Quality Health Care Elements OF Tqm AND Cqi-Myassignmenthelp.Com

Question: Difference Between Clinical Governance And Clinical Leadership? Answer: Introducation From the past two- three decades the greater emphasis on quantity care has turned into quality care. The term quality- in- health care is defined as the degree to which the health services that are provided to the persons and/or populations, enhances the likelihood of expected health-care outcomes in-accordance with the current professional knowledge (AHRQ, 2012). This quality in health-care should be clinically effective and safe. It should portrait the effectiveness of patient- care not only in the hospitalized care but also the quality-of-life after hospital treatment.As per AIHW (2017), Australia provides a good quality health-care to most of its population and rates high internationally and also strives continuously to improve health care performance. Total Quality Management (TQM) is known as continuous quality improvement (CQI) in the health-care administrational as well as clinical process. The term CQI means an organizations process that involve individuals in planning as well as implementing health-care improvements continuously to promote quality health-care, that either meets or exceeds the expectations. The three key elements of TQM and CQI in-regard to health care context are as follows. The philosophical elements which focuses on strategic plans (mission, values and objectives), customer satisfactions (client, care- provider, payer), health outcomes, health- care system analysis, evidence- based analysis, multiple root- cause analysis, identifying solutions, optimizing the health- care delivery process, constant emphasis on CQI and organizational learning (McLaughlin, 2012). Its structural elements involves forming and empowering health- care teams, developing separate health managerial structure to monitor CQI, statisti cal- process control, customer- satisfaction measures and bench marking to identify the best health-care practices. The specific health- care elements includes epidemiological with clinical studies along with medical data and insurance payment (basis for evidence based practice), involving clinical governance (quality assurance), using risk controlled outcome measures and cost- effectiveness analysis.; Patient safety and safety in healthcare Quality in health- care is nothing but the quality in patients care that incorporates patients safety which is a basic patient need. Health- care that is provided in a safer manner and in a safer environment is most essential for a patients survival and well-being (Douglas, 2012). Moreover, patient/ client safety involves preventing any risk/harm to the patients. The AHRQs Patient- safety network adds that preventing harm means keeping the patients free from any accidental and/or preventable traumas that are caused by medical care (AHRQ, 2012). This harm might cause temporary or permanent damage to the physical and/or psychological bodily functions and/or structure. Hence, a quality health- care delivery system should prevent patient errors (medication errors, falls, accidents, etc), learn from errors that have occurred and build a culture of safety by involving health- care providers, organizations, as well as patients. Many countries have framed quality frameworks and elements afte r realizing its importance in health- care industry. The Government of Australia has also implemented NSQHS standards for the same purpose. Patient safety that is one of the most important quality indicator forms the cornerstone of a high quality care. Themaintenance of safety in a health system was stated by theAustralian health performance (work) committeeby associating safety with that of avoiding or minimizing any of the actual or potential risk/harm that occurs in a health care sector and/or a hospital environment where patient care is rendered to an acceptable limit. Additionally, the former, National (Australian)- Council for safety quality in health- care has stated quality service in health care as a degree of health service that is rendered to the patients to reduce or avoid any potential harm/risk which could result in un-intended outcomes (AIHW, 2017). Therefore, patient safety with safety of health- care system forms the key for the quality- in- health- care. NSQHS standards- Australia NSQHS was implemented by the Australias Commission on safety- quality- in health care. It is funded by the Federal, State as well as Territorial Governments. These standards were framed to design a National strategic- framework with a uniform set of measures to guide its efforts to improve safety with quality of a variety of health services in health system of Australia. These standards frame evidence- related improvement measures to close the gap between current and best health- related practice. The NSQHS standards for client safety and quality are described as follows: 1. clear governance for safety in health service organizations that demonstrates quality mechanism of a health care organization to practice safe practices. 2. Partnering with clients that comprises of the systems with strategies to frame a client-centered health-care system. 3. Preventing controlling of health-care related infections (Duguid, 2011). 4. Medication safety that comprises the health- systems to check whether the physicians safely prescribe, administer and/ or dispense appropriate drugs to the clients. 5. Patient identification with procedural matching that encompasses the health- systems to appropriately identify and match the clients with appropriate treatment. 6. Clinical hand- over that comprises of the health- systems to enable proper clinical communication between health- care professionals. 7. Blood its products that include health- systems to promote safety, effectiveness and appropriat eness in the management of blood and its products to ensure safe administration of blood (NBA, 2011). 8. Preventing treating pressure ulcer that comprises the health- systems to prevent the clients from developing pressure ulcers and to develop best- practices to manage pressure ulcers. 9. Recognize adequately and respond to critical situation in any of the acute care services by health- service organizations. 