Critical Review of Mechanisms Used to Monitor and Audit the Quality in Care Services

The definition of high quality care proposed by Lord Darzi in High Quality Care for All (2008) has now become enshrined in the Health and Social Care Act 2012. To achieve high quality care all 3 elements of patient experience, patient safety and clinical effectiveness must be present.

Quality Improvement (QI) is an organizational approach leading to the quality of patient care and patient services through use of specific guidelines, principles, and methods to ensure quality of care for every patient and health care facility throughout the world. Quality outcomes focus on the principles of quality management. These measurements investigate the quality of care, patient outcomes and consumer needs, through being part of the participant group. This quality improvement discussion will review the foundational frameworks of QI and explanation of each framework in detail. Included in this QI report will be

These require managers to possess specific sets of knowledge, skills and qualifications to undertake the role. They specify that managers must adhere to the NISCC Code of Practice for Social Care Workers and ensure that care staff are aware of their responsibilities. I can evaluate my performance against these standards and codes of practice by ensuring my individual training and development plan contains clear goals and expected outcomes in relation to these standards codes of practice and my job description and responsibilities, which way to achieve them and expected timeframes for completion. When undertaking appraisals and supervision with employees of the organisation, it is imperative that their personal training and development plan reflects their current job role, any gaps in knowledge or training deficits and gives clear goals and opportunities to improve any shortfalls, so as to assist them in meeting required benchmarks. The care workers progress in meeting set targets will be continually monitored throughout the year through supervision and appraisal.

Quality Assurance/Performance Improvement (QAPI) “an initiative that goes beyond the current Quality Assessment and Assurance provision, and aims to significantly expand the intensity and scope of current activities in order to not only correct quality deficiencies, but also to put practices in place to monitor all nursing home care and services to continuously improve performance”.

One of the central codes of practice in health and social care has been provided by the GSCC and it sets standards of practice and behaviour for staff working in that field, including standards

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

The Care Quality Commission makes sure that hospitals, care homes, dental and GP surgeries, and all other care services in England provide people with safe, effective, compassionate and high quality care, and they encourage these services to make improvements.

them gain basic management and effective communication skills. The value base The standards are based upon management practice which has person-centred support at its heart, with people who use services firmly in control and identifying what is personally important for the achievement of preferred outcomes. The standards emphasise relationship-centred care as the major approach. Managers

Take part in courses to learn new skills to incorporate into day to day working.

Care Standards Act (2000): it provides for the administration of different care institutions, for adults and children.It ensures that all care provision

This pathway gives staff structure, support and professional integrity. Additionally, The Royal College of nursing, SCIE, and primary care trusts are all involved in the development of protocols and guidelines. This does however indicate that no service users are involved in the creation process, possibly resulting in service and organisational focused guidelines. Successfully implementing protocols has its barriers. The Open University, (K101 Introduction to Health and Social Care, Resources, 2014) highlights several problematic factors including, limited resources, staff shortages and equipment and medical supply problems. However, once implemented successfully these policies may help to manage risk, control budgets and reduce litigation.

The NSF and NICE create a means by which NHS trusts ensure the provision of quality standards by making NHS employees accountable for setting, maintaining and monitoring standards of care (DoH 1997). The National Institute for clinical excellence was founded in 1999 and consists of a number of specialized organisations: the NHS centre for reviews and dissemination, national prescribing agency, medical devices agency and institutes of public health. All aimed at creating and maintaining national standards through effective management and cost effectiveness, through audits and reviews of health policies. The commission for health improvement (CHI) aims to monitor the delivery of these standards provided by NICE and NSF through national surveys of the patients experience (Freedom D, 2002). This commission (CHI) sets out to review all NHS trusts including community care. Each NHS trust will be visited over three to four years and be reviewed to decide whether or not national standards are being met and NICE guidelines are being adhered to.

A clinical audit is a quality improvement process which aims to improve care through a systematic review of practice against evidenced based criteria, followed by the implementation of change (Healthcare Quality Improvement Partnership, 2011). There are many different audit cycles to choose from which could be confusing for practitioners (Dixon & Pearce, 2011). The audit cycle pictured below (figure1) was selected as a bases for this project because it is simple to use and emphasises the importance of maintaining improvements.

Quality Objectives - The quality objectives define measurable goals relative to the company's quality management system. Requirements on the quality objectives are in ISO 9001:2008 section 5.4.1.

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.