NHS Interventions

Our Performance and Quality Improvement Process is based on the Continuous Quality Improvement Model which focuses on the importance of continuing to ask “Can we do it better? Can we do this more quickly? Is there something else we could do to improve the quality of care for our clients and the tools for our staff who deliver this high quality care?” In this model, the point is to focus on improvement even when nothing is wrong.

organizations that have been successful in implementing quality improvement programmes highlight the importance of active involvement of doctors and point to factors such as effective clinical and managerial leadership, preservation of clinician autonomy, support for training, and peer pressure as important in changing attitudes and increasing commitment

The prevailing paradigm in health care can usually be summed up in one word. In the 1970s and 1980s, the word was evidence; in the first decade of the 21st century, the word was quality. The paradigm shift from the efficiency frontier to a value frontier is occurring in healthcare. A value frontier is the linking of quality and efficiency data to identify optimum levels of healthcare performance. (Harrison, 2010) Thus the value considers not only efficiency but also quality. Continuous Quality Improvement (CQI) is the idea that no service or process is perfect and that an organization must continually strive to eliminate errors from its system to get closer to perfection. (Harrison, 2010) This requires assessment of processes and setting standards to monitor the quality of the system. Value should always be defined around the customer, and in a well-functioning health care system, the creation of value for patients should determine the rewards for all other actors in the system. (Porter, 2010)

Applying quality improvement has been recognized as one of the Institute of Medicine 's (IOM) core competencies. This competency serves to "continually understand and measure quality of care in

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.

As the increase in ethnic and racial minorities continue, so do the increase in health disparities among individuals with diabetes (Hispanic or Latino, 2014). Many interventions are currently being used in healthcare settings to help prevent further health complications among minorities with diabetes (Peek, Cargil, & Huang, 2007). A study by Peek, Cargil, & Huang (2007), titled, “Diabetes Health Disparities: A systemic Review of Health Care Interventions”, further examined the importance of education in the overall management of diabetes, and it’s improvement to better health outcomes (Peek, Cargil, & Huang, 2007). The purpose of this paper is to discuss the researchers report on its background of study, methods of study, results of study, and its ethical considerations towards diabetes health disparities.

Although there have been a wide range of projects reviewing and evaluating clinical governance there is little evidence, as yet, of significant improvement in quality outcomes. The UK system of healthcare governance is now a bench mark for other developed countries (Wright, Barnett & Hendry, 2001).

Key steps for successful change management include assessing readiness for change, establishing a sense of urgency, assembling the steering team, developing an implementation plan, executing a pilot, disseminating change, and anchoring the change within the organization. Adoption of change management practices increases the odds of success because focus is placed on the people in the organization who make things happen (Varkey & Antonio, 2010). In addition, enhancement of clinical performance and the continuous improvement of the safety, effectiveness and appropriateness of clinical care occurs through the introduction, use, monitoring and evaluation of evidence-based best practice. Ongoing evaluation of organisational and clinical performance is critical to good governance and involves the use of performance measures, clinical indicators and clinical audit. Reporting organisational performance is central to governance of clinical care and provides mechanisms for monitoring safety and quality performance and flagging issues that require intervention. Clinicians should provide input into prioritising improvement activities through identifying gaps between evidence and practice. Improvement activities

The focus of my leadership initiative is to develop a new, simpler and leaner approach (Fillingham, 2008) to the assessment process, ensuring safe and reliable delivery of right care, in the right place and at the right time, to the patients. Recently we implemented monthly practice governance meetings in our team to regularly reflect on areas of improvement and discuss changes that would improve patient care. I have been using the practice governance meetings to present results from our recent audit demonstrating increased treatment-waiting times, share real stories highlighting the gap between the current and desired state of the service and encourage engagement of frontline staff in delivering this initiative. Staff was given opportunity to perform a Cause and Effect Analysis (figure1) and map patient journey (figure2) to identify activities that add value (Bennington, 2011) and reduce waste. I was hoping to use these meetings to frame and embed a strategy of implementing the improvement initiative and whilst I have been successful in developing a framework of the new leaner assessment process, the process has suffered from poor staff engagement and conflicts with trusts’ agenda of standardising the delivery of care. During these practice governance meetings, the team was unable to come up with any suggestions to improve the assessment process and other agendas related to the new community service review policies were given greater priority. Some clinicians

As a clinician, we can come up with the best interventions. But, it is only going to be successful if the patient understands the intervention and implement correctly. In order to patients understand the information provided, a clinical need to speak the language and understand the culture of their patients (Benjamin, 2010). Pender, Murdaugh, and Parsons (2010) recommends few strategies for delivering health care information. The one I am going to us the most is breaking down complex information into small, understanding chunks. Regardless how much the information is simplified, remembering all the information is almost impossible. Therefore, I also going to provide a written handout according to the patient's literacy level or repeat the

Continuous quality improvement (CQI) is a topic that is taught from the beginning of nursing school. “Continuous quality improvement is an approach to improving quality on a continuing basis” (Pozgar & Santucci, 2015, p. 549). It is called continuous quality improvement because we will always have room for improvement throughout the healthcare system. “Continuous quality improvement involves improving performance at every functional level of an organization’s operation, using all available resources (human and capital)” (Pozgar & Santucci, 2015, p. 549). Continuous quality improvement is so important because it involves everyone. “It combines fundamental management techniques, innovative improvement efforts, and specialized technical skills

I think public health interventions are mainly responsible for improvements in health status of mothers and infants because there are few changes that has been happened in environmental interventions, health related education and overall economic growth. In early 20th century, the vaccines and antibiotics were not invented, so the main focus was to educate people and help them in family planning.

Health care improvement and high quality care requires more then the technical approach of tools and methods, improvements often require a change in attitude and sense of ownership for the quality of serviced provided by an organization. Many supporting factors must integrate QI into the structure and foundation of the company, these are also known as the building blocks. Improvement also implies that it will be implemented in a variety of settings, circumstances and various levels within an organization. The structure has to also define how the different parts and levels of the QI program fit together and how they will be synchronized.

The term CQI itself specify that it involves people in planning and implementing a constant enhancement in quality health care. As it is a continuous process, team work is essential in order to bring improvement in health care. A team should consist of knowledgeable people who understand each other and value each other’s opinion. Here, team leader also have important role in motivating the team members who can feel comfortable to share their ideas and opinions with the team. The team can work together to analyze problems and come with a solution for the better health care. They should share a common goal of improving the quality of healthcare. An individual person’s effort would not bring major enhancement as the team effort would. Without

An organisation must have to act according to the standards of modern day so do NHS have to. It must introduce initiatives of change regularly perhaps on multiples levels too like other organisations. On total quality a proper process of research need to be implemented. This will build cultures of compliance and health in turn. NHS has always worked on phenomenon of high quality care for all. Many leading organisations throughout the world are focusing on system of the organisation and system of the health at the same time in these days. These are linked with a promise that quality work today may pave way for tomorrows high quality work. The hallmark of a healthy organisation is that they embed culture promoting engagement, trust and openness. They achieve it on the basis of learning and improvement process.