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Presentation/PPT
27/08/2022
Over the years, health systems and facilities across the globe have been facing several pressing problems, from preventable medical errors, hospital inquired infections to clinical variations, delays in patients discharge, and dwindling health and financial records.
Although most of the health systems have consistently advanced their operations and innovated numerous healthcare facilities to tackle these challenges, scholars and medical professionals insist that there is still need to continually improve the quality of healthcare provided in the health facilities since the problems also advance continually (U. S. Department of Health, 2011).
Although there is no single definition of quality improvement in healthcare, the Institute of Medicine (IOM), which is a recognized advisor and leader on improving healthcare, defines quality improvement in healthcare as a direct correlation between the level of improved health services and the desired healthcare outcomes of individuals and population (Institute of Medicine, 2011). While there are many different definitions of quality improvement in healthcare, today’s healthcare quality improvement structures and models are products of a century-long experience of cumulative efforts (National Quality Center, 2008). In this regard, this essay analyzes the history of quality improvement and the significance of quality initiatives on the future of healthcare delivery. The report will also include an assessment of the accreditation process and its role in improving healthcare as well as literature review on the quality improvement initiatives that have been developed over the years and the impact of the initiatives on the quality of care delivered.
History of Quality Improvement in Healthcare
The history of quality improvement can be traced back to the work of epic figures such as Ignaz Semmelweis, an obstetrician who championed the importance of handwashing in medical care in the 19th century. By the early 20th century, several icon scholars began conducting researches about production and quality control (Cantiello, Kitsantas, Moncada, & Abdul, 2016). For instance, in 1920, an English nurse, Florence Nightingale, authored about the association between high death rates and poor living conditions among soldiers treats at army hospitals in the United Kingdom.
During the 1940s and 1950s, studies about quality improvement intensified across the globe, and various techniques of quality improvement were developed in Japan, the United States, and the United Kingdom under the expertise of health professionals such as Kaoru Ishikawa, Armand Feigenbaum, Joseph Juran, and Edwards Deming.
In the 1980s, Ernest Codman, a surgeon, introduced the creations of hospital standards, emphasizing on the implementation of strategies that assesses hospital outcome (Marjoua & Bozic, 2012). At the end of the 20th century, the Institute of Medicine (IOM) managed to capture the global attention when it released it sentinel report on patients’ safety To Err is Human: Building a Safer Health System, which featured numerous medical errors happening in the American hospitals, costing patients and the governments billions of dollars and lives (Institute of Medicine, 2011). Moreover, the report also recommended various measures that the American government should undertake to curb these problems and errors.
According to IOM, most of the medical errors resulted from system and culture fragmentations in the healthcare sector. The study indicated that not all mistakes and errors were not from the medical practitioners but mostly from the inherent shortcomings in the Medicare system (Agency for Healthcare Research and Quality, 2013). Subsequently, under the direction of Congress, the Agency for Healthcare Research and Quality (AHRQA), in connection with its federal and non-federal partners and stakeholders, started the initiative of implementing IOM’s research findings and recommendations.
Fast-forward, this community started the process by establishing a foundation so that they could better understand patients’ safety challenges and how they could rapidly implement effective solutions to counter healthcare errors and mistakes. Today, most of these recommendations form a body of knowledge of how to implement and sustain quality improvement approaches in healthcare across the globe.
The contemporary quality improvement approaches and models have since transformed to encompass a wide variety of techniques, stakeholders, ever-evolving set of objectives, and goals. In particular, the quality improvement movement has witnessed several profound improvements over the past half-century. Many studies indicate that a significant fraction of these improvements has been spawned by the consistent academic studies and researches on the subject since these studies often outline deficiencies in healthcare delivery, precipitating the need to improve the quality of healthcare continually. Some of the notable healthcare quality improvement that has occurred over the past half century includes rewarding of competition between healthcare providers and organizations, restructuring of healthcare systems, re-engineering of hospital management structures, the sophistication of monitoring techniques, and fostering the use of peer reviews in medical procedures among many other quality improvement efforts. For the medical practitioners, medical institutions have redesigned the professional medical education curriculum, enforced the reprimanding of underperforming medical scholars, intensified evaluation procedures, and improved the quality of medical tools to emphasize the practical essence of ensuring and maintaining quality improvement when delivering healthcare.
The Accreditation Process and Its Role in Improving Quality of Care
With the increasing government, public and media attention on frequency and magnitude of medical errors, healthcare professionals and managers are increasingly concerned with issues related to improving the quality of healthcare services provided in the hospitals.
In this sense, quality improvement management has become a paramount process for hospitals to achieve their goals and deliver quality healthcare for patients and institutions. Consequently, the increasing competition and expectations between hospitals and patients poised a significant challenge to the management in regards to quality improvement.
As a result, health services worldwide decided to embrace accreditation as a strategy to improve quality in healthcare. Accreditation refers to an external, voluntary process in which trained peer reviewers assess the performance and compliance of a healthcare organization relative to the pre-established performance standards.
Accreditation officially started in the United States with the formation of the Joint Commission on Accreditation of Healthcare Organization (JCAHO) in 1951 (Devkaran, & O’Farrell, 2015). The model managed to spread to Canada, Australia, and Europe in the 1960s, 1970s, and 1980s, respectively. By the beginning of the 21st century, accreditation programs had spread across the globe (Devkaran, & O’Farrell, 2015). Today, approximately 90% of the United States hospitals are accredited, making the Joint Commission one of the most prominent accrediting organizations globally.
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