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Key Topics
Requirement
IMPROVING THE QUALITY OF HEALTHCARE
Solution
INTRODUCTION
The success of any company whether it is manufacturing or service firms totally depends upon the type of products and services being delivered by them. Thus, if firms will not take care of the quality of services then the impact of the same will be seen on their sales and profitability related condition (Sherwood and Barnsteiner, 2017). Further, it also affects trust of buyers from the organization. Clinical governance is the framework which makes healthcare firms accountable for the quality of services being delivered by them to patients. In other words, it can also be said that clinical governance is basically systematic approach which creates pressure upon healthcare firms that they should comply with all type of service quality principles. However, in case if any firm does not comply with the quality principles at that time patients and other individuals have full freedom to file a case against the hospital. This governance has an important role in healthcare because it ensures that firms do not compromise on service quality.
In addition to this, the concept of clinical governance completely aligned with the principles of total quality management (TQM). Here, TQM is based on the aspect that improving the quality of an organization is a kind of work which needs to be done continuously (Cupit, Mackintosh and Armstrong, 2018). This is because it is through this way only information about problems that incurs on day to day basis could be gathered. Thus, by taking timely action towards the same improvement in the quality of services delivered by the corporation can be carried out. Further, this HA 2017-18 also gives details about the policies which should be followed with an aim to enhance the quality of healthcare services. These policies play a very important role in framing strategies related to clinical governance.
This essay will give a description of different clinical governance strategies which can be used with an aim to reduce the incidents related to sentinel events. In this regard, scenario one is taken into consideration in which due to the ignorance of surgeon piece of the broken drill was kept in the body of a patient who came for total replacement surgery. Herein, with an aim to examine main causes from the chosen scenario assistances will be taken from Ishikawa’s fishbone model. At last, the essay will be summarised in the conclusion.
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BRIEF ABOUT CHOSEN SCENARIO
This case is related to the hospital lack of compliance with quality from the side of a doctor. Herein, a patient came to undergo a hip replacement surgery. Before undergoing the surgery, different actions are taken by the individuals who are involved in the process. This includes checking and counting the instruments which need to be used in surgery. Further, all the necessary materials were also assembled which were required to assist this surgery. However, even after following all these things big mistake was happened due firm’s lack of compliance with quality of services.
ANALYSE
Introduction to Ishikawa’s fishbone model
With an aim to assess the causes of different sentinel events which occur in healthcare, Ishikawa’s fishbone model tends to play a very significant role. This model is recognized through several names such as fishbone diagram, herringbone diagram and cause and effect diagram. This framework was found by Kaoru Ishikawa in the year 1968 (FISHBONE (ISHIKAWA) DIAGRAM, 2018). This model basically identifies the reasons or causes for the occurrence of a specific event. This model is of fish shape and it uses three basic steps with an aim to examine the causes behind the identified problem.
Advantages and disadvantages of Ishikawa’s fishbone model
The framework which is used for assessing causes of the identified problem has different benefits and limitations. The main advantage of this model is that it clearly defines the main problem which is related with the retained instrument. Further, with this, it also helps in identifying several causes of the examined problem (Mort and et.al., 2017). Thus, model effectively represents a clear relationship between assessed problem causes and its effect. In addition, it encourages team building approach within the company. This is because, here with an aim to assess the causes for the examined problem discussion is being carried out by the employees who are working within the company. Thus, it is in this way the only framework provides support to the collective decision-making approach (Yang, Hunt, and Davidson, 2017). However, the main limitation of this model is that that causes which it represents us purely based on the opinion of people. Hence, it does not have any kind of evidence or proof which depicts the reason behind the suggestion of specific cause. Due to this limitation, chances are there that people might overlook the main cause of the problem and will invest their time in some noneffective activity.
Further, this model does not give information single or major cause of the assessed problem. Thus, it leads to the wastage of lots of time of assessor. In addition to this, sometime evaluator wasted their time on those issues or causes which have a very little impact on the problem. This model helps in making a decision in an enterprise. A manager of the firm can take a decision if discussion on the problem is carried out on regular basis. But, in case if the discussion is not carried out regularly by manager then there are chances that he might get deviated from the objective of the problem.
Analyzing causes from a chosen scenario by using Ishikawa’s fishbone model
This case is related to the sentinel event in which psychological injury is caused to a patient who came for hip replacement surgery. Hence, in this case, the occurrence of sentinel event in healthcare firm is the main problem. Thus, on the basis of this problem following possible causes identified which are presented through Ishikawa’s fishbone model.
