the leaders and the managers face problems in managing quality in the SNH. In this regard, the barriers are such as staff related barriers, organisational issues in managing proper culture, quality improvement barriers and service user related barriers (Krachler, and Greer, 2015). The staff are sometime not efficient, and lack of clinical expertise deteriorate the service quality where the employees including nurses and other staff cannot manage quality in providing proper service and care to the patients (Milani and Lavie, 2015). Moreover, the staff are not concerned about teamwork and this is one of the major issue in deteriorating the quality management in the health and social care context as the partnership working practice is necessary in the SNH so that all the members including doctors, nurses and managers can cooperate with each other and provide better care and service collaboratively by sharing their clinical knowledge and skill. On the other hand, there are some organisational barriers in the SNH such as lack of finance, inadequate resources and poor leadership which are the major reason for which the SNH cannot provide better care and services to the patients. Lack of leadership skill deteriorates staffing and managing the clinical staff as well as inappropriate resource allocation in the SNH which deteriorates the service quality of the nursing home. In addition to these, culture plays an important role in the SNH to improve quality in the health and social care settings and in this regard, poor organisational culture in the SNH, lack of commitment and collaboration, poor communication as well as inconsistent service and mistrust among the members are the major barriers in implementing the quality management strategies and planning. Health care quality improvement barriers include high waiting time, poor management, ineffective service, lack of reliability and clear focus, and lack of automated information management skill which are also major barriers in implementing the quality management strategic planning in the organisation SNH (Care Quality Commission, 2018).

TASK 3: Evaluating systems, policies and procedures in health and social care services

3.1 Evaluating the effectiveness of systems, policies and procedures used in a health and social care setting in achieving quality in the service(s) offered in Stretton Nursing Home

The policies and practices in the SNH include proper implementation of the Health and Social Care Act 2008 and Mental health Act which improves the quality of the Health and Social care services, provided by the nursing home. Through the policies and practices, the nursing home tries to enhance the wellbeing of the patients and treat each of the patient with quality care and efficient treatment so that their health needs and personal preferences can be maximised (Richardson et al., 2019). In addition to these, the diagnostic and screening procedure of the patients in the SNH are improved through implementing proper technology and hiring clinical experts who are taking care of the patient’s diagnosis so that it is possible for them to acknowledge the actual health needs and personal preferences of the patient (Lyle-Edrosolo and Waxman, 2016). In addition to these, treatment of disease, injury and disorders are also taken care of where the efficient doctors and the nurses have proper knowledge and technical skill to provide the best possible treatment a, medication and care so that the parents can overcome their health issues. The procedure of developing accommodation, proper financing in managing hygienic factors in the nursing home as well as implementing Regulation 12 HSCA RA Regulations 2014 Safe care and treatment are also effective to manage the quality of care in the nursing home (Care Quality Commission, 2018).

3.2 Analysing other factors that influence the achievement of quality in the health and social care service in Stretton Nursing Home

There are other factors that contribute positively in achieving the quality management practice in the SNH in which the staff members and the operators and managers can manage the organisation by developing proper culture in managing the patients and delivering quality care and proper support to them according to the health needs and personal preferences of the patients (Nair et al., 2015). As per the clinical report published by CQC, it can be seen that, there are more requirements of implementing better care and practice in order to maximise the quality of care and treatment (Ogrinc et al., 2015). Continuous motivation as well as providing performance related pay and effective rewards and incentives to the staff members are necessary in the SNH in order to encourage their creativity and increase their contribution in the nursing home so that they can perform better and meet their responsibility efficiently (Robinson, 2016). Moreover, proper organisational culture plays a crucial role in improving quality in the nursing home where showing respect, integrity as well as managing transparency and accountability are important to maintain the quality of care in the SNH (Care Quality Commission, 2018). Additionally, patient empowerment is another effective factor that influence the achievement of quality in the health and social care service in the SNH where the staff members and the health and social care professionals try to empower the patients and share their experience to acknowledge their actual preferences as well as develop proper care plan with proper cooperation with the patient. This further helps to improve trust and loyalty as well as the quality of care can be managed well where the staff members are efficient to satisfy the patients by providing quality care and support as per the needs and preferences of the patients. Showing empathy and caring the patients is also necessary to improve the quality of care in the SNH and apart from that implementing proper computerised system and cloud computing is necessary which is playing an important role in managing patient’s safety, which is one of the problems in the SNH in managing the quality of care (Shulman et al., 2015).

