Improving the Quality of Healthcare

 

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IMPROVING QUALITY OF HEALTHCARE 

 EXECUTIVE SUMMARY

In this essay, discussion is being carried out on the problem of hospital that is related to staff retention. It is assessed that nursing staff are leaving firm because they are not satisfied with the working condition. However, fishbone analysis is used with an aim to assess the causes behind the problem. In addition to this, with the help of force field analysis different factors examined that are resisting towards the change. Further, here risk management and complaint management clinical governance strategy are used with an aim to deal with the staff retention problem of hospital. Audit is carried out in order to track the activities of hospital in relation to change.  

Table of Contents

INTRODUCTION....................................................................................................................................................................................................................................1
ISHIKAWA’S FISHBONE.......................................................................................................................................................................................................................2
Explaining Ishikawa’s Fishbone..............................................................................................................................................................................................................2
Strength of Ishikawa’s fishbone...............................................................................................................................................................................................................2
Weaknesses of Ishikawa’s fishbone........................................................................................................................................................................................................2
CAUSE ANALYSIS USING ISHIKAWA’S FISHBONE...............................................................................................................................................................................3
APPLICATION OF LEWIN’S FORCE FIELD ANALYSIS FOR CHANGE IN PRACTICE................................................................................................................................4
CLINICAL GOVERNANCE STRATEGIES................................................................................................................................................................................................6
Strategy 1: Complaint management........................................................................................................................................................................................................6
Strategy 2: Risk management................................................................................................................................................................................................................6
IMPORTANCE OF SMART STANDARDS................................................................................................................................................................................................7
The standard for Strategy 1....................................................................................................................................................................................................................8
The standard for Strategy 2....................................................................................................................................................................................................................8
AUDIT .................................................................................................................................................................................................................................................8
CONCLUSION......................................................................................................................................................................................................................................9
REFERENCE......................................................................................................................................................................................................................................10

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INTRODUCTION

The main aim of the given essay is to gather the detail about the issue which is being faced by the hospital. For this essay, the author has selected third that is related to staff retention. Herein, it is assessed that there is a huge number of nursing staff is leaving the hospital. This is because they are not happy with the working condition of the hospital. Due to this issue, the firm is facing the problem of shortages of nursing staff (Alhatmi, 2010). 
Clinical governance is being regarded as the type of systematic approach that assists in maintaining as well as improving the quality of care given by healthcare firm to patients. In other words, it can also be said that clinical governance is the framework that direct firm for making a continuous effort on the process of improving the quality of hospital services. Clinical governance is important because it provides direction to the firm in the task of enhancing the overall quality of healthcare services. 
Clinical governance is associated with total quality management principle. Herein, it helps in giving description of the principles and approaches that need to be used by a healthcare firm with an aim to maintain the hospital service quality standard. 
Clinical governance is also related to the 2018-2019 HA annual plans. The given plan gives values to the person-centered approach, developing the team of competent staff and enhancing financial sustainability. However, with the help of clinical governance these all values can be fulfilled (Latino, 2015). This is because here it makes sure that proper principles should be framed that should fulfill the given values. It is through this way only high quality from the side of healthcare firm can be assured. 
This essay will showcase the causes behind the selecting scenario with the help of the fishbone analysis model. This essay will also depict about clinical governance strategies which will be used with an aim to take action towards the identified cause in an effectual way. Here, the essay will also depict the importance of using the SMART standard. Finally, the conclusion will be drawn.

ISHIKAWA’S FISHBONE

Explaining Ishikawa’s Fishbone 
Ishikawa’s fishbone is called by many names such as cause and effect diagram, herringbone diagram and fishbone diagram. The given diagram is evolved by Kaoru Ishikawa. This diagram aims to showcase the cause which exists behind the occurrence of a specific event. On the other hand, it can also be said that the given diagram can also be considered as a quality control tool. This is due to the reason that by using this tool, healthcare firm can get an idea about the factors which is leading it to the specific problem (Kilbourne and et.al., 2018). Hence, by making proper quality standard in relation to the same, the problem of healthcare firm can be improved. Further, this will also give the opportunity to the healthcare enterprise with respect to deliver high-quality services to its patients in an effectual way.
 
Strength of Ishikawa’s fishbone  
The tool is visual and thus it can be easily understood by any individual who is planning to incorporate the same in the process of assessing the root cause behind the firm’s problem. In addition to this, Ishikawa fishbone model also has strength in the form of seeing all the causes simultaneously at one specific place. For the individual, it is very effective that it is able to see all the reasons behind the occurrence of firm’s problem in one place. This is due to the reason that it is through this way only, an individual can gather an idea that in which specific problem it should work at first. Additionally, it also gives an opportunity to the evaluator with respect to perform the in-depth analysis of the assessed causes. It is through this way only healthcare firm can get a proper idea in relation to the problem. 

