Components of Quality Improvement Collaboratives †Assignmenthelp

Question: Discuss about the Components of Quality Improvement Collaboratives. Answer: Introduction: For health care organizations in Australia, fulfilling the vision of safe and high quality of care for all Australians is important as per the Australian Safety and Quality Framework for Health care. The quality aspects in health care can be defined by having an optimal balance between framework of norms and the key care component for each patient. The quality of the health care system is also dependent on the performance of health care professionals, engagement of patients and the contribution of the whole health care system. A study also supported the fact that information related to causal association between organizational structure, process of care and outcome of care is necessary to determine whether optimally effective care is provided in health care setting or not(Donabedian, (1988)). Hence, the assessment of quality is dependent on presence of specific structural attributes, process attributes and outcome attributes for safety. This essay further highlights the assessment pr ocess for quality in health care by explaining about the core aim of health care institutions and identifying process and data outcome related to quality and safety in health care. More clarity regarding the process is also provided by means of giving an example regarding a clinical care activity in which process and outcome data were collected to evaluate the quality of care. The core business of health care organization is to provide all kinds of advanced, fully developed emergency, and special department for addressing the health issues of patients. The main goal behind developing specialized health care department is to deliver appropriate health care service to those people in greatest need. A major focus is on improving health outcome of patients because this is reflective of a high quality and safe care in health care setting. To achieve the objective of high quality care and patient safety, the health care organizations focus on the elements of safe and effective care, patient-centeredness, timeliness, efficiency and equitability(The Six Domains of Health Care Quality | Agency for Healthcare Research Quality., 2017).Health care organization mainly aims to address the above mentioned components within the organization to maintain the quality of care. The health care perspective and aim regarding quality improvement is also to improve access to quality health care and service. This is done by strengthening the capacity of the health care staff, improving the efficacy of the health care system, increasing the enrollment in health care insurance. Health care managers divide the functions in the health care organization into risk management and quality(Nadeem, et al., (2013)). Hence, all organizational process and structure is framed around patient safety and efficiency of the health care system. Another researcher has also emphasize that in health care organizations, human factor system approach is critical for health care quality and patient safety(Rodriguez, et al., 2014). This means redesigning the whole health care system and processes to maintain quality of care. This is based on having the knowledge of the system and the impact of any complexity on patient care. On this basis, effective patient safe culture is established in h ealth care organizations and risk control measures are established. Apart from organizational structure and work process, the nurses also have a contribution to safety of patient as they are the one who spend maximum time with patients. The main role of the nursing sector in health care organization is to follow all the standards of practice related to engaging in therapeutic relationship with patient, collaborating with other professionals, maintaining the skills needed for practices, conducting high quality assessment, providing safe and responsive care and evaluating outcome to inform nursing practice(Birks, et al., 2016). Based on these professional standards, the nursing sector acts as the source to maximize well-being of patients and enhance the quality of care. They act as the gatekeeper of patient safety as they spend more time with patients. Another researcher also argues that nurses are an important component of the health care system and maintaining their ratio is crucial to safety-focused outcome(Needleman, 2009). Some of the critical tas k that is carried by nurse includes engaging in routine assessment and monitoring of patients, coordinating with other providers and educating patients and family members post discharge. Developing the nursing staff in health care setting is important not just to improve quality, but also to maintain cost too. This can be said because increasing staffing level reduces the risk of complications and length of stay at hospital. This consequently reduced the cost of the health care system too. Donabedian, (1988) presented a clear association between the process data and outcome data in relation to quality and safety. During the preliminary quality assessment process in health care organization, the process data gives information regarding the system or procedure present in an organization for receiving and delivering care. It involves both patient related activities such as their engagement or approach adapted whole seeking care and health care staff related activities such as diagnosis of illness and implementing interventions. Level and type of safety related measures present in a organization also gives information regarding process data for health care organizations. To collect the process related data to measure safety initiative in organization, health care managers can inquire whether patient safety culture is present or not. If it is present, critical analysis needs to be done regarding the reliability of the present system for safer care and the approach needed to further increase the quality of care(Latif, A., Holzmueller, Pronovost, J., 2014). Another approach to collecting process data for health care quality and safety includes quality measurements. In this process, the data related to clinical procedure is collected to evaluate the effectiveness of specific organizational protocols and performance of health care providers against quality indicators. This form of quality measurements can be done by various ways such as evaluating the characteristics of a care setting, patient related health outcomes and the process or service present to provide care. The process data is useful to compare and analyse whether the current