Project for Improving Quality of Healthcare

Quality of healthcare services is the degree to which the services achieve the desired
outcomes. Based on this definition, it is clear that the healthcare services that our organization
has been providing to individuals have not been of the quality we would be proud of. Therefore,
as a quality officer, I have decided to come up with various quality improvement initiatives
which I have provided in this paper.

Three Quality Initiatives for The Organization

The three quality initiatives that I believe will lead to significant improvements to the
organization are improvement of communication, employment of more nurses, and improvement
of administration of medication process. Regarding the first proposed quality initiatives, studies
have revealed that medical errors are one of the most common causes of poor healthcare
outcomes, such as injuries and deaths (Stanley, 1). Studies have also found that poor
communication is the leading cause of medical errors. Therefore, improving communication
among hospital staff will significantly reduce malpractices and improve patient outcomes. Some
of the methods that can be employed to improve communication among healthcare staff include
having healthcare workers operate in teams and implementing technology systems, such as
electronic health records (EHR).

The second quality improvement initiative, employing more nurses and physicians, will
reduce workload of nurses and physicians and, therefore, improve the quality of services that
they offer to patients. Shortage of nurses and physicians is a major cause of long waiting times

3

which not only reduce patient satisfaction with healthcare services but also worsen outcomes
(Stanley, 1). Additionally, having adequate number of nurses and physicians to comfortably
manage hospital workload will reduce instances of medical errors whose commitment can be
attributed to fatigue resulting from overwork.

The third initiative involves improvement of medical administration processes. Patients
receiving wrong medication due to, among other things, transcription errors, is a common cause
of poor patient outcomes (Stanley, 1). This problem can be solved through the use of Bar Code
Medication and Administration (BCMA). This technology allows hospitals to label each drug
with a barcode so that when a medication is prescribed to a patient, it is sent either by hand or
electronically to the pharmacy. Thanks to this system, hospitals ensure that patients receive the
right medication and at the right time.

Supporting Factors That Could Aid in Reduction of Healthcare Costs

The two main supporting factors that could aid in reduction of healthcare costs are use of
technology and compensation of physicians based on patient outcomes instead of number of
services offered. Through use of technology, many services can be automated thus freeing up
labor to be used exclusively to provide care to patients (Wani & Malhotra, 2). This is likely to
improve quality of services offered to patients. Secondly, paying physicians based on patient
outcomes instead of number of services offered will remove the urge to over treat patients (Lyu
et al., 3). Paying physicians based on patient outcomes will, therefore, encourage adoption of
effective treatment methods which are likely to improve outcomes for the patients and reduce
costs.

4

Differences between free market healthcare system and single payer government system

In free market healthcare system, patients pay for services provided to them by healthcare
providers (Liu & Brook, 4). They can either pay for themselves or use insurance companies to
pay for their medical expenses. Unlike in free market healthcare systems where each patient pays
for their care, in single payer systems it is the government that pays for healthcare expenses of all
individuals (Liu & Brook, 4). Healthcare providers record all their expenses and send the bill to
the government which then pays them on agreed times, such as at the end of every month, three
months, or six months.

Of these two systems, patients are likely to get high quality healthcare services in single
payer systems than in free market systems. One of the reasons why single payer systems support
delivery of high quality healthcare services is because it allows patients to maintain relationships
with their physicians and nurses for long regardless of change of their jobs or financial status
(Liu & Brook, 4). Having patients taken care of by physicians and nurses who know them well is
a critical component of high quality healthcare services. Unlike single payer systems, free market
systems are characterized by high levels of disruptions of patient-physician relationship. Change
of insurance plans by employers, constant hiring and firing of healthcare providers, and change
of financial statuses of individuals often leads to individuals regularly receiving care who know
little about them thus significantly reducing the quality of healthcare available to them.

Another reason why single payer systems are better at delivering high quality of care to
patients than free market systems is that they able to adopt effect preventive measures (Liu &
Brook, 4). Since there is a single payer, often the government, it is in the interest of the payer to

5

reduce healthcare costs by investing more heavily in preventive measures, such as anti-smoking
campaigns so that fewer people get sick. In free market healthcare systems, providers may be
reluctant to invest in preventive care because the costs of such investment are immediate but the
benefits take a long time to be realized thus making them not financially advantageous (Liu &
Brook, 4). Since preventive care is a key component of healthcare quality, the lack of incentive
to invest in such kind of care in free market systems makes it poorer at providing high quality
care compared to single payer systems.

Lastly, patients are likely to receive better quality of care in single payer systems than in
free market systems because they are better placed to develop a uniform, computerized medical
database that can track provider and patient characteristics (Liu & Brook, 4). For instance,
having one system contain patient data that is accessible by all healthcare providers that may
treat the patient significantly reduces risk of the providers making preventable errors, such as
providing inappropriate medications for patients with allergies. It is very hard for free market
healthcare systems to have such unified computerized systems with all the relevant patient data
because each healthcare provider often develops its own system.

Common law quality initiatives still found in 21 st century

Common law is a form of law that is made by a judge or judges. That is why it is also
called judge-made law or precedent. The healthcare industry is generally highly regulated.
Federal and state governments always strive to enact legislations that regulate most aspects of
healthcare services delivery. However, there are still some aspects of healthcare that are

6

regulated by case laws or judgements passed in previous cases. Some of these case laws govern
aspects related to healthcare quality.