In the above diagram, the main causes of examined problem are categorized into four categories. In this regard, it can be said that it is due to the presence of given causes only the issue of quality could be incurring in the healthcare firm (Hibbard, Greene and Parrotta, 2017). For instance, as per the given scenario, that first cause of the problem could be related to equipment. In this context, there are chances that hospital would not have changed its equipment from last many years. Thus, it is due to the presence of this aspect only the issue of a sentinel event is occurring in healthcare firm. Besides this, the causes are also categorized under policies and procedure section. In this, it is examined that it is because of firm lack of compliance with training and development type of practice respective problem is incurring. Herein, there could be chances that firm are not providing pre-operation training to the nurses. Thus, it is the reason why such big incident has occurred within the hospital.
In addition to this, the case depicts that doctor is in some kind of hurry and it is the reason why he had finished this operation within limited possible time frame (Gavin, Frederiksen and Moskosky, 2017). The reason for such type of behavior from the side of doctor could be high work pressure. In this context, there are possibilities that some target should be there for doctors regarding operation which they need to accomplish within the given specified time frame. Thus, it is due to the presence of given aspect only this incident has happened in the hospital. Furthermore, the line “The operation was uneventful” entail that doctors are not considering respective operation as an important one and taking it in a very light way. This indicates the careless behavior of the doctor which needs to be changed. This is because if this will not happen then issues related to the quality of hospital services will keep increasing in future also (Schmidt and et.al., 2017). Thus, it is required by the management of hospital that it should consider these cases very seriously and must take significant action towards them. Here, by complying with the given type of activity hospital can win the trust and confidence of its patients in an effective way.
CLINICAL GOVERNANCE STRATEGIES FOR RESOLVING ASSESSED CAUSES
Different clinical governance strategies identified which will provide a solution to the causes which are identified on a fishbone. For example, the causes which are examined under the policy heading of fishbone diagram can be resolved through nurse training and professional development related clinical governance strategies. Here, this tactic state that the hospital staffs who are caring for the patient should receive regular training from their senior personnel. This is because it is through continuous training only improvement in the skill of nursing staff of the hospital will be carried out. Furthermore, with this training, nursing staff will keep update themselves with the practice of prior preparation which should be done before any kind of operation. It is through this way only the control over the events related to retained instrument will be carried out (The main components of clinical governance, 2018). This will lead to cause a positive impact on the brand image of the hospital. This is because the image of service industry totally relies on its workers. This is because it is the services of firm’s employees only which shape positive and negative aspect of the company in the mind of its respective buyers. In addition to this, with the help of training both nurses as well as doctors could improve their knowledge about different developments that are happening in the clinical industry in an effectual manner. Hence, by applying the knowledge which is gained through training in their work both can deliver high-quality services to their patients (Humphreys and et.al., 2017). Thereby, both can enhance as well as maintain the satisfaction of their patients. This thing will lead to providing a positive benefit to the hospital in the form of increased profit and sale in an effectual way.
Besides this, forming the quality circle within the hospital could be considered as another most effective tactic which will help in resolving a firm problem related to equipment and people. For example, with the help of this circle regular examination will be carried out on the equipment which needs to be used for the today’s operation (Humphreys and et.al., 2017). Thus, through this way information about the defect in the equipment which is used for operation will be gathered. By taking timely and proper action with regard to the same quality of the services delivered to the patient will be enhanced in an effectual manner. Furthermore, this quality circle will also help in resolving the problems which are related to the people of the enterprise. For example, another role of this quality circle will be to analyze the amount of work allocated to each doctor. By complying with given type of activity, information will be gathered about the intensity of work pressure on one doctor. For instance, if through analysis it is examined by the team of the quality circle that one doctor is heavily loaded with back to back operation. Then in the given situation by allocating some work of specific doctor to another doctor, pressure upon the doctor can be reduced (Young, Roberts and Holden, 2017). Thus, the given thing will motivate doctor with regard to deliver its best services to the patients. However, this quality circle should be formed from the internal team only. This circle should include both nurses and doctors.