3.3 Suggesting ways in which the health and social care service could improve its quality in Stretton Nursing Home

It is necessary for the SNH to develop proper strategic planning so that, it is possible for the nursing home to mitigate the existing problems and develop proper planning to meet the quality standard stated by the CQC. Customer focus is one of the effective ways to improve the quality, where the health and social care providers need to diagnose the patient efficiently to identify the actual health problems and personal preferences of the patients, proper diagnosis and screening of the patients are necessary in this regard to treat the patient by maintaining its quality (Edvardsson, Watt and Pearce, 2017). Apart from that, empowering each patient in the care plan is also necessary where trust and loyalty can be built, and the patients are also trying to cooperate with the health care service providers to overcome their health issues. Moreover, it is necessary to improve the leadership practice in the SNH where the leaders and the managers need to manage their financial and other resource and reallocate it so that the resources are effective to meet the patient’s care. Developing proper organisational culture depends on the leadership practice and in this regard, the leaders and managers need to develop proper training and development program and group discussion so that the members can share their experience and improve knowledge and clinical skill as well as it in turn helps to improve team work in the SNH which is necessary for improving the quality of care in the nursing home. In addition to these, it is necessary to implement computerised system and cloud computing as well as make protected password so that the personal information of the patients can be safe and secured (Care Quality Commission, 2018). It further helps to improve trust among the patients and the individual also can shar their personal information and past medical records with the doctors and nurses through open communication, respecting the patients and developing person centred care is also beneficial in this regard for the SNH to improve quality care and serve each of the patients efficiently. Involvement with all the people is also necessary and in this regard implementing Information and Communication Technology (ICT) is required through which the external and internal communication can be enhanced and the leaders and the managers can build strong relationship with other stakeholders including the employees, nurses, staff members, doctors and other health care professionals, shareholders, government, service user in the society and CQC and other external stakeholders who are also engaged with the SNH for maximising patient’s care (Johnson et al., 2016).

TASK 4: Understanding methodologies for evaluating health and social care service quality

4.1 Assessing methods for evaluating health and social care service quality with regard to external and internal perspectives in Stretton Nursing Home

It is necessary to evaluate health and social care service quality with regard to external and internal perspectives in the SNH where quality audit and the quality reviews are effective was to evaluate the quality management practice in the SNH. In this regard, quality audit is effective through which proper assessment and monitoring process are beneficial for the managers to control the quality of the organisation and maintain track report of the staff members about their performance. In addition to these, feedback check is necessary for quality reviews where the organisation needs to provide proper feedback form to the service user where they can provide their information about their experience (Care Quality Commission, 2018). It is also effective to review the quality management practice and improvement in their quality of care. This is also effective for the organisational leaders and the managers in the SNH to assess the quality of care and ensure continuous improvement day by day by allocating the organisational resources. In addition to these, developing proper group discussion and general meeting with the health and social care service providers are also necessary for reviewing the quality in the SNH. Apart from, quality inspection is one of the effective ways to assess and evaluate the quality improvement process in the nursing home (Goff et al., 2017). In this regard, the yearly report of the nursing home as well as the report developed by CQC after proper assessment in the quality manage meet practice in the nursing home would be effective to recheck the policies and practices of the SNH to enhance the wellbeing of the individuals and promote patient’s safety and security in the nursing home.

4.2 Discussing the impact that involving users of services in the evaluation process has on service quality in Stretton Nursing Home

There are certain benefits of involving the service user in the health and social care service in the nursing home and among them improving service quality is one of the best impacts where the staff members and the doctors can provide better service after proper communication with the patients. It is also effective to acknowledge the actual health needs and personal preferences through diagnosis and counselling of the patient which is also another benefit if involving the patients. Moreover, self-esteem and self-confidence of the service providers can be improved where they try to involve the patients in developing the care plan, so that they can satisfy the individuals and create values for them. Greater feeling of control and welfare among the patients as well as sharing information can be possible through improving involvement with the patients in the SNH. Sharing agenda promote relationship and partnership working practice where the service users and the health and social care professionals try to cooperate with each other for maximising the health outcome. In this regard, patient centred care can be developed through increasing partnership with the patients as well as trust and loyalty among the patients can be built, where the individuals can rely on the service providers for accessing better treatment and quality care form them in the SNH.