health care procedure in health care organization is consistent with routine clinical care or not(Measuring Health Care Quality: An Overview of Quality Measures. , 2017). Hence, the data related to process measures mainly aims to evaluate whether the procedure in clinical setting is consistent with established standards of care or not. Having well-defined process measures ensure that recommended care is pr ovided and professional standard of care is maintained. Despite the benefit of process data on identifying areas of improvement and disease management in health care organization, collecting these data is very challenging. This is because certain process data in specialized area of care is not available. Majority of process data focus on preventive care procedure and this ignores data related to teamwork and organizational culture, which is also an indicator for quality of care in health care organizations(Moore, et al., 2015). Hence, in future, it is recommended to collect process data in the area of care coordination and technology too as this also influences the quality of care. As stated by Donabedian, (1988), data related to quality of care in health care organization is categorized into the structure, process and outcome. The outcome data is the information related to effects of care or particular services on the health status of individual patient or patient group. Some example of outcome data may include degree of patient satisfaction level after care, improvement in health status and changes in behavior after intervention. Therefore, the purpose of outcome measures in health care organization is to look at the effects of care on patients health, functioning, behavior and health status. Outcome measures are most important for patients and the data is often collected by patient-reported surveys or observation report. It may involves data related to remission rate, number of hospitalizations needed after care and quality of life related outcome of patient after care. Collecting appropriate and well-defined outcome measures is also limited because identify meaningful outcome measures related to a service may be difficult. Secondly, obtaining detailed information and evaluating them is a time consuming process and many enough data cannot be found. There are also chances of biasness in such data because of the effects of social determinants of health on health outcomes of specific patient. The background and difference in patient population groups cannot give true information regarding quality improvement in health information of patient(Price, et al., 2014). However, the data is useful in assessment of quality care in health care setting. Nowadays, great attention is pa id to performance improvement and outcome monitoring as both helps to track the quality and efficiency of care. Process and health care outcome data can be collected for the clinical activity of fall prevention in health care organization. Preventing falls in vulnerable patients is considered important for health care organizations because fall or injuries is associated with traumatic injuries, increase in hospital stay and increase in health care cost too. The clinical care activity related to fall prevention is in relevance with improving the quality and safety of patients during hospital stay. As patients come with conflicting health issues, it is important to maintain physical and mental functioning in an individual(Ganz, A., Shekelle, G., 2013). This is done by fall prevention activities like managing the fall risk factor of patients and optimizing nursing care and hospital environment to maintain the safety of patients. However, the clinical priority of engaging in effective fall prevention activities is difficult for nurses and other staffs because this needs to be balanced with many o ther considerations such as providing the best possible care to patient and maintaining the mobility of patients. Secondly, the success of fall preventing activities in health care setting is also dependent on interdisciplinary approach to care(El-Bendary, et al., 2013). During a nursing care placement, a hospital was found to have high rate of falls and injuries after admission. To evaluate the performances of hospital in fall prevention activities and reasons for deteriorating in quality and patient safety outcomes, process data and outcome data related to the fall prevention and management in the hospital was collected. The main aim of collecting process data was to identify the current protocol for fall management and how interprofessional health care team coordinated with each other to prevent falls. Therefore, main purpose of collecting process data was to identify the system level improvement in fall prevention activities to prevent falls. One of the initial areas of focus during the collection of process data was to evaluate organizations readiness for fall prevention activities. This was collected by means of survey tools which focused on getting the following information of the health care organization: Do all members and health care provides understand the need to prevent patient related injuries or falls in hospitals? Do health care leader support the fall prevention initiative? Are all resource and protocol related to fall management established in the organization Is the need for compliance with the fall prevention activities communicated all health care staffs? The informations or data collected for the above questions can give great detail regarding the commitment of the organization to prevent fall and manage fall risk in patients. Another approach that was useful in assessing the quality of care was the use of hospital survey method to evaluate the culture of safety present in the hospital. Collecting data in this area is also important for assessment of quality and safety because safety culture and fall prevention are found to be interlinked to each other(Hempel, et al., 2013). Presence of safety culture is an indicator of positive attitude towards change. In a safety culture, the interprofessional teams are bound to follow all systematic activities to prevent falls. This may includes assessment of patient after intervention, controlling the fall risk factor, educating patients about preventing falls and modifying the environment around patient to prevent falls(Wang, et al., 2014). Hence, data related to safety culture can determine the organizations preparedness or lack of preparedness regarding the fall prevention activities. Apart from collecting the process data to identify strength and limitations in assessment and management of fall, outcome data related to