10. Prevent falls harm due to falls that includes health- systems to minimize fall incidence in health-care organizations (NSQHS, 2012) Role of clinical leaders in ensuring Quality Improvement in health- care An effective clinical leadership is crucial in enhancing the quality of health-care system that provides a safer with efficient health-care (Francis, 2013).Many recent inquiries and reports suggest that promoting physician engagement with clinical leadership is critical to improve quality with patient safety.As, leadership is the process of influencing individuals to achieve goals, the quality improvement which is a sequential process of assessing as well as evaluating the health-care services to enhance health-care practice and/or quality- of- care; also requires effective clinical leaders to accomplish its goals. An Australian study quotes Garling Report in its description, which has given a recommendation to review and re-design the positions of Nurse- Unit managers to improve them as effective clinical leaders in patients supervision.Hence, the clinical leaders should act as a main driver for the health- service performance with considerable improvements in quality health-care, w hich could be only achieved by involving physicians and patients in this reforming process (Daly, 2014). The clinical leaders should make all the health-care team members to know the organizational dynamics so as to implement quality-related changes to improve health outcomes (Parand, 2014). Nurse leaders should be well- positioned in the hospitals to collaborate with other team members (IOB, 2011). In an individual point of view, an efficient clinical leader should have basic qualities that mirror positivity towards their profession; inculcate courage to tackle the issues; solve quality-related problems and participate in care-reflective practices (Jackson, 2013). Clinical-leaders should be efficient in promoting innovation and changes through quality- improvement which could be attained by recognizing, motivating and empowering persons through appropriate communication in-order to share as well as learn from other health-care professions. Overall, a clinical- leader should be dynamic, creative, innovative, effective communicator in a client-centric environment and engage in health-car e partnerships at the CNO/CMO level in emergency department; discharge- education and client- family-centered care to improve quality (Papa,2013). Clinical-governance is a system in which the managing directors (Board members and executives), physicians and staff- nurses share their responsibility as well as accountability for providing quality care and continuously promote, reduce risks and fosters a safer environment (of excellence) in caring the clients/ community whereas the clinical leadership substantially begins from physicians and nurses; even if they have a role in formal managerial functions or not. Physicians make front-line decisions to determine the quality of care and also possess technical skills to decide about patterns of health service delivery (Daly, 2014). Clinical- governance involves a framework and process by which a health-care organization fosters continuous improvements in all the divisions of health-care systems. It engages leaders and subordinates in quality-improvement activities while in clinical leadership, the leaders will lead the subordinates by their actions with a vision. The members of clinical governance will be associated with enhancing productivity, maintaining order and stability and running the organization nicely to improve quality- care whereas the clinical leaders will be associated with innovation, societal transformation and change to promote quality- care (Fealy, 2011). Clinical governance involves coordinating the efforts of varied levels of employees (from subordinate to advance) to achieve the quality goals of the hospital but clinical leadership involves influencing subordinates to attain quality goals. They establish a unity of purpose with common direction and create an internal environment with people who can fully involve in achieving the hospitals objectives. The senior leaders serve as a role model reinforcing the organizational values through their personalized roles in assessing, planning, evaluating health-care qualitys performance and staffs to achieve quality. In-regard to quality, an effective clinical-governance involves development with implementation of health-care practices that are designed to minimize errors and analyze the cause (Jeffs, 2012) and in an effective clinical-leadership, varied functions were linked with hospitalized care that includes system-performance, achieving health-reform objectives, health-care system integ rity with efficiency (MacPhee, 2013). Reference AHRQ. (2012). Agency for Healthcare Research and Quality: U.S. Department of Health Human Services. Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/understand/index.html AIHW. (2017). Safety and quality of health care: Australian Institute of Health and Welfare- Australian Government. Retrieved from https://www.aihw.gov.au/safety-and-quality-of-health-care/ Daly, J et al. (2014). The importance of clinical leadership in the hospital setting: Journal of Healthcare Leadership. 6: 75-83. Retrieved from https://doi.org/10.2147/JHL.S46161 Douglas, C. (2012). Potter and Perrys Fundamentals of Nursing- Australian version. Missouri: Elsevier Duguid, M Cruickshank, M. (2011). Antimicrobial Stewardship in Australian Hospitals. Sydney: ACSHQC Fealy, G et al. (2011). Barriers to clinical leadership development: findings from a national survey:J Clin Nurs. 20:20232032. Francis, R. (2013). Report of the Mid Staffordshire NHS Trust Public Inquiry-Executive Summary. London, UK: The Stationary Office. Retrieved from https://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf IOB-Institute of Medicine, (2011). Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing:The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press. Jackson, D et al. (2013). Understanding avoidant leadership in health care: findings from a secondary analysis of two qualitative studies:J Nurs Manag. 21(3):572580. Jeffs, L. P., Lingard, L., Berta, W. Baker, G. R. (2012). Catching and correcting near misses: the collective vigilance and individual accountability trade-off: Journal of Inter-professional Care. 26(2): 121-26. MacPhee, M et al. (2013). Global health care leadership development: trends to consider:J Healthcare Leadership: 2129. McLaughlin, C.P. (2012). Implementing Continuous Quality Improvement in Health Care: A Global Casebook. Sudbury, MA: Jones and Bartlett learning NBA- National Blood Authority. (2011). Patient Blood Management Guidelines: Module-1. Canberra: Commonwealth of Australia: 11 NSQHS. (2012). National Safety and Quality Health Service Standards: Australians Commission on Safety Quality in health-care. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf Papa,A. M. (2013). EMPSF: The Role of Nurse Leaders in Quality and Patient Safety: Patient safety and quality health care. Retrieved from https://www.psqh.com/analysis/the-role-of-nurse-leaders-in-quality-and-patient-safety/ Parand, A. (2014).The role of hospital managers in quality and patient safety. Retrieved from https://www.ncbi.nlm.nih.gov NCBI Literature PubMed Central (PMC)