Quality Management Process in Healthcare: Ensuring Excellence in Patient Care and Treatment

Introduction

Healthcare is one of the most changing and regulated industries in which maintaining quality throughout the process is important (Lloyd, 2017). NHS (National Health Service) and CQC (Care Quality Commission) set the guidelines for maintaining proper operation management process in the healthcare sector, in terms of ensuring the that patients receive the best provision of care and treatment process (gov.uk, 2018). According to CQC, the quality management process in healthcare is associated with the following process:

• Meeting the national healthcare standard set by NHS
• Monitoring the compliance
• Risk management process
• Technical assistance
• Process improvement

This presentation is going to identify and discuss the concept of quality management in the context of healthcare, with special reference to the operation management process in the Queen Elizabeth Hospital. This hospital is the part of the famous Lewisham and Greenwich NHS Trust in London, that provides the community care services to the 526,000 people. Moreover, this presentation will outline and describe the three reasons behind poor quality health framework of Queen Elizabeth Hospital. In addition to these descriptions of the quality management process, this presentation would make a suitable recommendation for Queen Elizabeth Hospital, in order to improve the quality of different healthcare aspects in this hospital. If you are looking for healthcare dissertation help, understanding the nuances of quality management in hospitals like Queen Elizabeth can provide valuable insights.

Task 1:

Determine and describe the concept of quality management:

According to NHS (National Health Service), Quality in the healthcare is the degree to which the health and social care service for the groups and population enhance the likelihood of the desired health outcomes (NHS, 2017). Care Quality Commission, UK (CQC) has defined the Quality Management System in the healthcare as the process to improve the usefulness of treatment and enhance the patient satisfaction by providing the optimum level of support and care to the patient in order to meet their individual needs (health.org.uk, 2018).

Guidelines for Quality Management by CQC:

Care Quality Commission has set the guidelines for the healthcare sector, in maintaining the NHS stranded of the care and treatment, to assure the best quality healthcare process. According to Lloyd (2017), Quality Management System in the context of healthcare is one of the inevitable part of the healthcare sector, which makes it obligatory for each hospital and healthcare organisation to maintain the CQC standard of the health care quality in the health framework. Queen Elizabeth Hospital, needs to follow the CQC criteria in order to maintain the quality in the treatment process and improve the overall healthcare framework. The guidelines are as follows:

• The patient centred approach is an important aspect of the quality management process in the health and social care context (NHS, 2017). CQC states that effective quality management process should focus on the needs of the patient, as the patient safety and wellbeing is the measurement of the usefulness of the tenement process (Tozzoet et al. 2018).
• Trained and high skilled staffs should be appointed in the hospital and healthcare centre which can deal with the patient with complex needs (Kanamori et al. 2015). In the Queen Elizabeth Hospital, some of the staffs and nurses are unable to provide compassionate care to the patient, which interfere with the quality and national standard of the care process.
• Close cooperation among the staffs and healthcare professional needs to be maintained in order to create a multidisciplinary team. Through a synergistic approach, staffs can ensure that better quality of treatment and overall care process.
• Following national guidelines is important for the healthcare centre and hospitals, in order to establish the standard and quality of care and treatment (Beattie et al. 2015). In Queen Elizabeth Hospital, staffs and nurses are unable to maintain the national standard and guidelines in order to provide proper safety and risk-free treatment process to the patient. As per the NHS guidelines for the healthcare quality management process, health professional needs to follow and implement the national guidelines and standard in order to deal with the patient with complex needs (NHS, 2018).
• Monitoring compliance is one of the major aspects of the quality management system in healthcare (Vaughn et al. 2019). Through monitoring the compliance of the staffs and the health care professionals to follow and establish the professional standard of the care and treatment, the usefulness of the healthcare system can be evaluated. Queen Elizabeth Hospital, need to focus on improving the compliance of the health staffs and the caregivers, in order to improve the efficiency of the treatment process.
• Risk management is another aspect that the health care staffs and professional needs to perform in the healthcare centre and hospital, in order to identify, analyse and mitigate the risk (Kanamori et al. 2015). Queen Elizabeth Hospital is also recommended by the CQC to improve their safety and care framework of the patient in terms of providing the risk-free treatment process. Through determining, analysing and eliminating the risk in healthcare, Queen Elizabeth Hospital can help the patient to stay free from any health threats and hazards.
• Process management is part of the quality management process in healthcare, in which through conducting the compliance audit. According to CQC, a compliance audit is one of the most important processes which assists the healthcare organisation to find out the areas of improvement. Through the audit, it is possible to highlight the weakness of each healthcare aspects. In the case of the Queen Elizabeth Hospital, a compliance audit has assisted the healthcare professional and staffs to find out the areas of improvement in which they need to focus to achieve the quality of care.