Weaknesses of Ishikawa’s fishbone
Apart from the identified strengths, there are some weaknesses also that are associated with the Ishikawa fishbone model. Herein, it can be depicted that the model has a weakness that the causes that it identifies are based on the opinion of people instead of some evidence. Thus, the given thing raises the chances that the assessed cause for the problem could be wrong. This could hamper the quality control process of the healthcare firm as well. Further, in this model, it will become very difficult for the individual to perform the proper sorting of the assessed cause behind the problem. This is due to the reason that there is some problem which does not have a major role in the firm’s problem (Hignett and et.al., 2018). If the firm will invest their time in such issue then there are chances that it might be ignoring some important cause for the problem.

CAUSE ANALYSIS USING ISHIKAWA’S FISHBONE

In the last twelve month, hospital unit has lost a huge number of nursing staff. Due to this, the firm is facing the issue of nursing staff shortage. However, from the analysis, it is assessed that people are not happy with the working condition of the hospital. Thus, retaining staff in healthcare firm is being regarded as the main problem. With an aim to assess the causes behind this issue, assistance is being taken from Ishikawa fishbone model. 

It can be summarized that in relation to the problem of staff retention the major cause could be related to the environment and people. Herein, it can be said that employees of the firm will feel unhappy at their work when they are not getting recognition for the work which is being done by them. In this context, it can be said that getting recognition is a matter of motivation for many employees. Thus, if they will not get the same then in this situation they will make a decision to leave the firm. On the other hand, high work pressure can also be regarded as another reason due to which employees are leaving the healthcare firm. Such type of situation will lead to a stressful situation. Thus, each and every employee tries to avoid working in such a situation. In addition to this, people always need some kind of support in relation to their work from senior staff (Rosen and et.al., 2018). If they will not get the same then in this situation their motivation will be impacted in a negative way. Due to this, they will take the decision to leave the firm.

APPLICATION OF LEWIN’S FORCE FIELD ANALYSIS FOR CHANGE IN PRACTICE


 
Figure 1 Lewin’s force field analysis
(Source: Delaney, 2018)
Lewin’s force field analysis is the model that motivates the employees of the firm to accept the change. The given model basically gives description about different driving as well as resisting factors that have an influence on any kind of change related decision which is being taken by the firm. The main benefit of a given model is that it tends to provide a visual summary of all the factors that have an impact on the change. Thus, in this way, it will become quite easier for the healthcare corporation with respect to taking significant actions in order to deal with various factors. It also gives the opportunity to the group with regard to developing a common understanding in relation to the subject. However, it is to be critically evaluated that this model works best when each and every individual of firm participates in the factor analysis process. This is because it is through this way only better understanding in relation to the aspect that is influencing the change can be gathered in an effectual way. On the other hand, the given model has a bad influence on the team of the firm. This is due to the reason that it divides the team into two groups. Here, one group will support changes and others will resist the change (American Diabetes Association, 2018). 
In this regard, it can be said that with an aim to resolve the issue of staff retention, the organization could bring changes in its working practices. For example, a present firm is not recognizing the work of employees. Thus, with an aim to resolve the same firm will introduce some incentive policy which will help in raising the motivation of employees. Thus, in relation to the given type of change, there are some driving and resisting factors of change examined. The driving factor of change will be high productivity from the side of employees, high employee retention and it will help in raising the motivation of employees.
Besides this, resisting factors of change are high cost and time-consuming process. Overall, it can be said that these are some two basic factors that are in favor and in non favor of the problem that is being identified in the fishbone analysis model. Here, by putting a major focus on driving factors change can be brought within the firm in an effectual way (Meesala & Paul, 2018).  

CLINICAL GOVERNANCE STRATEGIES

There are two different clinical governance strategies examined that will help in the task of reducing key causes and resisters that are related to the staff retention problem of the hospital. The details about both selected strategies are given below:

Strategy 1: Complaint management
From the conducted fishbone analysis, it is identified that hospital environment or the working condition is being regarded as the main cause due to which firm is not able to retain people in its firm for the longer period of time in an effectual manner. However, it is examined that the factors like poor communication, lack of work recognition and high work pressure are major factors due to which the problem of a huge number of nursing staff leaving the hospital is occurring. But, this issue can be resolved with the help of compliant management strategy. In this approach, efforts are being made by the hospital management in terms of recording all the complaints which are being given by employees (Ferris and et.al., 2018). For example, some employees have given a complaint that they are not able to directly communicate with the senior member of the hospital. Similarly, through this approach only, the hospital can also get an idea about the aspect that why the nursing staff is feeling pressure at their work. Hence, by taking necessary actions with an aim to resolve the same, the firm can maintain the satisfaction level of its employees. This will also lead to resolving the issue of staff retention in an effectual way.   

