Continuous Quality Improvement and Risk Management in Health Promotion Research Paper

Introduction

The definition of quality remains contested and multifaceted. Barbara and Goodstadt advance that quality is inherent with efficiency, effectiveness, and consumer satisfaction (Barbara & Goodstadt 1999). When focusing on quality, it depends on whether goods are the center of an intervention or a service. Ovretveit’s notion of quality is based on a three-tier model which examines and evaluates quality based on consumer satisfaction, efficient policies or set benchmarks, and professional assessment (Ovretveit 1996, p.55-62). When incorporating quality into management, continuous quality improvement dwells on an exhaustive management philosophy that focuses on an ongoing improvement by applying scientific procedures to gain knowledge and have a grip over varying work processes (Barbara and Goodstadt 1999 p. 83-91).

Historical background to CQI

Using U.S history as an example, CQI according to American Medical Association (APA) study in 1910, found the need to improve hospital conditions and follow up on patients to assess service delivery. By 1977, the American College Surgeon’s association had developed a criterion for measuring standards. It focused on the general hospital management structure. It further broadened the scope to include the external non-hospital environment as the community (Luce, Bindman & Lee 1994). By 1952, American Medical Association (AMA) and Canadian Medical Association (CMA) had joined to form a joint hospital accreditation forum. By 1966, the focus had shifted to the achievement of set benchmarks, rigorous and obligatory schedules, and more advanced techniques (Luce, Bindman & Lee 1994).

Currently, new methods of practice have broadened quality assessment and improvement programs. AMA and CMA standards have guided quality based on setting up clinical investigations and consensus conferences and recommending the way forward. Through physician profiling practice and data evaluation on clients, the progress is assessed. Besides, rogue physicians are induced to change their habits. The trend had improved recently to focusing on group improvement rather than individual physicians. It has also broadened settings to include ambulatory care and community mental health (Luce, Bindman & Lee 1994 p. 263-268).

In this criterion, hospitals aspiring for accreditation apply and upon assessment are given conditions of operation, or those which fail to meet standards may appeal. The professional standard organizations stress efficiency and quality. Peer review organizations review re-admissions, hospital admissions, operations, deaths, and complication rates. They identify problems and suggest remedies, alert practitioner institutions, new data, and accreditation bodies about malpractices or challenges experienced (Luce, Bindman & Lee 1994 p. 263-268).

Evaluating Quality Care

Various approaches have been identified that guide health management. Levin proposes the Deming Cycle (Plan-to-study-act). He outlines steps to be followed while managing a health issue. You begin by planning change, followed by implementing the change process and observing either positive or negative outcomes. Finally, the change is adopted or rejected (Levin 1994). Baker adds that identifying an outcome, focusing on an individual or community interest, and identifying how to recognize an improvement is followed. While conducting the process you open your mind to new ideas, options, or tests.

Barbara and Goodstadt (1999 p.83-91), argue that customers are a critical component in the health management process. The customers encompass patients, colleagues, the broader community, or even funders (Al Assaf 1993 p. 3-12). Assaf adds that customer satisfaction, which is a major force behind CQI, needs deep examination in the context of health promotion. Murray stresses the need for data to assist in decision-making while engaging in CQI (Barbara and Goodstadt 1999 p. 83-91). CQI is also conceptualized as a system where health promotion relies on the interconnectedness of parts.

To add on, CQI utilizes benchmarking to identify best practice processes (Buccini 1993 p. 455-463). As managers, it is important to note that variability of circumstances is and requires reduced rigidity in response. Besides, CQI promotes teamwork. When adapting CQI as health promotion, change interventions should promote goals, values, and tackle challenges (Barbara and Goodstadt 1999 p.83-91).

Designing an Outcome Measurement Strategy

A CQI strategy for improved health promotion requires a focused approach guided by desired change. While designing a workable strategy one should embrace an open mind to issues as they emerge.

The strategy

1. An identified change intervention that eyes health promotion will re-align with set goals, objectives, and missions of the health institution. This will be imperative in guiding through set benchmarks.
2. As a health-promoting institution, joining accreditation bodies that work towards CQI will be a priority. This has the benefit of sharing experiences among groups of colleagues from various institutions and peer-reviewing each other for improvement. Peer reviews instill quality and standards through checks and balances.
3. Setting up a repository center for epidemiological data is necessary for monitoring trends in practice, identifying new knowledge and challenges that inform decision-making in the health sector.
4. Continuous research identifies new knowledge, practices, and initiatives that can be shared among peer review organizations for the improvement of service delivery as a whole.
5. Lastly, a successful health promotion change initiative will focus on re-engineering the structure of management that embraces non-rigid styles. It will be a synergy of both vertical and horizontal chain of command. This will enhance community involvement and open decision-making.

Reference List

Al Assaf, A. F. (1994). Introduction to Historical Background. The textbook of Total Quality Healthcare, 4, 3-12.

Barbara, K. &. Goodstadt, M. (1999). Continuous Quality Improvement and Health Promotion: Can CQI lead to Better Outcomes? Health Promotion International, 14, 1, 83-91.

Buccini, E. (1993). Total Quality Management in Critical Care Environment: A Primer. Critical Care Clinics, 9, 455-463.

Levin, W. (1994). Using Theory to Improve Population Health: What healthcare can teach management, Canadian Journal of Quality in Healthcare, 11, 4-15.

Luce, J., Bindman, A., & Lee P. (1994). A Brief History of Healthcare Quality Assessment and Improvement in the U.S. West J Med, 160, 263-268.

Ovretveit, J. (1996). Quality in Healthcare Promotion. Healthcare promotion International, 11, 55-62.