Examples of case laws that were passed in the 20 th century that are still applied in the 21 st
include Donoghue v. Stevenson, United States v. Carroll Towing Company, and Canterbury v.
Spence. The Donoghue v. Stevenson case law established the concept of duty of care (Goe &
Round, 5). Even though it was passed in 1932, the ruling is still relevant in healthcare in 21 st
century. Healthcare providers are required to avoid any actions or omissions that may result in
harm to patients. The motivation to adhere to this case law, therefore, is likely to lead to
healthcare providers avoiding commitment of medical errors that may negatively affect health
outcomes of patients.

In United States v. Carroll Towing Company which was passed in 1947, the precedent set
was establishment of standard of care. This standard of care has been followed in healthcare with
healthcare providers using it to improve the quality of services that they offer patients in order to
meet the standard. As for Canterbury v. Spence, the precedent set was that of informed consent
(Ginsberg, 6). This principle allows healthcare providers to implement collaborative care with
patients which leads to better healthcare quality outcomes.

Defense of the Importance of Healthcare Quality

Providing the highest level possible of healthcare quality to patients is important to both
patients and healthcare providers. Patients benefit from high quality of healthcare services by
getting safe, efficient, and effective care (Allen-Duck et al., 7). They do not need to worry about

7

getting injuries, hospital acquired infections, or experiencing adverse events that may result in
their death because of unsafe hospital conditions and practices. They also need not worry about
being misdiagnosed or being given wrong or ineffective treatments. Equally important, being
treated in a good healthcare facility that values quality ensures that they are treated and
discharged quickly from the hospital. Such level of efficiency not only saves time but also
money.

For the healthcare organization, the biggest benefit of providing high quality healthcare
services is that it gets goodwill from the market. Healthcare organizations cannot provide
services for long if they do not have customers. Goodwill from individuals in the community that
the healthcare organization serves ensures that the healthcare organization will always receive
clients for its services (Allen-Duck et al., 7). Offering high quality services to individuals is,
therefore, good for the business of the healthcare organization. It allows the healthcare
organization to get the resources it needs to invest in employing highly skilled and experienced
healthcare professionals, buy high quality equipment to be used by the professionals, and acquire
appropriate technological systems to support delivery of healthcare services.

Plan to Protect Patient Information

Having access to relevant patient information at the right time is important for provision
of quality healthcare services to patients. To get the relevant information, healthcare providers
collect large quantities of patient data. This data needs to be effectively protected and only
accessed and used by authorized parties. Failure to protect patient information may result in loss
of patient trust and penalties for HIPAA violations.

8

HIPAA stands for Health Insurance Portability and Accountability Act. It is a legislation
that was passed in the US in 1996 (Tovino, 8). HIPAA seeks to promote patient privacy and data
security by imposing compliance standards that all healthcare providers are supposed to adhere
to.

My plan for patient information protection, therefore, simply seeks to ensure that there is
stricter HIPAA compliance. The plan has two components. The first one involves appointment of
a privacy officer. The privacy officer will be tasked with overseeing the development of privacy
policies and procedures that guide the handling of protected health information (PHI), as well as
the implementation of the policies and procedures. The officer will also ensure that all the
privacy policies and procedures are strictly adhered to.

The second component of the plan involves conduct of organization-wide risk assessment
to determine potential vulnerabilities and risks to the devices used to store and transmit patient
information. These devices include mobile devices, computers, and other record storage
equipment. The review will determine the type of security measures to be implemented that will
ensure that protected patient information is not used but stored safely. Apart from review of
devices used to store and transmit information, the risk assessment will also review workplace
operations to ensure that they do not have vulnerabilities that could be exploited by unauthorized
persons to access protected patient information.

9

Source List

1. David Stanley. 2016. “Quality Initiatives and Project Management.” Clinical Leadership
   in Nursing and Healthcare: Values into Action, 275.
2. Deepa Wani, and Manoj Malhotra. 2018. “Does the meaningful use of electronic health
   records improve patient outcomes?.” Journal of Operations Management 60: 1-18.
3. Heather Lyu, Tim Xu, Daniel Brotman, Brandan Mayer-Blackwell, Michol Cooper,
   Michael Daniel, Elizabeth C. Wick, Vikas Saini, Shannon Brownlee, and Martin A.
   Makary. 2017. “Overtreatment in the United States.” PLoS One 12, no. 9.
4. Jodi Liu and Robert H. Brook. 2017. “What is Single-Payer Health Care? A Review of
   Definitions and Proposals in the US.” Journal of general internal medicine 32, no. 7:
   822-831.
5. Bee Chen Goh, and Tom Round. 2017. “Wild negligence: Donoghue v Stevenson.”
   In Law as if Earth Really Mattered, pp. 91-106.
6. Marc Ginsberg. 2017. “Beyond canterbury: can medicine and law agree about informed
   consent? And does it matter?.” The Journal of Law, Medicine & Ethics 45, no. 1:106-111.
7. Angela Allen‐Duck, Jennifer C. Robinson, and Mary W. Stewart. 2017. “Healthcare
   quality: A concept analysis.” In Nursing forum, vol. 52, no. 4, pp. 377-386.
8. Stacy Tovino. 2016. “Complying with the HIPAA Privacy Rule: Problems and
   Perspectives.”