Strategy 2: Risk management 
For example, in the task of implementing an incentive system in the hospital, there are various resisting factors identified that are creating hurdle in the implementation of the same. These are the high cost and time-consuming process. Thus, hospital management is putting these reasons forward and avoiding the implementation of an incentive system which will help in recognizing the work of employees (Burns & Pauly, 2018). However, their resistance towards the change can be managed with the help of a risk management approach. The main purpose of the risk management technique is to assess different risks that are related to a specific decision. Here, hospital management can be influenced through the risk that cited firm could face if it will not take timely action in relation to the staff retention in hospital. Here, risk can be in the form of low profit and lack of satisfaction among patients due to shortages of nursing staff (Teno and et.al., 2018). Here, by using the given approach the resistance from the side of hospital management can be reduced. In addition to this, the given thing will also help in the process of improving the condition of the hospital. This will also have a positive impact on the overall services which is being given by the hospital. Herein, it has been seen that the success of any firm depends on its employees. Thus, if employees feel demotivated then in this situation they will not be able to deliver their best services to patients.  

 IMPORTANCE OF SMART STANDARDS

There is a significance of the SMART standard for a hospital setting. In accordance with the given context, it can be depicted that SMART refers as specific, measurable, attainable, realistic and time-bound. SMART standards help in the process of providing specific direction to the firm. This is because it clears the path or the goal that the firm wants to accomplish during the specified period of time. Thus, if some goal is there with the time boundation then in this situation an individual will feel highly enthusiastic with an aim to accomplish the same (Protzman, Mayzell & Kerpchar, 2018).
 On the other hand, with the help of SMART standard hospital can clearly state its purpose to the respective stakeholders. The given thing will help in the task of maintaining the satisfaction of the stakeholders of the company. Herein, it is also assessed that stakeholders like customers and employees will feel highly satisfied when they knew about the activities of the firm (Irvine & Irvine, 2018). This is because any kind of action which is being taken by the enterprise will have a direct impact on these people. Hence, with the help of SMART standard, the hospital can communicate its stakeholders. On the other hand, it can also be said that by using SMART standard hospital can also communicate about the things which is very much important for it. Thus, it is very correct to say that there is an importance of the SMART standard for the firm in an effectual way. In this regard, for both assessed clinical governance strategies following SMART standards are set (Werneburg and et.al., 2018). 

The standard for Strategy 1
To reduce the nursing staff turnover ratio by 30% within 3-month tenure with the help of complaint management tactic 

The standard for Strategy 2
To introduce change in the firm within 2 months by using risk management tactic
It can be said that these both standards are very much different from each other. Here, the firm first SMART standard puts a major focus on the causes that are being assessed from the fishbone analysis model. However, the second standard focuses on the way to reduce the resistance of employees in relation to the change that the firm is planning to bring. Hence, by working as per these both given standards the goals and objectives of the firm can be met. This will also assist in the process of eliminating the problem of the hospital within a specific time (Melnyk and et.al., 2018).  

AUDIT

The main aim to carry out audit is to assess whether the firm is going as per the set plans or not. The audit helps in making a comparison between the actual and standard result (Wang and et.al., 2018). Thus, it is through this way the only the manager of the hospital can get the idea that whether it is going on in the right direction or not. In this context, it can also be stated that audit is being regarded as the third clinical governance strategy that will be used with an aim to resolve the staff retention problem which is being faced by the hospital. 
With an aim to perform the monitoring of effective change, assistance can be taken from the method like the audit cycle. The audit cycle possesses five major steps. The very first step is of assessing the problem or the issue which is being faced by the firm. As per the given scenario, staff retention is the problem of the hospital. However, in the second step management of the hospital will set the standard or the criteria. In this regard, the criteria could be able to retain staff in people by implementing the incentive plans and making a strategy for the purpose to reduce work pressure among employees. In addition to this, in the third phase, data will be collected by the management of the hospital (Bombard and et.al., 2018). On the other hand, after collecting the data comparison will be carried out between the actual and standard performance of the firm in relation to change. Thus, it is through this way only management of hospital can get the idea that whether it had successfully implemented the change in firm or not. Here, if any kind of deviation will be found then necessary actions will be taken with an aim to resolve the same in an effectual way. Overall, it can be depicted that by performing an audit an idea can be taken that the strategy implemented by the firm has worked well or not. It is through this way only significant action can be taken by hospital management with an aim to implement that change that will resolve its problem of staff retention. This will have a positive impact on the overall performance of the hospital. It will also influence the profit of the hospital in a positive way (Elhoseny and et.al., 2018). 

