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9158 : Maintaining And Improving Quality Of Health Services
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9158 : Maintaining And Improving Quality Of Health Services
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Course Code: 9158
University: Centennial College
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Country: Canada
Question:
Assignment Focusa number of strategies that can be implemented to maintain and improve the quality and safety of health services provided by individual organisations and by the system as a whole. Two of the strategies focusing on strengthening the following areas:• effective communication between practitioners and patients• effective communication within the organisation which may include a timely reporting mechanism and no blame cultureTo make the strategies effective and successful in improving the quality and safety of services provided by healthcare organisations, a multi-level approach is required involving efforts in all four levels: government/system, organisation, team and individuals working in the organisation.Please discuss the current efforts that have been put into strengthening the above two factors in the system level (if you are not working for an organisation) or organisation, team and individual levels (if you are currently working for an organisation). Please also discuss the key challenges that can threaten the outcomes of such efforts and how these challenges should be (have been) addressed in order to maximise the continuous improvement of the quality and safety of health service provision?
Answer:
The world, (nations, governments, international organizations, hospitals, and local health facilities) is always and constantly putting effort to improve the level of health care they provide to the public. Individuals also try to put their best foot forward towards this action in order to improve their healthcare on a daily basis. So improving healthcare is a worldwide move practiced in every place. There are significant improvements in the field of health but also with challenges and failures (Piña et al., 2015). Despite all that, all the stakeholders continue to struggle to improve and maintain a high level and quality health care both for themselves and for the public. Improving and maintaining healthcare involves structures being put in place. Thus it has to start from the government who is the supervisor of the system; it also includes organizations both international and local not leaving behind individuals or groups of people working as a team. So it is evident that in the struggle to improve and maintain high-quality healthcare literary everyone is involved either directly or indirectly (Piña et al., 2015).
One of the areas found to be working with the aim of improving healthcare is effective communication. In the Oxford Student’s dictionary (3RD ed) describes communication to be the act of sharing or exchanging information, ideas and feelings. Thus effective communication in healthcare includes communication between practitioners or the healthcare personnel and the patients. There is another aspect of communication in healthcare that involves communication within the organization. This is between the management or the supervisors in an institution and the doctors or practitioners. Normally, reporting is done on time. In circumstances such as during an emergency, time is a crucial aspect and this would be possible only if there is effective communication (Janati, Hosseiny, Gouya, Moradi & Ghaderi, 2015). Another advantage would be every individual is able to take responsibility and there is no occurrence of blaming one another because there would be teamwork from communication. Communication helps individuals down in the healthcare management pyramid to also get to relevant authority either to get help or information in which they would need. This thus explains why and how communication would be crucial.
Yan-Shing, Kirstie, Anayda, and Debra (2018) acknowledge that communication is important in any organization. They, however, argue that there is no consensus definition of effective communication in the general public. That the public has no knowledge of good communication skills or even its importance and this can be catastrophic at all times. Sometimes the public may not really know the importance of sharing information with the doctors maybe because of different reasons. But it would be really essential for them to share and improve communication with the practitioners as this goes a long way in easing up work. The doctors and practitioners also need to practice communication skills as this would be easier to get information. Good communication influences the rate of recovery of the patients. This is because it is easier to diagnose a patient of a disease and after administering a prescription, with the help of the patient, monitor any developments as time goes by. The patient can help the doctor with monitoring the developments through communication and that’s better than the doctor struggling on their own to get that bit of information. Since good communication on the side of patients doesn’t improve with time, considerable effort is dedicated to medical practitioners to improve their communication skills which will enhance better communication with their patients. This thus means that they need to be trained and to master effective communication skills (Philippa, Solange, Olivares, Bravo?Soto & Theresa, 2018). The system has to then ensure that they improve effective communication within all the stakeholders.
There are and can occur challenges that can affect the effective communication between the practitioners and the patients. These may include a language barrier. Renata, Cindy, Norman, Andrew, & Julia (2015) discuss that barriers to effective and even equitable healthcare can result from linguistic differences of the patient and the doctor. They go further to explain that this may be caused by immigration whereby immigrants may not be speaking the same language as the medical practitioners who may be speaking native languages of the places they are in. This means that there is a possibility of errors occurring during the gathering of information from the patient and this can be dangerous and even life-threatening (Lewis, Damarell, Tieman & Trenerry, 2018). When a wrong diagnosis is done, obviously there would be the wrong prescription which will not only not improve the condition of but also put the patient in more danger. This also occurs when foreign trained staff comes to work locally whereby it means the doctor and patients would be speaking second languages. In simple terms when the doctor and a patient cannot communicate, how is there even a possibility of getting to know the problem, leave alone the solution? Cobos, Haskard-Zolnierek & Howard (2015) explain the white coat hypertension that occurs when a patient is in an office with a doctor. This possibly can then affect communication between the two because the patient is already not at ease. Study and research have shown that when a doctor is wearing a white coat, it causes some tension to the patient. This means the doctor or practitioner may have a challenge in identifying the problem. They thus explain that improving the relationship between a patient and the practitioner can help ease or reduce anxiety. For this to happen there needs to be trusted, effective communication and empathy.
