Managing Quality In Health And Social Care

Introduction Quality healthcare has in the recent past attracted a lot of emphasis from key policy makers, servicer users, health care professionals and other healthcare stakeholders. However, achieving quality health care is easier said than done as demonstrated by inspection report s On RUH bath hospital as produced By CQG. This paper present well research details on how to manage quality services in health and social care services. This paper is divided into four sections. The first section evaluates the perspective different stakeholder has on quality healthcare. Section two, evaluates strategies for achieving quality healthcare. Section three, evaluates systems, policies and procedure used to achieve quality healthcare while the last section, evaluates method of measuring quality as used in health care setting 1.1 Explain perspectives that stakeholders in health and social care have regarding quality Quality healthcare has been the primary focus of our health and social care system, particularly in recent times. However, what does quality healthcare truly mean? An analysis of the literature reveals that different healthcare stakeholders hold different perceptions regarding quality healthcare. Based on the analyzed literature, three levels of perception exist regarding quality care. The first level is held by healthcare management, administration, and politicians. The second level is held by physicians and healthcare professionals in general. The final level is held by patients and service users. Service users have a distinct perception of quality healthcare that differs from that of healthcare professionals. Additionally, the perception of healthcare professionals differs from that of management and policy makers. According to Sigh et al. (1999), service users' perception of quality healthcare is based on the delivery process and outcomes. They define quality healthcare services based on how staff members handle them, communicate with patients, provide care, and the resulting outcomes. Healthcare professionals perceive quality in healthcare based on investments in terms of equipment and the outcomes achieved (Stichler and Weiss, 2000). On the other hand, healthcare administrations and politicians view quality in terms of efficiency and effective resource utilization. As noted by Stichler and Weiss (2000), these differing perceptions are influenced by the roles and responsibilities played by different stakeholders. For example, management and policy makers are more concerned with resource distribution, which explains why they perceive quality in terms of efficiency and effectiveness of facilities. Although all these perceptions are crucial in the management of healthcare quality, the one held by service users is particularly important in achieving patient-centered services (Stichler and Weiss, 2000), which has been the focus of our healthcare system. The existence of different perceptions regarding quality healthcare necessitates stakeholder analysis when designing health and social care services. Prior to introducing a healthcare project, an analysis and understanding of different stakeholders should be undertaken. 1.2 Analyze the role of external agencies in setting standard. In an effort to achieve quality healthcare services, standards are used. According to Barnes, et al, (1995), standard refers to the required level of services. They refer to basic requirement that must meet in the provision of healthcare services. Standards can be set by an individual’s care organization but there are a number of external agencies that set standards for healthcare sectors. These agencies include, Department of health, medicine and healthcare product regulatory agency (MHPRA), National institute of health and care excellences (NICE), and the health and social care information Centre (HSCIC). Department of health play a very important role in setting standard in health and social care. It works include setting national standards for NHS and professional in England. In order to ensure healthcare products used by servicer user are of the right quality and are safe for use, MHPRA was established. The aim of this agencies is to set quality and safety standard for health care products including medicines, equipment among others. National institute for health and care excellences is another agency responsible for setting standard in health care. NICE is an independent agency responsible for providing national guideline for promoting health and wellbeing. NICE major roles including developing evidence-based guideline, setting standards for high-quality care among others. Health and social care information Centre is also responsible for setting standard in healthcare sector. This agency not only provide reliable and exclusive information about health and social care sector but is also responsible for setting standards relating to management of data in the sector. Care quality commission (CQG) is another agency involved in standard in health care sector. Although its main role is not to set standard, it ensures that the national health and social care standards as set by government through various agencies are being met by hospitals, care home, ambulances, dentist and other specialist services. It does this by regular review such as one conduct in RUH bath trust hospital where several standards were found not to be Mets. For instance, the Commission found out that the hospital was not meeting the data management standards as set by HSCIC as well as other standard set by NICE (RCN 2015a) 1.3 Assess the impact of poor service quality on health and social care