18. 09. 18
posted by: Living Wisely
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Quality improvement is a systematic and deliberate approach towards improving the quality of healthcare by health practitioners in measurable ways. Quality improvement which is also known as QI is an ongoing effort to make the process of healthcare better. Quality improvement has picked up in relevance and popularity in recent times and the number of piqued interests of people in the health industry is at an all-time high. https://www.healthcatalyst.com/5-Deming-Principles-For-Healthcare-Process-Improvement


Quality improvement put simply is making healthcare safe, timely, patient-centered, effective, efficient and equitable. Researchers and health practitioner constantly find ways to maximize quality improvement. Many health organization and practitioners are green on this topic and always have a hard time deciding where to start. Especially in large organizations with various departments, multilayered processes, and tons of staff.


Determining Where and How to Start Quality Improvement  

So how does one determine where to start when it comes to quality improvement. Health organizations might not even realize what their pain point is but suppose they do how do they determine which pain point to pursue first. Health Catalyst mentions that usually before these questions can be answered the health organization needs to embark on process improvement. Many health organizations or health practitioners will answer this based on the number i.e they will choose to start their quality improvement in the area that has the largest potential return on investment (ROI). This may not be the best cause of action especially considering that health organizations should be patient driven and not profit driven. This points to a larger problem in the healthcare system of the United States but I digress. So how can they determine where to start?


Health practitioners are advised to take other factors into consideration when making this decision such as the readiness and openness to change in each department and area. For example, a certain department may show as needing quality improvement in theory or prove to provide the best potential return on investment, but in looking at the personnel you realize that they have a good team that is already inclined to exchange information and is very open to using evidence-based medicine. You also see that they have successfully navigated this type of change before, whereas it is uncharted ground for the other two areas. In this case, where you need a quick win and a showcase project, you will likely get your best overall return on your efforts by working with this team in a tweaked way. That is, of course, assuming your quality improvement plan has room for flexibility (which it should)  They can then set the example, and perhaps even provide guidance to the other teams when it’s time to tackle opportunities.


Another key determinant is Variation. Let variation be your map. There are software and systems that have been designed to uncover significant variations in a system that can help health practitioners identify the greatest opportunities for improvement and serve as the map to help you get started. This will not help you through the entire process or do the work for you, it but will serve as a nudge in the right direction, a guide down the right path,


Variation is a very important guide and it also helps eliminate waste. Put eloquently by Health Catalyst:

  • Variation in what care is ordered
  • Variation in how care is delivered
  • Preventable complications resulting from care delivery—termed defects in Sigma/Lean terminology—that can harm or injure patients (e.g., hospital-acquired conditions)


Creating standardized clinical effectiveness guidelines that reduce variation can not only serve as a guide in a quality improvement plan but definitely improve clinical performance. 



Closing Thoughts on Quality Improvement in Healthcare

When you walk into a doctor's office, clinic or hospital, it may not feel like there have been any significant changes. In fact, many aspects of the health care system feel like they move at a snail's pace. However, an evolution has made its way through the underbelly of the data and how that information is treated. Just because change is not readily visible to incoming patients does not indicate a lack of progress, but a seamless knitting together of normal practice and "sophisticated analytical infrastructures".

If you are wondering how daily interactions and data analytics speak to the future of healthcare, all you need to do is understand the possibilities that are available or will be as advancements continue to mature. This starts with the fact that the daily medical occurrences aren't simply filed away in a personal medical record. Each event with its many diversities and normality are stored as a means to later being able to interpret someone's situation. By pooling the vast amounts of information, a stronger foundation of knowledge is being developed and utilized by healthcare professionals.

Another step forward for this industry is found within the walls of standardization in diagnoses and treatments. Also known as Population Health Management (PHM), for those familiar with inside terminology, can provide a more cost-effective yet efficient brand of care. When data regarding the workings of facilities are gathered and analyzed, a picture begins to be painted not only about traits within the organization, but also the people and community that are receiving care. This picture represents evidence-based information where and how care can more productively be administered.