Understanding Quality Information * Quality improvement is finding different outlets to execute plans on improving an already in place process. Chapter four in “The Healthcare Quality Book” by Keith Warren outlines and explains quality improvement. Warren applies it to the health care and gives different case studies to explain it. Quality improvement evolves different factors to properly execute any plans for the new process. Warren helps the reader understand the healthcare foundational frameworks of quality improvement. In chapter two: Basic Concepts of Healthcare Quality by Leon Wyszewianski explains why various health care stakeholders define the quality of care differently and the roles of various clinicians and patients in quality improvement. After understands QI the reader can know why quality management needed in the healthcare industry and areas must be monitored for quality. Warren also explores some of the accrediting and regulatory organizations are involved in quality improvement their roles and the helpful resources and organizations affect quality improvement. All of these factors are the reason QI is very important health care. The first thing that needs to be explored is the foundation of QI. “The strength and principles of the foundation of a product, belief, or concept can define the sustainability of that product, belief, or concept. “ (Warren, 2008) Meaning it is important to understand the product that needs improving and how the improvement can sustain itself. Finding ways to improve quality can be easy but being able to sustain it is not easy. QI needs to be planned and tested before it becomes a permanent change. One of the best ways to describe this view is the idea of Joseph Juran. Joseph Juran is one of the major contributors of QI’s development. He thought that the foundation of QI was based on three main steps called the Juran’s Quality Trilogy. The trilogy describes three interrelated processes: quality planning, quality control, and quality improvement. The idea is based on the outline below: (Warren, 2008) This figure explains each step in the trilogy. Quality planning is first identifies the need that should be improvement and the development of a plan to fix those inefficient processes. Understanding the customer is the first thing that needs to be done. If improver cannot identify itself customer then there is no point in improving anything. After identifying the customer than next should be the identification of the customer’s needs; once the needs are finalizes the improver can plan the attack of improving those unmet needs. Finally, the improver can then advance to the QI portion. QI is develops the process to product the product, meaning how can a person execute that plan and what does the person need to do make sure the process succeed. QI is trouble shooting and putting the previous planning to work. The last part of the foundation is quality control, basically sustaining the plan and putting is to work. Once of the three steps are done, Juran suggests that the improvement should exceed. Next, in chapter two: Basic Concepts of Healthcare Quality by Leon Wyszewianski, explores do various healthcare stakeholders define the quality of care differently and the roles of various clinicians and patients in quality improvement. Different stakeholders tend to attach different important levels to individual attributes (Blumenthal 1996; Harteloh 2004), resulting in differences in how clinicians, patients, managers, payers, and society each tend to define quality of care” (Wyszewianski, 2008, p. 39) Wyszewianski suggest that based on the type of services and physicians, stakeholders define them with different quality. Basically, stakeholders look toward “value” more than anything to determine quality. Stakeholders are not the only ones who have a role in QI, clinicians, patients, managers, payers, and society has roles; specifically clinicians and physicians. Clinicians “who provide healthcare services, tend to perceive quality of care foremost in terms of technical performance. ” (Wyszewianski, 2008, p. 41) Clinicians base the quality on how good the services are and the technical aspect of the service. “Quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”. (Wyszewianski, 2008, p. 41) Based on this information the question why QI is important in health care is answered. QI looks toward technical performance, management of the interpersonal relationship, amenities, access, responsiveness to patient preferences; equity, efficiency and cost-effectiveness are attributes need to be monitored in healthcare to make sure everything run smoothly. Lastly, Warren also explores some of the accrediting and regulatory organizations are involved in quality improvement their roles and the helpful resources and organizations affect quality improvement. Organizations like Medicaid and Medicare proved money to healthcare providers have to participate in QI. Many rural areas have lost their accreditation because Medicaid and Medicare deemed that the quality of their health care was not adequate. Warren states in the case of the rural areas losing accreditation to not necessarily saying that their dedication is not up to par but that the level of quality was not of Medicaid and Medicare’s view. This can be a good thing and bed thing; the bad is that a dedicated health care office is shut down based on a standard of rules and process not geared for every situation but it is a great idea that these state run program and are practicing QI. In conclusion, is very important in the health care world. Both Warren and Wyszewianski explained the important types and understanding of quality improvement. Each chapter explained: foundational frameworks of quality improvement, why various healthcare stakeholders define the quality of care differently and the roles of various clinicians and patients in quality improvement and why quality management needed in the healthcare industry and areas must be monitored for quality. The chapters even look at some of the accrediting and regulatory organizations are involved in quality improvement their roles and the helpful resources and organizations affect quality improvement. All of these explanations are important in understanding QI and need for it in health care. Bibliography Warren, K. (2008). QUALITY IMPROVEMENT: THE FOUNDATION,PROCESSES, TOOLS, AND KNOWLEDGE TRANSFER TECHNIQUES. In E. R. Ransom, The Healthcare Quality Book: Vision, Strategy, and Tools (pp. 63-83). Health Administration Press. Wyszewianski, L. (2008). BASIC CONCEPTS OF HEALTHCARE QUALITY. In E. R. Ransom, The Healthcare Quality Book: Vision, Strategy, and Tools (pp. 25-39). Health Administration Press.
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