stakeholders. Poor health and social care services have a lot of impacts not only on servicer user and their relatives but also on care organization as well as the health care professional. Poor quality services mean the failure by care organizations in meeting health and social care standards. Poor health care services mean that the healthcare needs of patients are not meant. This contributes to low quality of life especially to individual living with long-term condition (Foot, Raleigh, Ross 2011). Equally, poor health care services not only result to deteriorating public health but also led to increased mortality rate in a given population (DH 2009). Organizations offering poor health quality services not only attract bad publicity but also risk being closed down by care quality commission for failing to meet the required standards. Poor health care services not only attract but publicity but also attracted severe consequences from the governments on the trusts. In RUH bath hospital, the failure by the hospital to meet national health care standards saw resulted to the hospital being served with warning from regulator (CQC 2014) Professional and care organizations found offering poor care services are also likely to face disciplinary action for regulator, governments or professional bodies. Equally, they can also be slapped with heavy fines if sue on various ground such as negligence among others. 2.1Explain the standards that exist in health and social care for measuring quality There are a number of standards that exists which are used as benchmark for quality health care services. They include health and social national occupation standard, the NHS performance framework, national minimum standards, standards of proficiency for social worker. Health and social National occupation standards outline the values, skills and knowledge that constitute best practices. These standards are used as the basis for qualifications, recruitments, defining Roles and are also used as benchmark for performance appraisal (RCN 2015a). The NHS outcome framework contains quality indicators that NHS Organization must met. The revised NHS outcomes framework for 2015-2016 contains a total of 68 indictors which are used to measures performance in health and social care. The aim of these indicators is to ensure all the NHS organizations are providing quality health and social care services at National level (DH 2015a). The national minimum standard sets out the basic standards that must be met by various health care organizations for them to be allowed to operate. These standards are designed to ensure care services provided is fit for the purpose and met the needs for health and social care users. These standards apply to care homes, domiciliary services, and adult placement scheme, nursing agencies and children's welfares (DH 2015b). Another standard applicable in health and social care services is the standards for proficiency of social care worker. These standards outline the standards that must be met by those aspiring to be professional social worker (Skill for care 2012). 2.2 Evaluate different approaches to implementing quality systems There are different approaches in which quality systems can be implemented in health care. These include reflective practices, benchmarking best practices, being mentored or coached, SWOT analysis among others. Reflective practices are a method which involves studying own experience with the sole aim improves on the way you work (Brightside 2015). In this method the care organization self-evaluate themselves to identify area which need improvement. The advantage of this method is that it helps organization to continuously identify and improve on their weakest area before damage is done. Reflective practices are well explained by the Gibb’s reflective cycle. According to Gibb’s reflective cycles, this method involves the following steps. • Describing what happened. • Evaluating one feeling about what happened • Evaluating the negatives as well as the positive of what happened • i.e., making sense of it • Drawing conclusion of what would have happened and • Finally developing action plan to ensure it happen the right way in the future. In simpler word, reflective practices involve evaluating how services were delivered in a given period of time. What went wrong and what went right and based on that evaluation, an action plan for improvement is developed and implemented. Another method of implementing quality system is by studying the best practices and using the as point of references when implementing own quality system. This method helps in eliminating trial and error method as quality system is design and implemented based on the beast practices (Patel n.d). However, if proper study is not well done, benchmarking may fail to achieve its objective since no two organizations are similar. What have worker for another organization may not work in another organization. SWOT analysis is also another method used to implement quality system. In this system, care organization conduct and internal as well as external analysis of their environment to identify, weakness and strength, opportunity as well as threats. Understanding these four components help in designing servicer that take leverage on their strength while at same time working on their weakness. Also anticipating threat before they happen, help care organizations take precautionary measure to ensure the quality of services offered remains intact (Adams 1998). 