On the other hand, for effective communication within an organization, it has to start with the management of the organization or institution. Brach (2017) describes a health literate institution as one that makes it easy for patients and people visiting the place easy to navigate from place to place, ease of access to information and services for their benefits and their patients. Clearly, this has to be associated with effective communication for that to be possible. She goes on to describe that health literacy has to become an organization’s main priority for it to achieve its aim or even missions. Through focusing on written and spoken communications the organization will be able to achieve beyond its limits or even expectations. Savoia, Lin & Gamhewage (2017) articulate that the 21ST century offers specific challenges especially when dealing with emergency risk communications. Further, they explain that the time of/ during an exchange of information between experts and practitioners and people who face threat to their lives is so crucial and shouldn’t be played around with. The life, health, and recuperation of patients may be dependent on the effectiveness of communication between the practitioners and also the organization.
Communication is important even in the surgical rooms (Bala et al., 2015). Good leadership and communication are demonstrated when the leader is able to flexibly adapt opinions from members of a surgical team and that means holding professional conversations and discussions all like a team. Even the small things like passing equipment require very good communication so as to save time and improve efficiency. This develops both the members and makes it easier to work in the room. As the saying goes two heads are better than one. Koo, Horowitz, Radice, Wang & Kleinman (2016) in their survey on the use of communication between nurses observed and concluded that communication should be patient-centered to increase patient understanding to help improve the health.
Within an organization, there is to need to have a timely reporting mechanism that is effective and flexible to work with. Janati, Hosseiny, Gouya, Moradi & Ghaderi (2015) wrote about the world systems of reporting communicable diseases. In their article, they evaluate the systems and describe the world system as having poor surveillance and lacking supporters to push it forward. They concluded that the reporting system of diseases in the whole world has challenges thus the need to address continuous monitoring is very important. A timely reporting mechanism is not only important in an organization but also in the system whereby the government is now included. This again rolls down to an individual in that in case of a problem or when an abnormality is spotted quick action has to be taken in communicating to the relevant authorities (Revere, Calhoun, Baseman & Oberle, 2015). The public and individuals ought to know the right channels of communication so that necessary action can be taken. For example, during an outbreak of a disease, the first and most important action to be taken is to communicate so that the public can take preventive measures and sustain the outbreak.
(Cooper et al., 2017) recognize the presence of blame culture and fear of retribution and view them as barriers to reporting patient safety incidents. It is normal for individuals to be in fear of taking responsibility when something happens. On the other hand, this can only happen if there is no effective communication. In an institution that has developed proper channels of communication, reporting of an incident would be free because there is no fear of retribution. In an institution that lacks an effective communication channel, there will definitely be the tendency of having individuals blaming one another before, during and even after an incident.
Conclusively, in improving effective communication between practitioners and patients, this involves the organization in place, practitioners working as a team and also individuals. In this case, the government or system plays a very little role in affecting effective communication between practitioners and patients. There are currently a lot of efforts being made to improve communication because communication is at the core of the healthcare sector. (Haberer et al., 2017) discuss that even though many of the people living with HIV are adhering well to therapy, most of them still suffer and cannot be helped by therapy because of poor communication. HIV patients suffer from trauma which may be caused by the society in which they live in. if this is not addressed in the right way; it could lead to depression and the virus being severe on the patient because they will not be even able to pick their medicine due to fear of retribution from the society. (Colvin et al., 2014) In this case, both the patient and the society need proper communication for the benefit of the patient and also the society. In the year 2015 in July after the Belinda Gates Foundation met there arose better interventions that could help in scaling down trauma in patients. In the interventions counseling, education, communication technology, health delivery restructuring, and economic incentives were some of the solutions that were discussed to help such patients. In all the interventions that arose from this meeting, it could be seen that proper communication was key to achieving the aims of the foundation on the trauma of HIV patients. There is a lot being done to improve the quality of healthcare being provided. (Pantoja et al., 2017) discuss the points where the efforts of improving healthcare should be directed to. In their study, they pinpoint healthcare recipients in medical and prescription adherence as one of the areas. They also include healthcare workers and organizations.
In conclusion, communication is a very important tool in any environment and should be taken seriously. Communication should be constantly improved so as to better the services that are being provided. Better communication in an organization improves the services being provided. How information is passed from the administration in an organization, in this case, a health institution is very crucial. This also applies in how the doctor or practitioner communicates to help in diagnosing the problem working through it to come to a solution. The success and ease of this whole process are dependent on the level of communication practiced at that given time. Communication alone goes a long way in improving and maintaining high standards in the healthcare sector. Thus the practitioners and the patients should exercise and try their level best to improve communication and in that case effective communication.
