Quality management in healthcare

Healthcare organizations such as hospitals and medical clinics are responsible for maintaining the highest quality of services. In addition to implementing policies, organizations should set up system designs to ensure policies are followed, measured, and evaluated. This will help them achieve and maintain the desired level of excellence.

This is called quality management in healthcare. It focuses on the services, products, and actions that help an organization offer the best healthcare services.

Read on to learn more about quality management in healthcare, including what to consider, its importance, barriers to overcome, tools you can use, and more.

Quality management in healthcare is the administration of policies, processes, and system designs to achieve excellence in service delivery. It ensures that services, products, and human resources can fulfill and maintain the highest standards.

Healthcare organizations achieve their desired results by constantly monitoring existing processes, collecting and analyzing data, and making relevant alterations.

Quality management in healthcare involves using tools known as quality management systems (QMS). They organize, standardize, implement, and improve activities related to the products or services aimed at patients.

Measuring the effects and outcomes of different factors through data collection enables stakeholders to identify issues with the system. They can then implement evidence-based solutions to develop or alter processes and improve patient care.

New information is collected while the solutions are implemented to determine whether the changes are beneficial or need further adjustments. The ultimate goal is consistently delivering high-quality patient care and services while causing minimal discomfort, mortality, and morbidity. Boosting patient satisfaction and loyalty is key.

Healthcare organizations that employ quality management achieve far better results than those that don’t.

Here are some of the benefits of quality management in healthcare:

Improved patient safety

Maintaining patient safety is every medical organization’s ultimate priority. Therefore, implementing quality management helps prevent errors and establishes a safety culture.

Reducing infections, avoiding adverse drug effects, and preventing avoidable deaths are the main things healthcare organizations focus on.

Improved operational efficiency

With a QMS, healthcare organizations can set up operational processes for everyone to follow across the board. They can streamline patient intake and transfer, schedule staff conveniently, create a patient portal to improve patient care, and more. This removes any hurdles these processes cause and improves efficiency.

Cost-effectiveness

The next step after improving operational efficiency is becoming more cost-effective. This can free up funds for other things that improve service delivery, like equipment, treatments, and training.

Continuous improvement

The healthcare industry is constantly evolving. Quality management systems can help you determine how to meet current needs through regular reviews, appraisals, and better service delivery methods.

It’s easier to find and address poor performance

Carrying out regular reviews pinpoints poor performance in your healthcare organization. This allows you to review your current processes and find measurable solutions to offer the highest quality services.

The Institute of Medicine (IOM) has established six crucial domains or building blocks for quality management in healthcare. 

1. Patient safety

2. Effectiveness

3. Patient-centeredness

4. Timeliness

5. Efficiency

6. Equity

Here’s a breakdown of these elements:

Patient safety

This principle ensures healthcare organizations treat patients with respect and understanding. Healthcare facilities must consider all feasible steps to protect their patients from potential medication or diagnostic errors, infections, defective devices, and preventable death.

Effectiveness

This domain refers to how well a healthcare facility achieves its purposes. Healthcare facilities must use the most appropriate procedures and treatments to adhere to best practices and high standards of care.

Patient-centeredness

This domain emphasizes the importance of considering the patient’s perspective. Healthcare professionals should work with patients to identify and address their needs.

It also promotes an individualized approach to service delivery and allows patients to take control of their experiences.

Timeliness

While timeliness mainly applies to emergency services, it also includes routine medical care, like treatments and checkups.

Efficiency

Efficiency is an element that measures how well a healthcare organization uses resources to get the best results. It examines inputs, such as human resources and finance; outputs, such as services provided; and processes, such as management.

Improving a healthcare organization’s efficiency usually includes identifying ways to reduce unnecessary costs and increase production while enhancing quality.

Equity

Healthcare organizations should maintain equity in their service delivery. This means no single person or group of people receives better services than others.

Everyone should receive proper medical care regardless of their religion, sexual orientation, socioeconomic status, geographic location, age, or gender.

Several factors undermine quality management in healthcare, affecting staff members, leadership, and patients seeking medical services.

Here are some of the barriers you might face when implementing quality management in healthcare:

Convincing stakeholders about the problem

Convincing stakeholders that a problem needs addressing is one of the most significant challenges in improving healthcare quality. Some clinicians may argue that the problem being targeted isn’t a real problem. They might suggest that other crucial issues should be addressed instead.

