Service improvement is arguably one of the most important challenges facing the National Health Service (NHS) today, as both patients and service users search for a ‘good quality’ service, and expect services to be both efficient and effectual. All staff within the health service need to be educated and competent in their roles, in order to be able to offer a service that is beneficial to the patients that make use of it. Fitzgerald et al (2013), described service improvement as ‘…a planned and targeted effort to improve patient-facing outcomes from a service…’. The key message in this is that the effort of service improvement should be both ‘planned’ and ‘targeted’ to a specific audience, as well as provide an improvement in the outcomes for a patient. Without a targeted, specific improvement for patients, the focus of a service improvement proposal is lost, and little value or quality is gained from the change. In light of this, the assignment aims to discuss and explore a service improvement proposal that will improve ‘patient-facing’ outcomes for people with dual diagnosis of a mental illness (MI) and a learning disability (LD). The improvement proposal in question, is specifically, a workshop that is aimed at educating and improving the knowledge and confidence of nurses who come into contact with patients who have a LD, and who may also be experiencing a MI, that may be overlooked or be going unnoticed. In order to discuss the implementation of the service
Is it important to focus on organisational values and engaging stakeholders, including patients, when working to improve care quality and patient experience?
The importance of continually providing knowledge and practice is to keep up with the constant changes that are happening all the time. Globalisation and technology have made changes in health and social care at a rapid rate. There has been a significant change in the way that care is being experienced and there are higher expectations in the quality of care. A more personal approach is required and accessibility to training resources ensures that we can all be the best in our job roles and in line with legal requirements. There are opportunities available now, thanks to technology advancements, to share responsibilities across the board, we have better access to other partnerships,
Training is imperative. There has to be a shift in the orientation of the healthcare personnel. Extensive direction is required through in-service and basic training. The perception of their role as simply delivering government health programs needs to be changed to being agents of health development. They need to be sensitive to the local needs. In addition to technical skills, they will need social skills to negotiate with other sectors, and communication skills for organization and empowerment of communities.
Dual diagnosis refers to the co-existence of a developmental disability (DD) and a mental health problem, and those who present with this type of diagnosis receive support from a number of different experts on CAMH’s interdisciplinary team. Before any client is admitted to the inpatient unit, the team attempts to collect as much information about the individuals as possible (i.e. past diagnoses, family history, psychological/behaviour assessments, etc.) and document this information on their online database and in separate client binders located on the unit. In order to build a rapport with each other clients, I started by first reading each of their binders and files. This information gave me a better understanding of their strengths and needs, as well as the best ways to communicate. For example, client PC, presenting with ASD, DD, and ADHD, was mostly nonverbal and communicated by touching your hand and guiding you or by using loud vocalizations. While becoming familiar with his file, I learned that he could read, write and understand basic math equations at a grade 3 level. Using this information, I prepared a package filled with different worksheets and sat with him in the lounge while he completed them. Although he was nonverbal, he would communicate that he wanted me to mark his math homework by passing me the sheet and handing
ensure that workforce and resources needed to create positive practice environments are met → deliver high quality care
Some advantages of the self-administered survey are: Low cost. Extensive training is not required to administer the survey. Processing and analysis are usually simpler and cheaper than for other methods. The reduction in bias error. The questionnaire reduces the bias that might result from personal characteristics of interviewers and/or their interviewing skills. Greater anonymity, absence of an interviewer provides greater anonymity for the respondent. This is especially helpful when the survey deals with sensitive issues such as questions about involvement in a gang, because respondents are more likely to respond to sensitive questions when they are not face to face with an interviewer.
The pace of change throughout the healthcare industry has never been greater, due in large part to a growing emphasis on improving patient satisfaction, managing costs, and improving quality of care. This is referred to as the “triple aim” of healthcare reform. In fact, healthcare reform has directly and indirectly driven the development of accountable care models and many other quality initiatives such as episode-based payment and shared risk programs. As a result, hospital revenue is now increasingly tied to measures related to patient satisfaction, health outcomes, and compliance with evidence-based standards of care. For example, one third of Medicare payments to hospitals are now based on quality or value.¹ These include a growing portion
As expense for-volume offers approach to charge for-worth, doctor 's facilities and social insurance frameworks are finding that their time-tried blocks and-mortar development methodologies will no more serve their long haul objectives. Today 's quality driven clinical and plans of action require a movement in center — from experience based solution to populace wellbeing administration. Systems to advance development — fundamental for quality based achievement — will depend on patient maintenance and new instruments for picking up piece of the pie.
* Salary is low and there are no benefits – no weekend rates, no holiday rates. Workers have to pay for their food on their break.
“Changing service means adjusting the structure needed to support that service" (Porter-O'grady & Malloch, 2016, pg. 322). When considering a change it is imperative that interprofessional teamwork be involved, this element underpins the change towards value-based care that will be the behavior change (Porter-O'grady & Malloch, 2016). This is the kind of change that will be looked at differently because of the new information in this chapter. Changing the current structure from traditional compartmentalization, that our institution seems to operates in to a complex adaptive system is needed. Complex adaptive systems are not vertically based, but allow staff members across the continuum to make contributions. I would change to this structure because this structure is research based in the sciences. Human
Health care delivery need to perform vital role that is expected of them in order to improve quality care and patient safety. The IOM report is also turning nurses away from the old
In order to continuously provide effective and efficient healthcare, variation has to occur within the healthcare organization. As the book states, “variation in healthcare indicates inconsistencies in the quality of care provided to different populations of patients” (Ransom, 2008, p. 55). For this to occur, organizations have to make small changes to improve their patients health and quality of life. Process variation, outcome variation and performance variation all have an impact on how care is provided and assessed. For instance, if a physician uses a different method for the screening of colorectal cancer that will not necessarily led to outcome changes or quality improvement. A good start at implementing healthcare changes could be done by creating changes in supply-genitive care (local healthcare system) (Ransom, 2008, p. 59).
The author of this assignment is currently a second year Trainee assistant practitioner (TAP) working in an Inpatient Assessment and Treatment (A&T) unit for adults with a learning disability and/or co-morbidity. In accordance with the skills for Health (2013) Code of professional conduct, confidentiality shall be maintained and the names and places will remain confidential and pseudonyms (*) will be used, for the purpose of this reflection the patient will be referred to simply as”Lizzie”.
People come to us every minute to seek solutions to their health problems. Are we truly providing the best solutions to our clients as we should? Or we are rather adding up to their problems. “Major difficulties arise when introducing evidence and clinical guidelines into routine daily practice” (The Lancet, 2003). “Data show that, many patients do not receive appropriate care or receive unnecessary or harmful care” (The Lanset, 2003). “Substantial evidence suggests that to change behaviour is possible, but this change
Nurses are key to achieving high quality care which is patient centred and effective, and opportunities exist for ANP’s to work in new ways in response to the needs of the public so enabling innovation to thrive (Sturgeon 2008), (Prime Ministers Commission 2010). The public have increasing knowledge of healthcare and expect equity of services, they want faster access to treatments and individual choice, direct linking to highly trained nurse led services have proven to improve health outcomes and assist in preventing delays resulting in cost effective responses to healthcare needs (DOH 2009a), (DOH 2010a), (DOH 2010b) (RCN 2010).