2.3 Analyze potential barriers to delivery of quality health and social care services There are several barriers faced by care organization in their quest to implement quality system min their system. According to Garvin (1988), implementations of quality system in care organization mean changes. Therefore, resistances to changes are one of the barriers which if not well address can result to failure in implementation of such system. Workers feel threaten when new system or process is being introduced in their organization as a result of this, they develop negative attitude toward the intended changes (Garvin 1988). it is therefore important to address the human side when implementing quality system to ensure the support of majority is gain for the quality system to work. Another barrier closely related to resistance to changes is organization culture. Some organizations cultures are so flexible and can easily adapt to any changes introduced, however, there are those culture that are so rigid such that they fight any attempts to introduces new system in their process. Such cultures can act as barrier to the implementation of quality system in care organizations. Another barrier that hinders implementation of quality system in care organization is insufficient resource. According to World health organization (2006), implementation of quality system required injection of more resources into the organizations process which may include human resources, additional capital among other. Lacks insufficient resources can therefore hinder effective implementation of quality system in care organizations. It is therefore important for care organizations to put in place necessary measure to ensure all the required resource for successful implementation of quality system are readily available or will be easily accessed when needed. As noted by WHO (2006), successful implementation of quality system also dependent on the ability and leadership willingness. lack so proper leadership ability or lack of leadership willingness and commitment can result to failure in implementation of quality system in care organizations, it is therefore important for leader to shows their willingness and commitments for quality health care services to be delivered. 3.1 Evaluate the effectiveness of systems, policies and procedures used in a health and social care setting in achieving quality in the service(s) offered. There are several systems, policies and procedure put in place to ensure quality health care is achieved in our health care system. They include clinical governance, ISO9000, total quality management (TQM) and organizational policies and procedures (RCN 2015b) Clinical governance is a system used to ensure NHS organizations are continuously improving on the quality of services they deliver to patients. . According to RCN (2015b), Clinical governances are system designed to ensure quality is maintained and continuously improved in NHS. Clinical governances are made up of three components which include clinical effectiveness, risk management and patient focus and public participations. The introduction of clinical governances in NHS has results to increased effectives in clinical process. According to RCN (2015b) Clinical governances has resulted to increased level of compliance with different standard including national minimum standard among other. Total quality management is another system used in health care setting to ensure quality healthcare. According to Patel (n.d) TQM refers to a system of quality management which requires all employees to commits to the process of improving quality in every process of care organization. The use of TQM in healthcare setting results to reduced rate or errors, timely services delivery and more importantly increased access to healthcare services due to reduced prices (Patel N.d) ISO 9000 is another system meant to ensure quality healthcare is achieved; ISO 9000 is an internationals standard whose aim is to ensures internal and external customer satisfaction and continuous improvement. ISO 9000 ensures that services delivered are. of quality standard and met customer needs. In health and social care setting ISO has ensured that NHS organizations are continuously improving on the quality of standard to always meet the diverse needs of services user. 3.2 Analyze other factors that influence the achievement of quality in the health and social care service There are a number of factors that influences the achievement of quality in health and social care setting. According to Lang and Shannon (1997), the perceptions and attitudes of employees as well as those of services user is very instrumental in achieving quality health care. Lang and Shannon argue that quality system involves following procedures and adhering to policies. If employees and services user are against the established quality procedures and policies, then quality healthcare can hardly be achieved. On the other hand, when the perception and attitudes is for the policies and procedures, it then becomes very easy to achieve quality healthcare (Lang and Shannon 1997) Health care practitioners also play a very important role in achieving quality health care. Their level of commitment to quality is very essential in achieving quality healthcare (Foot, et al 2014). As seen earlier, servicer user perspective of quality is based on process of services i.e., waiting times, how they are talked to, how they are treated etc. (Sign et al 1999). Since health care practitioners are the individual who comes into direct contents with the services user, they greatly influence the services delivery process. Their commitment to timely delivery of services, effectiveness of intervention, and professionalism in their work contributes to achievement of quality healthcare especially in the eye