It can also be challenging to convince clinical teams to change when they think they’re doing well. Your efforts may be futile unless you prove action is necessary.

Data collection and evaluation

Data collection and evaluation are indispensable in quality management. However, these processes can be a burden for the target audience or considered irrelevant. This risks alienation rather than engagement.

Choosing inadequate methods and tools for data collection and evaluation can also contribute to inconsistent data, especially when participants are incentivized to produce random numbers.

Lack of resources

It’s natural to feel enthusiastic about improving quality in healthcare—but you might find it overwhelming in reality. In most cases, the resources needed are greatly underestimated. Failing to meet objectives can risk alienation and disillusionment, even when proper budgets are set.

Organizational culture, context, and capacity

Quality management outcomes in healthcare may be affected by morale, management, and leadership. For instance, clinical staff may be hostile toward improvement efforts. Or, managers may be too busy to take an interest, especially if they feel threatened.

Lacking proper structures to support improvement efforts can also affect quality management outcomes.

The International Standard of Organization (ISO) has developed seven fundamental principles that organizations can build upon to ensure consistently high-quality service delivery. These standards are similar in healthcare quality management.

Let’s have a closer look at these principles:

Engaging people at all ranks

Quality management isn’t just for senior management. Everyone should contribute.

While engaging other people in your organization, ensure they understand their roles and feel valued for their contributions. This will help enhance collaboration, increase job satisfaction, and motivate the team, allowing for better feedback from all stages of process implementation.

Customer focus

Without customers, your healthcare organization wouldn’t have any services or products to offer. You need to keep them returning to your facility by meeting their expectations and building their confidence in the services or products you offer.

Gathering feedback is key—whether it’s good or bad. It helps you spot non-conformities, such as customer complaints, missed appointments, and defective products while improving quality management processes.

Leadership

Strong leadership shows you envision your healthcare organization’s future. It also ensures unified and attainable approaches via preset policies and processes, reinforcing the purpose of your efforts and goals.

Process approach

The ISO has established the plan-do-check-act (PDCA) principle to promote a process-driven culture across organizations. You can use it to establish a plan and manage strategies and resources to continuously improve service delivery. All the individual processes required to achieve your ideal outcome should work together as a unit.

Improvement

Continual improvement is critical to quality management in an organization. It includes identifying processes, risks, and opportunities and solving non-conformities to find ways to make your organization better.

Evidence-based decision-making

Every decision you make regarding quality management should be based on facts. Evidence-based decision-making involves evaluating facts, evidence, cause-and-effect relationships, and other data that allows you to deliver the best services.

You can achieve consistent results when you base your processes on specific standards. Next, monitor the outcomes, collect data, and make necessary alterations to determine whether you have achieved the desired results and improve your quality further.

Relationship management

Healthcare organizations should maintain supportive relationships with their retailers, suppliers, partners, and financers to achieve positive outcomes. You can maintain a reliable supply chain when you share goals and understanding. 

You can follow the Donabedian model to measure quality in healthcare. This model involves three components: structural, process, and outcome measures.

Structural

Structural measures assess the healthcare organization’s capacity, processes, and systems for providing and maintaining quality care. Some aspects to look into are:

• Use of technology to handle daily tasks

• Number and proportion of board-certified doctors

• The patient–doctor ratio

Process

Use process measures to assess the healthcare provider’s efforts to maintain and improve patient health.

They usually reflect accepted clinical recommendations. Here are some examples:

• The percentage of patients receiving preventive medical services

• The percentage of diabetes patients using medication

Process measures can also give patients information about the care they will likely receive for their condition.

Outcome measures

Outcome measures enable you to see how your organization’s actions have impacted patients. From this insight, you can assess whether your organization has met its goals. 

Reduced mortality is an example of an outcome measure. It indicates improvements have been made.

Tools are essential for measuring quality and efficiency in healthcare management processes.

Most tools use traditional statistical calculations and methods to identify and evaluate different quality-defining parameters. Here are some of those tools:

• PDCA and checklists

• Cause-and-effect diagrams or fishbone diagrams

• Pareto charts

• Process mapping or flow charts

• Scatter diagrams

• Gantt charts

• Histograms