Issues in Quality Management process in Queen Elizabeth Hospital:

In the given case study, the audit conducted by the CQC has shown that Queen Elizabeth Hospital needs to focus on several areas of improvement in order to maintain proper NHS standard and quality of the health care. There are different issues regarding the quality care management process of Queen Elizabeth Hospital, which are as follows:

• Poor emergency as well as urgent service that needs immediate review and improvement process in order to faster the delivery of emergency care to the patient with the critical health condition (Kanamori et al. 2015).
• Medical care, especially for the older people needs a proper quality management framework, in order to improve the safety and risk-reducing techniques in the tenement and care process (Prince et al. 2016).
• Healthcare staffs and nurses sometimes do not take the compassionate approach to patient treatment and safety.
• Poor and limited resources that make this hospital staffs and health professional unable to provide high-quality treatment to the patent with complex needs.
• Lack of safety and quality management in the surgery make a big question on the quality of the proper treatment process.
• Reporting as well as learning from the incidents is not achieved consistently. Health staffs do not provide the care and support to each patient for meeting their individual needs (Fatima et al. 2018).
• Poor infrastructure for critical care for the patient with complex needs. Lack of consultants in terms of dealing with critical cases leads to revealing the fact that the hospital cannot meet the National guidance in the context of patient staffing ratio.

Task 2:

Three underlying reasons behind the poor quality of the Queen Elizabeth Hospital:

Different reasons present behind the poor quality of Queen Elizabeth Hospital, out of which the most important reasons are as follows:

• Insufficient staffs and consultants
• The poor risk assessment framework
• Lack of a compassionate approach to patient (Fatima et al. 2018).

1.Insufficient staffs and consultants:

• According to NHS (National Health Service), hospitals and other healthcare organisations should follow the patient staffing guidelines in the nursing and healthcare setting (NHS, 2017). Patient and staff’s ratio is one of the inevitable aspects in the healthcare sector which influence the effectiveness of the treatment process (Thakur and Ramesh, 2015).

  In case of Queen Elizabeth Hospital, as compared to the patient, the number of consultants and healthcare staffs are not adequate, which not only affect the delivery of treatment process but also pose an adverse impact on the overall quality and degree of healthcare in this hospital.

• Lack on consultants in Queen Elizabeth Hospital points out to the fact that national guidelines for patient staffing ratio are not followed by this hospital, which reduces the usefulness as well as the quality of the care process. Based on the NHS guidelines, if the consultants and healthcare staffs are not sufficient in any healthcare centre as compared to the patients, then it is obligatory to the HR officials and higher administrative staffs of the healthcare organisation to conduct the immediate hiring of eligible staffs (Thakur and Ramesh, 2015).
• In the case of the Queen Elizabeth Hospital, lack of consultants, increased the risk of poor care treatment process in the critical care segment, on which they need to deal with a patient with complexed needs. As a result, in emergency care, the quality and degree of treatment are highly ordinary that lacks the patient centred approach (Morozov et al. 2018).
• Due to the inadequate emergency consultant and health staffs in the emergency department, there is the long waiting process for the patient to meet the consultants or to get the ned in the hospital for the treatment of critical disease (Fatima et al. 2018). Due to this reason, health professionals cannot manage the time for focusing on individual needs in a proper manner, which makes them unable to reach the optimum patient satisfaction level.
• Moreover, due to the insufficiency of the doctor, there is a huge crowd of the patient in the hospitals. Even often the patient is unable to get the bed and are placed on the corridor floor with a screen around them (Lloyd, 2017). Due to this process, the quality of care is not maintained by health staffs and professions. Patient faced severe unhealthy and insecure treatment condition, in which they suffer from lack of proper health assessment, timely delivery of foods and medicines and regular check-up.

