Health Care Quality: Models and Standards

Abstract

This paper investigates the models and standards used by a particular healthcare agency for quality improvements. The findings indicate that the agency has implemented already established options for standards of care, care delivery models, quality improvement, leadership, and evidence-based care. The paper demonstrates that an agency can adopt such models to the benefit of the population that it serves and employ them to foster quality improvement.

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Introduction

High-quality care presupposes multiple benefits for patients and healthcare organizations. In this paper, the application of care delivery systems, standards, approaches to quality improvement, leadership, and evidence-based practice will be considered with the help of a healthcare agency which will be used as an example. The analysis suggests that various care problems can be resolved by employing well-established models and methods of quality improvement and leadership.

Nursing Care System and Standards

The described agency is rather small, with four healthcare practitioners and two other staff members who are busy with administrative tasks. The team has one psychiatric nurse and one practicum nursing student; this arrangement determined the need for a particular nursing care delivery system which can be defined as a form of team nursing (MacPhee & Havaei, 2018). Indeed, the agency has a nurse leader who selects the tasks meant for the student. It might be a temporary arrangement, but for the time being, the nursing care delivery system is defined by differences in the team members’ experience.

Regarding quality standards, the agency uses them for care processes and outcomes, which were customized. Such customizations were based on the recommendations of relevant organizations, including the American Psychiatric Association, as well as applicable legislation. It is not an uncommon approach (Pelletier, 2018), which shows that the agency’s standards are determined by the needs of the population it serves, that is, people with mental health conditions.

The agency works with older adults, and the most common diagnoses include depression, prescription medication or alcohol abuse, and Alzheimer’s. The population that is considered high-risk by the practice includes people with suicidal ideation or intent. These features are screened for, especially in patients with the conditions that are associated with such risks, for instance, depression. The practice regularly faces multiple problems, especially those related to the care for particular populations. Older people with psychiatric conditions tend to have common needs, including reduced mobility or mental capacity. The agency has broad goals that describe high-quality care and quality improvement, but it could also be helpful to incorporate the specifics of caring for older populations into them. Some possible examples are presented below:

  • developing care plans that take into account the specific needs of older people with mental conditions;
  • developing care plans that incorporate ethical considerations related to caring for older people with mental health conditions.

Approach to Quality Improvement

The described agency employs the PDSA model to structure its quality improvement efforts. This method is relatively common with the model being very popular; it is an abbreviation of “Plan, Do, Study, Act” (Pelletier, 2018, p. 291). This approach is implemented by planning a quality improvement project in response to a particular need, piloting it, evaluating the results, and incorporating it fully. This way, the agency ensures that its practice is capable of change and development.

Leadership Style

The leadership style of the practice is determined by its small size, due to which the engagement of all the members is rather easy. Shared leadership appears to be the best descriptor: leadership responsibilities can be distributed between the four specialists, as well as one other staff member, as needed for the agency’s functioning and in recognition of each member’s unique abilities (D’Innocenzo, Mathieu, & Kukenberger, 2016). As a result of this approach, the members are empowered to propose and lead change efforts, which is encouraged within the practice due to the universal understanding of the importance of the quality of care.

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Evidence-Based Solutions to Care Problems

Being comprised of trained healthcare professionals, the agency recognizes the value of evidence-based solutions. The members explicitly state that they use the Iowa Model when an evidence-based practice element is supposed to be implemented (Iowa Model Collaborative et al., 2017). For instance, if the practice aims to introduce telehealth services to help older people with reduced mobility in accessing care, the following steps will be taken. First, an evidence-based telehealth solution will be found, checked for compatibility with the practice, and its pilot will be planned. After piloting, the necessary adjustments will be made, and if the solution is sufficiently effective, it will be fully integrated. Thus, an evidence-based solution that addresses the particular needs of older people could be introduced through the Iowa Model or PDSA within the studied practice.

Conclusion

To summarize, the described agency uses well-established models of care delivery, care standards, leadership, quality improvement, and evidence-based care. The majority of the mentioned factors can enable quality improvement projects. The provided example of a potential change illustrates the fact that these models could be used to guide an effort dedicated to addressing the agency’s primary care challenge by enabling it to respond to the particular needs of the population that it serves.

References

D’Innocenzo, L., Mathieu, J., & Kukenberger, M. (2016). A meta-analysis of different forms of shared leadership–team performance relations. Journal of Management, 42(7), 1964-1991. Web.

Iowa Model Collaborative, Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M.,… Tucker, S. (2017). Iowa Model of Evidence-Based Practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175-182. Web.

MacPhee, M., & Havaei, F. (2018). Professional practice models. In D. Huber (Ed.), Leadership and nursing care management. (pp. 225-239). Amsterdam, Netherlands: Elsevier.

Pelletier, F. (2018). Quality and safety. In D. Huber (Ed.), Leadership and nursing care management. (pp. 286-316). Amsterdam, Netherlands: Elsevier.

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