CONCLUSION    

It can be concluded from the conducted analysis that staff retention is the main problem which is being faced by the Hospital. However, from the fishbone analysis, it is assessed that main causes for the given problem are high work pressure, not a supportive staff, poor communication and not getting support from the staff, etc. There are some drivers and resisters also that are also influencing the change within the hospital. The resisters are high cost and time-consuming process. These both given factors could influence the firm with respect to implement the change within the firm in an effectual way. 
However, with an aim to resolve the given issue assistance is being taken from clinical governance strategies such as compliant management and risk management. By using these both causes and factors that are related to the firm’s problem can be managed. On the other hand, with the help of audit hospital can assess whether it is going on to the correct path or not in terms of strategy application.     

REFERENCE

Alhatmi, Y.S. (2010). Quality audit experience for excellence in healthcare. Clinical Governance: An International Journal, 15(2), pp.113-127.
American Diabetes Association. (2018). 1. Improving care and promoting health in populations: standards of medical care in diabetes—2018. Diabetes Care, 41(Supplement 1), S7-S12.
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., ... & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science, 13(1), 98.
Burns, L. R., & Pauly, M. V. (2018). Transformation of the health care industry: curb your enthusiasm?. The Milbank Quarterly, 96(1), 57-109.
Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia. Collegian, 25(1), 119-123.
Elhoseny, M., Ramírez-González, G., Abu-Elnasr, O. M., Shawkat, S. A., Arunkumar, N., & Farouk, A. (2018). Secure medical data transmission model for IoT-based healthcare systems. IEEE Access, 6, 20596-20608.
Ferris, R., Blaum, C., Kiwak, E., Austin, J., Esterson, J., Harkless, G., ... & Tinetti, M. E. (2018). Perspectives of patients, clinicians, and health system leaders on changes needed to improve the health care and outcomes of older adults with multiple chronic conditions. Journal of aging and health, 30(5), 778-799.
Hignett, S., Lang, A., Pickup, L., Ives, C., Fray, M., McKeown, C., ... & Bowie, P. (2018). More holes than cheese. What prevents the delivery of effective, high quality and safe health care in England?. Ergonomics, 61(1), 5-14.
Irvine, D., & Irvine, S. (2018). The Practice of Quality: Changing General Practice. CRC Press.
Kilbourne, A. M., Beck, K., Spaeth?Rublee, B., Ramanuj, P., O'Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018). Measuring and improving the quality of mental health care: a global perspective. World Psychiatry, 17(1), 30-38.
Latino, R.J. (2015). How is the effectiveness of root cause analysis measured in healthcare?. Journal of Healthcare Risk Management, 35(2), pp.21-30.
Meesala, A., & Paul, J. (2018). Service quality, consumer satisfaction and loyalty in hospitals: Thinking for the future. Journal of Retailing and Consumer Services, 40, 261-269.
Melnyk, B. M., Gallagher?Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2018). The first US study on nurses’ evidence?based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence?Based Nursing, 15(1), 16-25.
Protzman, C., Mayzell, G., & Kerpchar, J. (2018). Leveraging lean in healthcare: Transforming your enterprise into a high quality patient care delivery system. Productivity Press.
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433.
Teno, J. M., Gozalo, P., Trivedi, A. N., Bunker, J., Lima, J., Ogarek, J., & Mor, V. (2018). Site of death, place of care, and health care transitions among US Medicare beneficiaries, 2000-2015. Jama, 320(3), 264-271.
Wang, Y., Kung, L., Wang, W. Y. C., & Cegielski, C. G. (2018). An integrated big data analytics-enabled transformation model: Application to health care. Information & Management, 55(1), 64-79.
Werneburg, B. L., Jenkins, S. M., Friend, J. L., Berkland, B. E., Clark, M. M., Rosedahl, J. K., ... & Sood, A. (2018). Improving resiliency in healthcare employees. American journal of health behavior, 42(1), 39-50.
Stephens, T. J., Peden, C. J., Pearse, R. M., Shaw, S. E., Abbott, T. E. F., Jones, E., ... & Martin, G. (2018). Improving care at scale: process evaluation of a multi-component quality improvement intervention to reduce mortality after emergency abdominal surgery (EPOCH trial). Implementation Science, 13(1), 142.
Wachman, E. M., Grossman, M., Schiff, D. M., Philipp, B. L., Minear, S., Hutton, E., ... & Alvarez, C. (2018). Quality improvement initiative to improve inpatient outcomes for neonatal abstinence syndrome. Journal of Perinatology, 38(8), 1114.
Chartier, L. B., Cheng, A. H., Stang, A. S., & Vaillancourt, S. (2018). Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department. Canadian Journal of Emergency Medicine, 20(1), 104-111.
Cardoso, L., Marins, F., Quintas, C., Portela, F., Santos, M., Abelha, A., & Machado, J. (2018). Interoperability in healthcare. In Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications (pp. 689-714). IGI Global.

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