2.Poor risk assessment framework:

Risk assessment process in healthcare is important for improving the equality ad degree of the care process and healthcare service. According to the Care Quality Commission (CQC), risk assessment process in the healthcare is associated with determining, evaluating and mitigating the risk in order to ensure patient safety and wellbeing (Bloom et al. 2015). In the given case study, one of the important reasons behind the quality issues in the healthcare system of Queen Elizabeth Hospital is its poor risk assessment framework, which affects the usefulness and quality of eth overall health care process in the following ways:

• NHS guidelines make it obligatory for all the healthcare organisation that the healthcare staffs and professionals would take the compassionate approach for the patient in order to analyse and meet their individual needs (NHS, 2017). On the other hand, in case of the Queen Elizabeth Hospital, staffs are unable to consistently demonstrate the compassionate caring approach towards the patient which reduce the degree of the usefulness of the overall degree of the treatment process.
• CQC states that compassionate care is important for maintaining the patient dignity, respect and values, which assist them to develop their emotional, spiritual and psychological wellbeing (Kanamori et al. 2015). In the case of the Queen Elizabeth Hospital, the patient is not treated with dignity and respect.
• Due to lack of compassionate care, healthcare staffs mans health professionals in eth Queen Elizabeth Hospital cannot focus on eth individuals needs of the patient with the critical health condition, which leads to their unfortunate death or worse health condition.
• According to NHS, compassionate care is also associated with the proper implementation of the resources, in order to improve the effectiveness of the treatment process (Prince et al. 2016). However, in the case of Queen Elizabeth Hospital, the staffs face difficulties in obtaining the additional resources in order to support the patient with the complex needs.

TASK 3

Recommendation to the Queen Elizabeth Hospital in order to improve the quality of the healthcare framework:

Queen Elizabeth Hospital can be recommended to conduct the Total Quality Management (TQM) process, which would assist its staffs and healthcare professionals to improve eth quality of overall healthcare framework.

Total Quality management in health care:

National Health Service (NHS) states that, Total Quality Management (TQM) in healthcare is an innovative approach or strategy of healthcare organisations to change the behaviour and attitude of healthcare personnel, in terms of learning and using the qualitative methods, to reduce the cost and meet the critical as well as individuals needs of the patient.

Through implementing the TQM, Queen Elizabeth Hospital in recommended to improve the overall healthcare management process through:

• Empowering the clinicians as well as care managers to improve and analyse the overall healthcare process.
• Adopting the appropriate norm that would consider the patient preference and needs as the primary determinants of the quality
• Developing the multidisciplinary approach that can goes beyond the professional lines and conventional departments
• Providing the motivation for the rational data-based synergistic and cooperative approach in order to process the overall analysis and change in the healthcare
• Conducting a proper risk assessment framework, which is known as the Health Risk Assessment (HRA) framework. Through this HRA process, Queen Elizabeth Hospital would be able to:
  • Maintain the detailed and personalised report on the determined risks, their severity and areas of needs
  • Assist the health care staffs and the patient to be aware of the different healthcare risk and hazards
  • Conduct effective strategies to mitigate and eliminate the risk inte healthcare. Such as improvement of the treatment process, installation of new software, increase the number of resources.

Appointing the adequate high skilled staffs and consultants, in order to meet the national guidance of the patient staff ratio. Inadequate staffs are one of the most important reasons behind the poor quality of healthcare in the hospital.

Taking a compassionate care approach towards the patient in order to focus on their individual needs. Queen Elizabeth Hospital can implement the proper compassionate approach in the care ogress through making regular check-up, health assessment and risk assessment for each patient.

Conclusion:

From the abovementioned discussion, it can be concluded that Quality Management is one of the important processes in the healthcare, which assists the healthcare personnel to apply compassionate and patient centred care framework in order to meet the degree of effectiveness of the treatment process. Different reasons can lie behind of the failure of a healthcare organisation to meet the national quality standards of the healthcare such as poor resource, inadequate staffs and consultants, or risk assessment framework and lack of modern medical instruments and machines. Through implementing a proper quality management process in healthcare, the healthcare organisation can achieve the following aspects such as:

• An innovative and highly modern treatment process that would consider the patient needs and offer as the primary determinants of the quality of the care process
• Strong leadership strategy, which assists the staffs and the managers in order to choose the right technique and decisions in favour of patient safety and wellbeing
• Reliability in the healthcare process, which ensures healthcare staffs would focus on their performance improvement, patient wellbeing and the quality of the overall healthcare process
• Equitability that assures that healthcare quality should not differ according to the caste, religion, ethnicity and race of the patient. All the patient will have high-quality care and support from the caregivers and health professionals.
• The efficiency of the managers and administrative personnel in the healthcare to minimise the waste, reduce the cost in order to supply more resources into the healthcare centre
• The real-time process that assists the healthcare staffs in order to eliminate the wasting of time in order to provide faster delivery of quality treatment and care to the patient.

