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Basics of Quality Improvement in Healthcare


Quality improvement is about making healthcare more secure, successful, patient-focused, timely, adequate, and reasonable. The financial crisis implies an end to a yearly economic downturn, and healthcare leaders are being forced to react not via arbitrary ways, but by improving quality, lessening harm, and enhancing effectiveness. Quality improvement in healthcare is now an important requirement within the industry, backed up by initiatives like advocating for conceptual payment frameworks, and quality-focused accounts. The leader has an important duty to play to ensure that the organization concentrates on quality improvement strategies, implements them, and attains the required results (Wachter, 2007).

This report emphasizes one key aspect of the quality plan, that is, the improvement of quality in healthcare. It focuses particularly on organizational approaches that aim at initiating a measurable improvement through the application of specific techniques within a hospital environment.

Quality Improvement Framework

Obviously, getting an actual understanding of healthcare quality is hard, yet critical. As a result, there is an enormous need for an approach to organize and present data, its definition, and challenges to clinicians and patients. Several organizations are striving to resolve this issue, but more studies are required in learning how to recap and present the outcomes and risks of assessing quality in healthcare.

Drawing on the decisive work of Waring (2007), quality in healthcare has been divided into three elements, which are design, procedure, and results. The design represents the aspects of the healthcare structure, namely, staff development and skills, resource mobilization, and organizational methods of effectively managing such resources for the best patient care. The procedure involves the application of suitable diagnostic and curative approaches for patients.

In facilitating the applicability of procedure evaluations, an ideal patient subset without complications for treatment is regularly utilized as the denominator, and patients that have received suitable therapy are considered to be the numerator. The word “results” denotes the outcomes of therapy and can refer to causes of problem development (death and readmission), patient condition (signs, working, and general health), and/or cost. Many organizations implement their quality improvement plan based on this model (Waring, 2007).


Both quality and quality improvement signify diverse issues to diverse individuals in various situations, which can be perplexing. The below section focuses on common definitions of the two words.

Within the health system, there is no generally agreed meaning of “quality”. Conversely, the following definition is regularly adopted, that is, an extent to which people and societies boost the likelihood of expected patient results and are aligned to the current healthcare skills (Hosford, 2008). The Healthcare Foundation considers quality to be the level of efficiency in healthcare. Efficiency is multi-dimensional. For instance, referring to the Institute of Medicine description, it is broadly agreed that healthcare has to be secure, efficient, patient-based, timely, effective, and reasonable (Waring, 2007).

So, Anita Robinson needs to keenly take into account these six features when drafting her priorities for quality improvement. There are issues among the six dimensions that require to be solved, for instance, patient safety may not at all times work together with effectiveness. Meanwhile, it is critical to consider the diverse perspectives of stakeholders concerning what they regard as necessary, and what the key areas of attention need to be within the healthcare system.

On the other hand, there is no description of quality improvement, and no single methodology seems to be effective. Conversely, some descriptions define quality improvement as an organized method that utilizes detailed approaches in improving quality (Waring, 2007). The most critical aspect in winning and constant enhancement is how the quality plan is incorporated and carried out.

Role of clinicians and patients

The role of various clinicians involves delivering healthcare based on the patient’s view of quality improvement, in addition to the care that is secure, efficient, person-based, timely, and reasonable as described by the Healthcare Foundation. Clinicians become aware of issues affecting healthcare and research on quality improvement, for example, practical outreach and constant patient monitoring encourage clinicians to assume a dynamic role in improving quality. On the other hand, a patient has three roles to improve patient safety, which is assisting in ensuring his or her safety, cooperating with hospitals in improving patient safety at the organization level, and advocating as agents for change and responsibility of the healthcare system performance (Waring, 2007).

Why Quality Management

Many healthcare organizations believe that there is an undeniable need to apply organizational quality improvement techniques to the health sector. The proof that using such quality improvement methods can minimize the cost of health care is inconsistent, while there are increasing suggestions that a few can be successful if applied correctly (Wachter, 2007).

But an emphasis on improvement is not just concerning minimizing expenses. It is as well about ensuring that patient care is as secure as it can be expected. Currently, the proof is obvious that health systems are not at all times safe – 10% of inpatients are likely to encounter a bad event during treatment (Wachter, 2007). As such, there is a likelihood that even high-performing hospitals can enhance the quality of patient care they deliver, bringing about improvements in individual results, experiences, and effectiveness.

Areas of concern

The quality improvement plan should involve the following:

  • Quality improvement process – there ought to be an approach of monitoring the procedures of patient care and related results. Not all features need to be determined constantly or in tandem. It is significant for healthcare organizations to be capable of ensuring that local policies adapt to current policy suggestions.
  • Internal capability – physicians who attend to individuals should have an essential skill of quality improvement and its process. Minimum standards must take into account the disease component of quality improvement.
  • Documentation – the patient care plan must be recorded in the healthcare records.
  • Initial evaluation – an essential component of the assessment is that of ensuring a precise diagnosis.

Accreditation and regulation

One of the exciting functions that accreditation agencies play to improve quality is that of a change agent. Among the reasons for developing fresh accreditation bodies in various sectors is that of encouraging wide organizational change with a view of improving quality.

Compulsory adherence to codes of conduct is in addition to an ordinary aspect of many accrediting and regulatory agencies. The relationship of such ethics with other regulatory measures is another quality monitoring element of regulation programs. This relationship can be achieved through a standard like the American Speech Accreditation Standard requiring that medical learning processes ensure the safety of each patient is taken into account (Waring, 2007). Such accrediting and regulating bodies include American National Standards Institute and Healthcare Foundation.


Hosford, S. (2008). Hospital progress in reducing error: The impact of external interventions. Hospital Top, 86(1), 9-19.

Wachter, R. (2007). Understanding patient safety. New York: McGraw-Hill.

Waring, J. (2007). Adaptive regulation or governability: Patient safety and the changing regulation of medicine. Social Health Illness, 29(2), 163-179.