References:
Bala, N., Sandhu, K., Bansal, L., Attri, J., Sandhu, G., & Mohan, B. (2015). Conflicts in operating room: Focus on causes and resolution. Saudi Journal Of Anaesthesia, 9(4), 457. doi: 10.4103/1658-354x.159476
Brach, C. (2017). The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement. Studies in Health Technology and Informatics, 240, 203–237.
Cobos, B., Haskard-Zolnierek, K., & Howard, K. (2015). White coat hypertension: improving the patient–health care practitioner relationship. Psychology Research and Behavior Management, 8, 133–141. doi.org/10.2147/PRBM.S61192 Colvin, C. J., Konopka, S., Chalker, J. C., Jonas, E., Albertini, J., Amzel, A., & Fogg, K.
(2014). A Systematic Review of Health System Barriers and Enablers for Antiretroviral Therapy (ART) for HIV-Infected Pregnant and Postpartum Women. PLoS ONE, 9(10), e108150. https://doi.org/10.1371/journal.pone.0108150
Cooper, J., Edwards, A., Williams, H., Sheikh, A., Parry, G., Hibbert, P., … Carson-Stevens (2017). Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database. Annals of Family Medicine, 15(5), 455–461.
https://doi.org/10.1370/afm.2123 Haberer, J. E., Sabin, L., Amico, K. R., Orrell, C., Galárraga, O., Tsai, A. C., … Bangsberg
R. (2017). Improving antiretroviral therapy adherence in resource?limited settings at scale: a discussion of interventions and recommendations. Journal of the International
AIDS Society, 20(1), 21371. https://doi.org/10.7448/IAS.20.1.21371 Janati, A., Hosseiny, M., Gouya, M. M., Moradi, G., & Ghaderi, E. (2015).
Communicable Disease Reporting Systems in the World: A Systematic Review Article.
Iranian Journal of Public Health, 44(11), 1453–1465.
Koo, L. W., Horowitz, A. M., Radice, S. D., Wang, M. Q., & Kleinman, D. V. (2016). Nurse Practitioners’ Use of Communication Techniques: Results of a Maryland Oral Health Literacy Survey. PLoS ONE, 11(1), e0146545. https://doi.org/10.1371/journal.pone.0146545 Lewis, S., Damarell, R. A., Tieman, J. J., & Trenerry, C. (2018). Finding the Integrated Care
Evidence Base in PubMed and Beyond: A Bibliometric Study of the Challenges. International Journal of Integrated Care, 18(3), 11. https://doi.org/10.5334/ijic.3975 Pantoja, T., Opiyo, N., Lewin, S., Paulsen, E., Ciapponi, A., Wiysonge, C. S., … Oxman, A.
(2017). Implementation strategies for health systems in low-income countries: an overview of systematic reviews. The Cochrane Database of Systematic Reviews, (9), CD011086. Advance online publication.
https://doi.org/10.1002/14651858.CD011086.pub2 Philippa M M., Solange R G., Bravo?Soto C., Olivares T. & Theresa A L. (2018)
Communication Skills Training for Healthcare Professionals Working with people who have Cancer. Cochrane Systematic Review Retrieved from: Cochrane Library Piña, I. L., Cohen, P. D., Larson, D. B., Marion, L. N., Sills, M. R., Solberg, L. I., & Zerzan,
(2015). A Framework for Describing Health Care Delivery Organizations and Systems. American Journal of Public Health, 105(4), 670–679. https://doi.org/10.2105/AJPH.2014.301926
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003751.pub4/abstract
Renata M,. Cindy G,. Norman S., Andrew G. R., & Julia H. (2015) Overcoming Language Barriers in Healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language BMC Health Services Research 15,
371 https://doi.org/10.1186/s12913-015-1024-8 Revere, D., Calhoun, R., Baseman, J., & Oberle, M. (2015). Exploring bi-directional and SMS messaging for communications between Public Health Agencies and their stakeholders: a qualitative study. BMC Public Health, 15, 621. https://doi.org/10.1186/s12889-015-1980-2 Savoia, E., Lin, L., & Gamhewage, G. M. (2017). A Conceptual Framework for the Evaluation of Emergency Risk Communications. American Journal of Public Health, 107(Suppl 2), S208–S214. https://doi.org/10.2105/AJPH.2017.304040 Yan-Shing C., Kirstie C., Anayda G. & Debra B (2018). Interventions to Support Effective
Communication Between Maternity Care Staff and Women in Labour: A mixed-methods Systematic Review. Midwifery 59, 4-16 doi.org/10.1016/j.midw.2017.12.014
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