Quality Improvement and Sustainability

Quality Improvement and Sustainability

Q.1 Theory

The implementation of quality healthcare and patient safety program is essential. Healthcare provision in hospital facilities is critical. Many factors hinder the provision of quality services and ensure patient safety is a priority. The provision of quality services further relies on the error discoveries so that the necessary precautions can be taken to correct the mistakes. Different theories explain quality health care and patient safety successful implementations such as the System Theoretical Accident Model and Process that support the successful implementation of the program. There are models such as Plan-Do-Study-Act, Lean Production System, and Six Sigma that work together to support the implementation of an application. When these models are well-strategized, the program is expected to yield its intended results. The paper will discuss the STAMP theory in detail and its support towards the implementation of the program. Then, it will further discuss a model that will be relevant in implementing a successful program while explaining the expected outcomes of the application and its sustainability.

According to Leveson (2011), the use of the Systems-Theoretic Accident Model and Process (STAMP) is a system theory used to explain the concept of safety as an arising problem. It is derived from the interaction and coordination of system components rather than individualized ones. Hence, regarded as a non-linear chain model. The theory focuses on systematic control where there is a limitation in providing proper safety measures as required, keeping in place the routine processes. STAMP uses safety checks to ensure that operations conducted in the system follow provided safety guidelines. In an example, Leveson explains the theory’s concept using a passenger train’s operating system. He points out that the doors of a train can only open when there is a clear indication that passengers are safe to alight. Failure to critically analyze the safety measure and operation mode may lead to accidents (Leveson, 2015).

The system theory works through its ability to understand the operations from a hierarchical angle. The function of the hierarchical control system is to put in plan safety checks. It puts in place behavioral measures to the providers and ensuring that control actions are followed through. After the steps are in place, there is a need for feedback from those using the system. To evaluate if the order is working as anticipated. By so doing, it provides adaptability to the changes and a conducive environment where there is a balance in the safety operations and evolution of behavior. In this case, the theory builds on providing improved health care and patient safety by bringing in the coordination of different departments or system controllers who include the nurses, clinicians, technicians, among other key heath providers (Canham, 2019).

The STAMP theory suggests several steps necessary to implement the quality of healthcare and patient safety. Among other goals, its target is to define safety operations and checks distinctively, then pinpoint what the safety checks required to take the necessary actions. The actions put in place run from the top to the bottom of the chain in that incase these actions are not followed; accordingly, the impact would not be felt or realized. The theory points out the importance of observation to give an overall overview of the current operating system. Then, consider the processes put in place to provide feedback back and forth. Lack of proper procedures may lead to inaccurate information, and an implementation may be deemed difficult (Leveson, 2015).

Q.2 Design/Model

Plan-Do-Study-Act (PDSA) is the best design to provide improved quality healthcare and patient safety and make some needed changes in the healthcare processes to yield expected results (Taylor et al., 2014). The model’s main characteristics are its ability to impact changes through various activities and studies overtime before making significant changes to the system. The work of PDSA is to make sure that the changes affected are functional and can relate to each other to give the intended outcomes. PDSA usage requires analyzing program goals. Then, the criteria are vital in realizing if the goals are attainable. And, necessary steps to take in accomplishing the goals. The design will assist in identifying the problem critically analyzing its nature and scope. It will pinpoint the required changes needed for the program and the main stakeholders of the program. It will also look into the specifics of planning, the determinants of change, and the strategies in place to determine the target. Afterward, the information collected will lead to change implementation. Assessment and interpretation of data will provide a statistical analysis of whether the program will be a success or whether it will need further adjustments.

In combination with PDSA, Six Sigma is another design that is important in ensuring the implementation of the quality healthcare and patient safety program. The model has a business-oriented strategy meant to analyze the application, design a plan for improvement, and monitor the process carefully. The main aim of the model is to reduce the cost of implementation of the program while providing quality services. The process’s performance is measured by giving a comparison of the process at the initial stage and after the suggested improvements have been put in place. The model utilizes two methods; one mainly targets the outcome of the process by inspecting it and analyzing the number of abnormalities that exist, their rate per million. It then converts these numbers to a sigma metric. It is a useful method of providing statistics before starting a program and the final program statistics, giving conclusive evidence of the success of the program. The other method utilizes performance prediction of the process, analyzing the capabilities of the program, and challenges that may be experienced. It is an experimental method that provides specifics in terms of its accuracy and perfection level.

Both Six Sigma and PDSA use the same procedures, and the two complement each other. They provide the best results when used in unison. The two focus of DMAIC, where D stands for problem definition, M measures while stands for analysis, I refer to Improvement, and C points out to the control approach. For the program to be successfully implemented, there is a need for a previous case study review. Define specific expectations of the program—the continuous setting of program objectives and goals, monitoring of the program progress stage by stage. The steps point out the work of the two models.

Another model suitable for the program’s implementation is the Lean Production System. It is interconnected with the Six Sigma design in several ways. The only difference between the two models is the Lean Production System focuses on the needs of customers. And, making use of the essential services key in the process to keep operations in progress (Lean Six Sigma: Improving the Health Care Industry, 2015). It then eradicates those processes that are not essential and focus on the root cause of problems. Once the problem has been identified, strategies are put in place to avoid their occurrence. When the principle is applied in the health care system, common errors that occur in the health care systems, for instance, in medical and pathology laboratories and, in pharmacies are drastically minimized. Past studies indicate that the use of the Lean Production System led to quality health care provision and patient safety improvement in health care facilities. The study revealed that the use of the analysis of root cause of problems, setting goals, eradication of vagueness, and specifying various roles to different healthcare providers led to improved healthcare to patients. Interprofessional collaboration in the health care facility will bring in place robust plans that are improved, easy to interpret, and understand. Besides, the work process will be redesigned.

