Quality health care is defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”. The goals of measuring health care quality are to determine the effects of health care on desired outcomes and to assess the degree to which health care adheres to processes based on scientific evidence or agreed to by professional consensus and is consistent with patient preferences. Because errors are caused by system or process failures, it is important to adopt various process-improvement techniques to identify inefficiencies, ineffective care, and preventable errors to then influence changes associated with systems. Efforts to improve quality need to be measured to demonstrate “whether improvement efforts lead to change in the primary end point in the desired direction, contribute to unintended results in different parts of the system, and require additional efforts to bring a process back into acceptable ranges” . The rationale for measuring quality improvement is the belief that good performance reflects good-quality practice, and that comparing performance among providers and organizations will encourage better performance.
You can apply the following strategies if you want:
1. Plan-Do-Study-Act: Quality improvement projects and studies aimed at making positive changes in health care processes to effecting favourable outcomes can use the Plan-Do-Study-Act model. This is a method that has been widely used by the Institute for Healthcare Improvement for rapid cycle improvement. The purpose of PDSA quality improvement efforts is to establish a functional or causal relationship between changes in processes and outcomes. Change is then implemented, and data and information are collected. Results from the implementation study are assessed and interpreted by reviewing several key measurements that indicate success or failure.
2. Six Sigma: Six Sigma, originally designed as a business strategy, involves improving, designing, and monitoring process to minimize or eliminate waste while optimizing satisfaction and increasing financial stability. There are two primary methods used with Six Sigma. The second method uses estimates of process variation to predict process performance by calculating a metric from the defined tolerance limits and the variation observed for the process. One component of Six Sigma uses a five-phased process that is structured, disciplined, and rigorous, known as the define, measure, analyse, improve, and control approach. To begin, the project is identified, historical data are reviewed, and the scope of expectations is defined. Next, continuous total quality performance standards are selected, performance objectives are defined, and sources of variability are defined. As the new project is implemented, data are collected to assess how well changes improved the process.
3. Root Cause Analysis: Root cause analysis , used extensively in engineering and similar to critical incident technique, is a formalized investigation and problem-solving approach focused on identifying and understanding the underlying causes of an event as well as potential events that were intercepted. RCA is a technique used to identify trends and assess risk that can be used whenever human error is suspected with the understanding that system, rather than individual factors, are likely the root cause of most problems. Taken one step further, the notion of aggregate RCA used by the Veterans Affairs is purported to use staff time efficiently and involves several simultaneous RCAs that focus on assessing trends, rather than an in-depth case assessment. Using a qualitative process, the aim of RCA is to uncover the underlying cause of an error by looking at enabling factors, including latent conditions and situational factors that contributed to or enabled the adverse event.
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