Moreover, the fourth factor of fishbone model is related to environment. In this regard, it is examined that the given case showcase careless attitude of the doctor as he is considering this hip replacement operation as uneventful (Stojanovic, Gligorijevic and Obradovic, 2017). This means that respective operation does not mean anything to the doctor. However, the respective attitude of doctor could be changed by applying evidence-based care and effectiveness related clinical governance strategy. By using this tactic, the importance of taking good care of the patient can be explained to the doctor. Furthermore, it is through this way an only significant change in the attitude of the doctors will be carried out regarding the each and every operation which they perform. Thus, it is correct to say that clinical governance strategies have implications for the healthcare firm. This is because, respective concept give guidance to both doctors and carers about the way to carry out their duties and responsibilities (Hignett, Lang and Bowie, 2018). These principles will also assist in controlling the incidents which are associated with sentinel events. Thus, overall it will play a very important role in improving the brand image of the hospital in an effectual manner.
CHANGE MANAGEMENT
Any kind of strategy which is applied to the existing operation of firm always comes with some kind of changes. The same thing is with the case of above-mentioned strategies also. In this context, it can be said in the process of applying these strategies some changes will occur within the hospital. Thus, it is not necessary that each and every individual of the hospital will accept the changes and will start performing according to that from day one itself (Kelley, Covinsky and Ritchie, 2017.). It is due to the presence of given issue, the need for change management arises in front of the organization. Change management is the process in which support is provided to employees regarding the change by the change agent. Here, this agent influences those people who are not ready to accept the change. For example, in the identified strategies there are chances that staff of hospital could resist complying with the concept of attending training and development program on regular basis. Here, they might give the excuse of work pressure and personal issues etc. Therefore, with an aim to influence these staff members assistance can be taken from Lewin’s force field analysis (Young and Kroth, 2017).
Figure 1 Lewin’s Force analysis model
(Source: Braithwaite, Matsuyama and Johnson, 2017 )
For example, by using this model different forces can be examined which will influence nursing staff of the hospital for accepting the change. For example, with regard to the change of providing training and development to the employees, forces of change could be an improvement in the service delivery skill of nursing staff and enhancement in the salary of nursing staff. With the help of these forces or change drivers nursing staff can be influenced and as a result of it, they will accept the change. However, there are some factors which could resist the change (Maslach and Leiter, 2017). This means that respective factors will influence nursing staff of the hospital in a negative way and due to this, they will not accept the change which is happening in the hospital. These factors could be not ready to shift from their comfort zone and high work pressure etc. However, control over these resisting factors will be carried if management of hospital will take part in change management process. In this context, management should explain its nursing staff about the benefit of accepting the suggested change. Thus, by complying with given type of activity each and every member of nursing staff could be driven towards the change. This thing will not only improve service quality of hospital but it will help in controlling the incidents related to sentinel event in an effectual manner (Epstein, Duberstein and Kaesberg, 2017).
In accordance with the given context, it can be said that Lewin’s Force analysis model is effective because it clearly gives description about forces which could drive or resist the changes occurring within the firm. Here, by getting an idea about these forces manager of the firm can form its tactic. For example, with an aim to enhance participation of nursing staff in the training and development activity as organized by hospital driving force could be an opportunity to get promoted or enhancement in the salary. In a similar way, this model states about the forces which could restrict employees from accepting the change (Jego, Abcaya, ?tefan and Gentile, 2018). By taking action towards these restricting forces the assessed change can be managed. However, it has been critically evaluated that this model only state about driving and restricting forces but it does not give an explanation about a way to manage these forces. This is the major limitation which is associated with the respective model.
CONCLUSION
From the above report, it can be concluded that it is the responsibility of healthcare firms that regularly deals with the critical condition of patients that it should take utmost care about the quality of services which they are offering to their buyers. This is because if this will not be done then the firm could lose the trust of its patients. Furthermore, the given thing will also cause direct impact on the brand image of healthcare firm. As a result of its sales and profitability, related condition of the enterprise will be impacted in a negative way.
In addition to this, fishbone model is one of a most effective tool for the healthcare industry. This is due to the fact that by using this approach hospitals can examine varied causes which are negatively affecting the quality of their services. By taking significant action towards the same the incidents related to sentinel could be reduced. In addition to this, the principle of clinical governance also plays a very significant role in the process of dealing with the problems which are affecting enterprises. Finally, with the use of change management model like Lewin’s Force analysis model, change with respect to clinical governance can be bought. This will lead to cause a positive effect on the quality of healthcare services.
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Books, Journals and online
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