Reference list:

• Aktas, A., Cebi, S. and Temiz, I., 2015. A new evaluation model for service quality of health care systems based on AHP and information axiom. Journal of Intelligent & Fuzzy Systems, 28(3), pp.1009-1021.
• Barbé, B., Yansouni, C.P., Affolabi, D. and Jacobs, J., 2017. Implementation of quality management for clinical bacteriology in low-resource settings. Clinical microbiology and infection, 23(7), pp.426-433.
• Beattie, M., Murphy, D.J., Atherton, I. and Lauder, W., 2015. Instruments to measure patient experience of healthcare quality in hospitals: a systematic review. Systematic reviews, 4(1), p.97.
• Bloom, N., Propper, C., Seiler, S. and Van Reenen, J., 2015. The impact of competition on management quality: evidence from public hospitals. The Review of Economic Studies, 82(2), pp.457-489.
• Davy, C., Bleasel, J., Liu, H., Tchan, M., Ponniah, S. and Brown, A., 2015. Effectiveness of chronic care models: opportunities for improving healthcare practice and health outcomes: a systematic review. BMC health services research, 15(1), p.194.
• Fatima, T., Malik, S.A. and Shabbir, A., 2018. Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems. International Journal of Quality & Reliability Management, 35(6), pp.1195-1214.
• Findlay, P., Lindsay, C., McQuarrie, J., Bennie, M., Corcoran, E.D. and Van Der Meer, R., 2017. Employer choice and job quality: Workplace innovation, work redesign, and employee perceptions of job quality in a complex health-care setting. Work and Occupations, 44(1), pp.113-136.
• gov.uk, (2018), Available at: [Assessed 22 July, 2017]
• health.org.uk, (2018), Measuring quality of health care in the NHS available at: [Accessed 13 December 2018]
• Höög, E., Lysholm, J., Garvare, R., Weinehall, L. and Nyström, M.E., 2016. Quality Improvement in large healthcare organizations: Searching for system-wide and coherent monitoring and follow-up strategies. Journal of health organization and management, 30(1), pp.133-153.
• Kanamori, S., Shibanuma, A. and Jimba, M., 2016. Applicability of the 5S management method for quality improvement in health-care facilities: a review. Tropical medicine and health, 44(1), p.21.
• Kanamori, S., Sow, S., Castro, M.C., Matsuno, R., Tsuru, A. and Jimba, M., 2015. Implementation of 5S management method for lean healthcare at a health center in Senegal: a qualitative study of staff perception. Global health action, 8(1), p.27256.
• Lloyd, R., 2017. Quality health care: a guide to developing and using indicators. Jones & Bartlett Learning.
• McFadden, K.L., Stock, G.N. and Gowen III, C.R., 2015. Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety. Health care management review, 40(1), pp.24-34.
• Morlion, B., Clemens, K.E. and Dunlop, W., 2015. Quality of life and healthcare resource in patients receiving opioids for chronic pain: a review of the place of oxycodone/naloxone. Clinical drug investigation, 35(1), pp.1-11.
• Morozov, S., Guseva, E., Ledikhova, N., Vladzymyrskyy, A. and Safronov, D., 2018. Telemedicine-based system for quality management and peer review in radiology. Insights into imaging, 9(3), pp.337-341.
• Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M. and Karagiannidou, M., 2016. World Alzheimer report 2016: improving healthcare for people living with dementia: coverage, quality and costs now and in the future.
• Thakur, V. and Ramesh, A., 2015. Healthcare waste management research: A structured analysis and review (2005–2014). Waste Management & Research, 33(10), pp.855-870.
• Tozzo, P., Mazzi, A., Aprile, A., Rodriguez, D. and Caenazzo, L., 2018. Certification ISO 9001 in clinical ethics consultation for improving quality and safety in healthcare. International Journal for Quality in Health Care, 30(6), pp.486-491.
• Vaughn, V.M., Saint, S., Krein, S.L., Forman, J.H., Meddings, J., Ameling, J., Winter, S., Townsend, W. and Chopra, V., 2019. Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies. BMJ Qual Saf, 28(1), pp.74-84.