For the implementation of the program to be a success using the three models, the stakeholders need to be committed and supportive of the implementation process. Provision of the required financial, among other resources, to provide training and purchase of necessary equipment. Stakeholders must understand the need to pinpoint the needed safety measures to be put in place. Finding solutions to problems identified in the program requires the stakeholders to address the core issues related to up ineffective communication, the importance of interprofessional collaboration, culture discipline, and viewing the outcome of the same program in other facilities. It is crucial to take into consideration the different views to be brought forward by the stakeholders. It is challenging to have a unison agreement among all the stakeholders and the involved members. It is, therefore, vital to get them involved in the early stages, keep them engaged with back and forth feedback until the necessary changes in the process are addressed. With the help of the models described above, the pinpointed issues can easily be tackled, and the program is successfully implemented (Hughes, n.d).

The models’ successful implementation will depend on the motivation and empowerment of the participants, including staff members from different professions within the hospital. The PDSA model will provide relevant tools that will bring in education programs to promote knowledge empowerment and training. The model will work towards building a team that will work together to encourage collaborations among the different departments within the hospital. It will provide clear guidelines for all the team members and their specific roles in the program. By so doing, there will be no misunderstanding and confusion to facilitate success in implementation and quality improvement in health care services.

Q.3 Expected Outcomes

Implementation of the quality healthcare and patient safety program is set to yield a successful outcome. One of the expected results from the application is the simplification and standardization (Hughes, n.d). The intended outcome will be able to reduce the dependence of staff members on critical stakeholders to make decisions. The processes and protocols of decision making will be simplified, not relying on others for making informed decisions. Standardization will facilitate the contracts necessary for the administration of medications and patient admissions. The outcome will reduce time-wasting, improve effectiveness if nurses in handling patients and thermal efficiency as well. Another intended result is the reduction of common errors that occur in the hospital through the use of information technology systems. It will privilege automated checks that are commonly left out. The technology installment will promote quality service provisions and enhance patient safety by ensuring that confidential patient files remain private. Apart from reducing human error occurrence, there are prescription calculations to standardize dosages through the use of information technology. Alerts and reminders will provide the caregivers with an easy way to contact nurses and clinicians in cases of emergencies. Barcoding and order entry in the hospital will improve medication safety thanks to digitization.

Participation in the leadership of the hospital in the continual monitoring of the program’s progress is necessary. Since the administration we involved from the initial stages of the program, there is a possibility that leaders will be committed to the project, empower and motivate workers to provide quality healthcare services, and put patient safety at the forefront. The successful implementation of the program depends highly on the support and commitment given by the leaders. Involving the right stakeholders from initial stages up to the end of the project will facilitate a successful implementation program. The hospital will develop a culture of maintaining safety measures and providing quality healthcare; thus, in turn, will lead to an infrastructure that is firm and well structured. The implementation will lead to interprofessional collaboration through communication actions such as meetings, one on one interactions with each other and conferences. The application will create a platform that enables all the healthcare providers to come together to provide better and quality healthcare to patients (Hughes, n.d).

In conclusion, the STAMP theory is an excellent explanatory hypothesis that has shown significant improvements in the healthcare sector from previous studies. The STAMP theory, as provided necessary steps that, when followed, can help support the implementation process. The main aim, as discussed in the text, is to give a clear definition of the safety operations while providing guidelines that need to be followed. It also gives the researchers a vital outline of observation in the implementation process. As it is only through observation that there are clear communication and feedback among the stakeholders and other key participants in the program. PDSA, Lean Production Systems, and Six Sigma have been identified as the key models in the implementation of the quality healthcare and patient safety program. The models highlight that for an application to be successfully implemented, there is a need for proper communication channels, the involvement of critical stakeholders from initial stages standardization of hospital, and medical protocols. Every plan has to have good teamwork, motivation, and empowerment of the teams to yield change and successful results. Putting these strategies will not only facilitate successful implementation but also provide sustainability of the program in the long run.

References

Canham, A. (2019, August 8). Examining the application of STAMP in the analysis of patient safety incidents. Retrieved from https://repository.lboro.ac.uk/articles/Examining_the_application_of_STAMP_in_the_analysis_of_patient_safety_incidents/9355205

Hughes, R. G. (n.d.). Tools and Strategies for Quality Improvement and Patient Safety. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2682/#!po=41.5254

Lean Six Sigma: Improving the Health Care Industry. (2015, July 21). Retrieved from https://goleansixsigma.com/lean-six-sigma-how-it-helps-improve-the-health-care-industry/

Leveson, N. G. (2015). A Systems Thinking Approach to Risk Management Through Leading Safety Indicators. Reliability Engineering and System Safety, 17–34.

Leveson, N., Samost, A., Dekker, S., Finkelstein, S., & Raman, J. (2016). A Systems Approach to Analyzing and Preventing Hospital Adverse Events. Journal of Patient Safety, 1. doi: 10.1097/pts.0000000000000263

Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014, April 1). Systematic review of the application of the plan–do–study–act method to improve quality in healthcare. Retrieved from https://qualitysafety.bmj.com/content/23/4/290