falls were also collected. This was done to get a clear picture regarding the process present for fall prevention as well as the effect of the activity of patients outcome. Such method of data collected will eventually expose the human or organizational factors that impedes standards fall prevention activities and lead to formulation of plan to improves the current process of fall prevention and management too(Neily, et al., 2007). Therefore, the data related to the outcomes of fall prevention activity was collected by surveying patients and analyzing the incident to determine the cause of injuries in patients. The key data elements that can be collected from surveys included fall rates in hospitals, types of falls reported, severity of falls and impact of fall on quality of care and daily life activities. The incident reports can be specifically designed to inquire about the time, location and type of falls in particular patient. On the basis of categorization of anticipated falls or unanticipated falls, it can be easily judged whether the nursing staffs or other inter-disciplinary team took the right approach to respond to anticipated risk of falls(Quigley, et al., 2017). Hence, the outcome date related to fall prevention activities can give idea about the overall pattersn and trends related to fall occurrence in hospital setting. Hence, by means of surveys with nurses, health care providers and evaluating incident reports related to fall in hospitals, both outcomes measure and process measures for preventing and managing falls can be evaluated. This data can be eventually used to promote quality and safety by addressing the organizational factors or process related to fall prevention and changing the attitude of staffs towards fall prevention too. One research study gave an idea about the successful patient safety programs where root cause analysis helped to identify the factor of communication problem leading to fall and injuries in hospital(Miake-Lye, et al., 2013). This limitation of lack of communication and inter-professional collaboration for managing fall of patient was addressed by setting three strategic objectives. This included implementing tracking system to identify patients at high risk of fall and communicate to all health care staffs regarding the changes needed in plan of care. Secondly, stri ngent system was set in place to timely report about falls rates and injuries on the basis of severity. A reporting and signage program was also implemented to systematically communicate about patients who are at risk of fall(Quigley, et al., Measuring fall program outcomes., 2007). Hence, the data collected process related to process and outcome measures finally promotes changes in the right area which enhance the quality of care and safety of patients too. The essay summarized the need to provide high quality health care to patients and assessment regarding the quality of care in health care organization was proposed by collecting data related to structure, process and outcomes measures for health organization. This process of quality assessment is considered critical for quality improvement and driving the positive change process in health care organization. The essay gave a discussion regarding how process and outcome data related to a clinical activity can be collected and how this process can inform about the inefficiency present in the system, structure or health care staffs or patient. The whole process was made clear by giving example regarding the quality assessment and data collecting process for evaluation of fall prevention activities in health care organization. Bibliography Birks, M., Davis, J., Smithson, J., Cant, ., R. (2016). Registered nurse scope of practice in Australia: an integrative review of the literature. Contemporary nurse,, 52(5), 522-543. Donabedian, A. ( (1988)). The quality of care: how can it be assessed? Jama,260(12), 1743-1748. El-Bendary, N., Tan, Q., Pivot, C., F., . . . A. (2013). FALL DETECTION AND PREVENTION FOR THE ELDERLY: A REVIEW OF TRENDS AND CHALLENGES. International Journal on Smart Sensing Intelligent Systems, 6(3). Ganz, A., D., Shekelle, ., G., P. (2013). Inpatient Fall Prevention Programs as a Patient Safety StrategyA Systematic Review.. Annals of internal medicine, 58(5_Part_2), 390-396. Hempel, S., Newberry, S., Wang, Z., Booth, . . . ., D. A. (2013). Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness. Journal of the American Geriatrics Society, 61(4), 483-494. Latif, A., Holzmueller, C. G., Pronovost, ., J., P. (2014). Evaluating safety initiatives in Healthcare. Current anesthesiology reports, 4(2), 100-106. Measuring Health Care Quality: An Overview of Quality Measures. . (2017, August 28). Retrieved from https://Measuring Health Care Quality: An Overview of Quality Measures Miake-Lye, I. M., H., S., Ganz, A., D., Shekelle, ., G., P. (2013). npatient Fall Prevention Programs as a Patient Safety StrategyA Systematic Review. Annals of internal medicine, 58(5_Part_2), 390-396. Moore, F., G., Audrey, S., Barker, M., . . . Bonell, C. H. (2015). Process evaluation of complex interventions: Medical Research Council guidance. bmj, 350, h1258. Nadeem, E., Olin, S., S., Hill., C., L., Hoagwood, . . . M., S. ((2013)). Understanding the components of quality improvement collaboratives: a systematic literature review. The Milbank Quarterly,, 91(2), 354-394. Needleman, J. . (2009). The role of nurses in improving hospital quality and efficiency: real-world results. Health Affairs, w625-w633. Neily, J., N., R., Watson, M., N., M. S., BSN, M. W., C., R. N., . . . N., M. S. (2007). MEASURING FALL PROGRAM OUTCOMES. Online Journal of Issues in Nursing, 12(2). Price, A., R., Elliott, N., M., Zaslavsky, M., A., . . . D., P. (2014). Examining the role of patient experience surveys in measuring health care quality. Medical Care Research and Review, 71(5), 522-554. Quigley, P., Neily, J., Watson, M., . . . K. (2007). Measuring fall program outcomes. Online journal of issues in nursing,, 12(2), 1-17. Rodriguez, A. J., Hundt, S., A., Hoonakker, P., Holden, R., . . . P., A. (2014). Human factors systems approach to healthcare quality and patient safety. Applied ergonomics, 45(1), 14-25. The Six Domains of Health Care Quality | Agency for Healthcare Research Quality. (2017, August 28 ). Retrieved from Ahrq.gov. : https://www.ahrq.gov/professionals/quality-patient-safety/talkingquality/create/sixdomains.html Wang, X., Liu, K., You, M., L., . . . W., X. (2014). The relationship between patient safety culture and adverse events: A questionnaire survey. International journal of nursing studies,, 51(8), 1114-1122.