of servicer user. 3.3 Suggest ways in which the health and social care service could improve its quality Achieve quality healthcare has remain dream of many care organizations. Due to some barrier as well as challenges quality health care has not been fully achieved by many care organizations as demonstrated by Care quality commission report on RUH bath hospital. There are number of ways in which organizations such as RUH bath hospital can do to achieve quality healthcare. One of such factors is to automatic their process as much as possible. Automation of process saves time such as time taken to retrieve patient information, time taken to carry diagnosis etc. This not only helps care organizations to offers timely services but also go a long way in improving the relationship with servicer user. Automation has also result to increased level of clinical effectiveness (DH 2009) Staff training is also very essential in changing employees’ attitude, knowledge and skill to support changes aimed at improving quality. Employees should be trained on how to maintain and offer quality services to servicer user. Knowledge sharing can also help in improving quality in NHS. Care organizations should shares and enumerate best practices with their fellow care organizations. Additionally care organization should go beyond enumerating best practice of their fellow NHS organizations. They should also be on the look of best practices from all o9ver the world and us such practices as benchmarks. 4.1 Evaluate methods for evaluating health and social care service quality with regard to external and internal perspectives Measuring quality of healthcare is very important as it gives detail of how well the system is offering safer, effective and reliable services to patients (ACC 2015). There are several methods that are used to measure quality. One of such method is the use of the health care standards. In this method, the actual performances of organizations or of it worker is measured and compared to the established health care standard such as national minimum standard, code of conducts for employees among others. The use of this method forces care organizations to align their process and practice with the established standard. However, the use of this method ignores the opinion and views of other stakeholder such as services user, health professional, etc. has on the quality of services delivered (Barnes et al 1995). Quality of services can also be measured using servicer user feedbacks. Servicer user feedback can be collected using questionnaire, interview or any other techniques. Analysis of these feedbacks is then analyzed to understand the level of quality of services offered. The advantage of this method is that evaluation data is collected from the individual who uses the services, and it is therefore more reliable as compared to other method (ACC 2015). Another method of measuring quality is seeking the opinions and views of health care practitioners. The advantage of this method is that professional view is used to measures quality. Professionals are at better positions to give unbiased and professional opinions that organization can use to improve their service further (ACC 2015). The final, method of measuring quality is through the inspection reports. Care quality organizations do carry out regular inspections on care organization upon which they issue reports showing the quality of services offered by a particular organization. For instance, after conducting an inspection on RUH bath hospital, care organizations wrote a report which shown that quality of services offered the hospital. The reports were very important to RUH hospital as it help them identify and improve on their weakest points (CQG 2014). 4.2 Discuss the impact that involving users of services in the evaluation process has on service quality As noted by health foundation (2011) one of the key components of effective quality evaluation process is services user participation. Involves user in evaluations process has some benefits to the care organizations. One, servicer user are valuable sources of information that organizations need to improves on the quality of services. The opinion, view and idea given by servicer user are therefore valuable in designed user-centered services. According to Health foundation (2011) the success of any quality improvement program is judged on patients’ outcomes and feedbacks. It is therefore important to consult the service user. Their experiences are very essential as they provided basis for case for changes and also to plan for future improvement. Involving service user also help is also cost effective. Service user provides information at will without incurring extra cost. This help care organization collect quality and reliable information which is used to measure quality of service in their organizations. Conclusion Evidence presented in this essay have shown that quality healthcare is not a matter of chances. Achieving quality healthcare is a process that involves many activities including planning, implementing and measuring. In planning stages, there are a lot of considerations that must be taken into account including the external standards as set by government and other organization such ISO. In the implementation stages, a lot of thing needs to be done which include design a quality and implementing quality system as well as dealing with challenges that might hinder successful implementation. In the evaluation process, deciding on the best evaluation method is very important. Additionally, involving different stakeholders key among them servicer user is essential to effective evaluation