Quality Improvement Programs in Health Care Systems

Upholding quality is a primary goal in health care, the reason being that health care organizations fundamentally exist to offer care to ill people and help them to improve their well-being (World Health Organization, 2016). Much as healthcare institutions give their best to achieve this, they often encounter challenges, some of which are beyond their control. It is for this reason that organizations use appropriate frameworks and tools to assess and understand the health care environment so that they can design appropriate programs for improving quality. One such tool is the SWOT model.

The strengths, weaknesses, opportunities, and threats-SWOT-model is one of the commonly used tools of strategic planning in organizations. Generally, conducting a SWOT analysis helps organizations in identifying areas that need improvement (Fallon, 2013). In health care, SWOT analysis guides and informs the making of strategic choices focused on quality improvement. According to Fallon (2013, p.35), health organizations are required to prioritize issues so that resources are allocated in such a way that “the organization stays responsive to the patients and population it serves”.  This is important considering that health care organizations operate in a highly uncertain environment in which no direction is given and the organizations must determine the services to be delivered to different client groups, as well as how to secure the resources needed for this (van Wijngaarden, Scholten & van Wijk, 2012). The direct results of applying SWOT in quality improvement initiatives in health care include reduced mortality rates, minimizing medical errors, and improve patient experiences.

Total Quality Management vs. Continuous Quality Improvement

The TQM (total quality management) theory, as the name suggests, focuses on every area of operation in business organizations, seeking to optimize operations. Wan and Connell (2003) define TQM as a management philosophy whose focus is promoting positive change in organizations while at the same nurturing a conducive cultural environment so that all operations aspects within the organization experience continuous improvement. Besides TQM, organizations also use the continuous quality improvement-CQI-framework, which essentially entails use of team work together with disciplined inquiry to measure, evaluate and improvement product and service quality (Wan & Connell, 2003).

There are two different schools of thought regarding the two models described above. To some people, CQI and TQM are synonymous; to others, the two are totally different models. This insinuates that there are some similarities as well as differences between TQM and CQI. A key difference is that whereas CQI concerns itself with “the process part of quality” (O’Donnell & Gupta, 2020), TQM is broader in scope and focuses on how business is conducted within organizations. In simpler terms, CQI uses methodological techniques to solve problems, usually in team settings; data is also collected and evaluated using statistical analyses. In contrast, TQM includes the organization’s culture, and besides using CQI tools together with methods, it also focuses on building effective leadership and maintaining a motivated, highly competent workforce.

Going by the differences outlined between TQM and CQI, the former appears to be the most suitable and effective theory for improving quality in health care environments. This is because quality encompasses all the operational areas within an organization. Since CQI only focuses on the process component, it is possible that crucial areas such as people and outcomes are ignored. Moreover, the nature of health care is that the people involving in delivering care must be adequately motivated, sufficiently rewarded and equipped with the resources they need to give the best to patients. As such, focusing only on the processes through which care is delivered without checking to see whether or not the people involved are satisfied will generate poor results.

It is remarkable that CQI uses teamwork, besides disciplined inquiry, to improve quality. However, it must be kept in mind that health care organizations, like every other organization, operate in a multi-cultural environment in which the right climate must be maintained so that diverse patient needs and demands are addressed. At the same time, effective leadership must be in place to guide the organization in navigating through change when it occurs. All these considerations make TQM the most suitable approach towards quality improvement in health care.

Applying TQM to Improve Health Care Quality

A number of issues frequently arise in health care organizations. According to O’Donnell and Gupta (2020), close to 100,000 people die every year in the United States as a result of medical errors that could have been prevented. Common issues faced in health care organizations include inaccurate/incomplete patient records, wrong diagnoses, follow-up errors, and miscommunication during transition (World Health Organization, 2016). The latter is often attributed to unavailability of timely summaries of discharge, failure to notify the primary care physician once a patient has been admitted into the emergency department, and unrealistic expectations and instructions regarding pathology follow-up (World Health Organization, 2016). The issue of miscommunication during care transition may be addressed by applying the TQM model. Here, a conducive work climate will be created and maintained such that clinician s are comfortable discussing and expressing their concerns about follow-up instructions with the top management. In addition, open communication will be maintained such that general practitioners are notified immediately patients are transferred to the emergency unit.

References

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Fallon, L. F., Begun, J. W., & Riley, W. J. (2013). Managing health organizations for quality and performance. Burlington, Mass: Jones & Bartlett Learning.

O’Donnell, B., & Gupta, V. (2020). Continuous Quality Improvement (CQI). StatPearls [Internet].

van Wijngaarden, J. D., Scholten, G. R., & van Wijk, K. P. (2012). Strategic analysis for health care organizations: the suitability of the SWOT‐analysis. The International journal of health planning and management, 27(1), 34-49.

Wan, T. T., & Connell, A. M. (2003). Total Quality Management and Continuous Quality Improvement. In Monitoring the Quality of Health Care (pp. 143-158). Springer, Boston, MA.

World Health Organization. (2016). Administrative errors: technical series on safer primary care. World Health Organization.

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