Conclusion

It can be concluded that, the nursing home, Stretton is effective to provide better care and treatment to the patients and in this regard as per the quality report by CQC, there needs some improvement in terms of policy and practice, patient’s safety and quality treatment where the nursing home has the capability to reallocate their resources and improve the efficiency of the staff member to promote patient’s safety and developer high quality treatment and care to all the individuals for enhancing their wellbeing in the social communities. Proper evaluation and assessment as well as involvement of the stakeholders in the Stretton would be beneficial where the leaders and the managers can implement latest technology in the nursing home and improve quality standard of the care so that they can treat each of the patients proficiently according to their patient’s personal preferences and their health needs.

Reference List

Edvardsson, D., Watt, E. and Pearce, F., 2017. Patient experiences of caring and person‐centredness are associated with perceived nursing care quality. Journal of advanced nursing, 73(1), pp.217-227.

Goff, D.A., Kullar, R., Bauer, K.A. and File Jr, T.M., 2017. Eight habits of highly effective antimicrobial stewardship programs to meet the joint commission standards for hospitals. Clinical Infectious Diseases, 64(8), pp.1134-1139.

Johnson, M.C., Schellekens, O., Stewart, J., van Ostenberg, P., de Wit, T.R. and Spieker, N., 2016. SafeCare: an innovative approach for improving quality through standards, benchmarking, and improvement in low-and middle-income countries. The Joint Commission Journal on Quality and Patient Safety, 42(8), pp.350-AP11.

Krachler, N. and Greer, I., 2015. When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act. Social Science & Medicine, 124, pp.215-223.

Lyle-Edrosolo, G. and Waxman, K.T., 2016. Aligning healthcare safety and quality competencies: quality and safety education for nurses (QSEN), The Joint Commission, and American Nurses Credentialing Center (ANCC) magnet® standards crosswalk. Nurse Leader, 14(1), pp.70-75.

Maybin, J., Charles, A. and Honeyman, M., 2016. Understanding quality in district nursing services. London: Kings Fund.

Nair, M., Baltag, V., Bose, K., Boschi-Pinto, C., Lambrechts, T. and Mathai, M., 2015. Improving the quality of health care services for adolescents, globally: a standards-driven approach. Journal of Adolescent Health, 57(3), pp.288-298.

Nelson, R. and Staggers, N., 2016. Health Informatics-E-Book: An Interprofessional Approach. London: Elsevier Health Sciences.

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F. and Stevens, D., 2015. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. The Journal of Continuing Education in Nursing, 46(11), pp.501-507.

Qose, I., Conte, R., Sansone, F. and Tonacci, A., 2018, July. New Models in Managing Out-of-Hospital Care of Chronic Patients and Aging Population. In Italian Forum of Ambient Assisted Living (pp. 23-33). Springer, Cham.

Richardson, E., Walshe, K., Boyd, A., Roberts, J., Wenzel, L., Robertson, R. and Smithson, R., 2019. User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England. Health Expectations, 22(2), pp.245-253.

Robinson, A., 2016. Care Quality Commission and diabetes: a new review of community services. Practical Diabetes, 33(3), pp.96-97.

Smith, M., Roos, L.L., Burchill, C., Turner, K., Towns, D.G., Hong, S.P., Jarmasz, J.S., Martens, P.J., Roos, N.P., Ostapyk, T. and Ginter, J., 2019. Health services data: Managing the data warehouse: 25 years of experience at the Manitoba Centre for Health Policy. Health Services Evaluation, pp.19-45.

Waring, J., Allen, D., Braithwaite, J. and Sandall, J., 2016. Healthcare quality and safety: a review of policy, practice and research. Sociology of Health & Illness, 38(2), pp.198-215.