Factors affecting Quality Improvement in Healthcare

The Federal government plays a vital role in supporting the delivery of safe, high quality care, including paying for care, monitoring quality, addressing disparities, providing technical assistance, supporting research, and directly providing care to the communities (Department of Health and Human Services, U.S., 2011).

Public and private supports to healthcare providers’ desire to deliver higher quality care are critically important. It is important to dedicate resources to QI activities. The executive team must be supportive; they must create financial and human resources, and allow sufficient time for the project team to work. Collaborative efforts at the local level are also a vital resource for measuring, monitoring, and improving quality of care (Department of Health and Human Services, U.S., 2011).

Community leaders and members themselves play a crucial role in healthcare quality improvement. Community-based programs, working out local values, forming coalitions around specific problems will enhance local health care services.

Qualification of the health care providers is another factor affecting healthcare quality improvement. Therefore, health care professionals should be encouraged to maximize their training and skills through life-long learning that includes the application of QI principles. At the same time, boards of medicine, nursing, and other providers enhance the quality of care that patients receive by requiring that practitioners continually demonstrate skills and knowledge critical to their field (Department of Health and Human Services, U.S., 2011).

Technical component has strong impact to facilitate QI implementation. A study conducted on QI implementation among Korean hospitals by Lee, Choi, Kang, Cho & Chae (2002) showed that the relevant scientific analytical skills and the establishment of a quality information system with valid data are key success factors for CQI implementation. They justified this result with another study finding that inadequate information system and technical skills are barriers against implementation of CQI in healthcare areas.

Organizational culture, the underlying beliefs, values, norms and behaviours of the organization, strongly influence the productivity and efficacy of that organization. Lee, Choi, Kang, Cho & Chae (2002) stated that employee empowerment and autonomy are key cultural factors to be emphasized when an organization pursues CQI. They explained about four culture types which are group, developmental, rational and hierarchical in nature.

Group culture emphasizes the development of human resources, affiliations, employee empowerment, teamwork and consensus building. Developmental culture pursues changes and growth, and regards innovative thoughts and prospective strategies as important assets. Rational culture is highly performance oriented and emphasizes on planning, productivity and efficacy. In hierarchical culture, bureaurocracy and stability are the underlying forces that move the organization, and compliance with organizational mandates, enforced roles, rules, and regulations are emphasized.

Based on the conceptual disciplines of CQI, Lee, Choi, Kang, Cho & Chae (2002) hypothesized that group and developmental culture would be more likely to achieve a higher degree of CQI, and CQI implementation would be positively correlated with the extent to which organization empowered their employees and allowed them decision-making autonomy. Systematic literature review by Minkman, Ahaus & Huijsman (2007) showed that large hospital experienced lower clinical efficiency due to more bureaucratic and hierarchical cultures.

Reference:

Department of Health and Human Services, U.S. (March 2011). Report to Congress: National Strategy for Quality Improvement in Healthcare. Retrieved 26 April, from http://www.healthcare.gov/law/resources/reports/quality03212011a.html

Lee, S. H., Choi, K.,  Kang, H.,  Cho, W., & Chae, Y. M. (2002). Assessing the factors influencing continuous quality improvement implementation: Experience in Korea hospitals. International Journal for Quality in Health Care, 14(5), 383-391. Retrieved http://intqhc.oxfordjournals.org

Minkman, M., Ahaus, K., Huijsman, R. (2007). Performance improvement based on integrated quality management models: What evidence do we have? A systematic literature review. International Journal for Quality in Health Care, 19(2), 90-104. Retrieved http://intqhc.oxfordjournals.org