The
United States has the most costly healthcare system but major quality and
safety issues persist (Davis, 2010). An article from Agency for Healthcare
Research and Quality (AHRQ) compares the years 2002 and 2012 to determine the
most costly health conditions in the U.S. In both years, the same five medical
conditions (heart disease, trauma related disorders, cancer, chronic
obstructive pulmonary disease and asthma, and mental disorders) were ranked
highest for medical spending (Soni, 2015). The data presented in this
article shows that expenditures have risen in some areas (mental health) and
have stayed nearly the same in other areas (heart disease and cancer)—proving
that the same costly medical conditions have continued to exist over the past
decade. These problems aren’t being fixed, proving the need for quality improvement
in our healthcare system.
Quality is
constituted by the degree of excellence something possesses, as compared to
other things of a similar kind (Google Chrome online definition). In
class, we also learned quality to be defined as the science of process management.
Florence Nightingale was a prime example of contributing to quality improvement
with her genuine caring, data collection, and use of statistics for data
visualization. Her research helped show others in her day about the need for
improved care through better sanitation measures for patients. Now different
national organizations have been implemented to support nurses in giving
quality care with research, data collection, and evidenced-based practice. The
Institute of Medicine, Robert Wood Johnson Foundation, American Nurses Association,
and National League for Nurses are a few of these organizations helping set
standards of quality care. They conduct research on our behalf to find ways to
prevent errors, improve outcomes, and improve processes. One of their most
important goals is to encourage nurses to attain higher levels of
education in nursing so they can render safe care and be able to implement
change as leaders themselves. (I am currently in the Bachelors of Nursing
program because of this.)
During this
unit we also learned about Deming’s 14 Points of Profound Knowledge for quality
improvement. His system stated that usually quality improvement ideas sound
great, but in reality, they forget the complexity of life. So many x-variables
affect the y-dependent outcomes and a thorough examination of systems, variation,
theories, and human behavior is only what will lead one to find the profound
lens of knowledge (QI idea) suitable for solving the problem or enacting
positive change (Lloyd, 2009). The quality improvement team must take into
account the different common causes and special causes while looking for
different trends, in order to help identify more thorough quality improvements. It begins with working as an
interdisciplinary team, establishing leadership, removing slogans and fear, and
maintaining a continuous quality improvement philosophy.
In our
Quality Improvement Lecture, we also learned that quality care is meeting
customer expectations. In healthcare, the patient is the customer. I want my
patients to feel safe and confident that they are receiving the best possible care.
If every practicing nurse can adapt the philosophy of continuous quality
improvement and abide by it, I believe medication errors, hospital acquired
infections, falls, central-line infections, bed sores, (etc!) can be decreased
substantially. This would be the epitome of quality healthcare.
References
Davis, K., Schoen, C., & Stremikis, K. (2010).
Mirror, mirror on the wall: How the
performance of the U.S. health care system compares internationally, 2010
update. Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2010/Jun/1400_Davis_Mirror_Mirror_on_the_wall_2010.pdf
Lloyd, R. (2009 January). Deming’s System of Profound Knowledge 2. Retrieved from the IHI’s
online course https://www.youtube.com/watch?v=STTwZGNvLmM&list=PLMB9evqeBMEjBxqB8dNS9CFhcsI0uHJIh&index=4
Soni, A. (2015 April). Statistical brief #470:
Trends in the five most costly conditions among the U.S. civilian
noninstitutionalized population, 2002 and 2012. Agency for Healthcare Research and Quality. Retrieved from
http://meps.ahrq.gov/mepswe/data_files/publications/st470/stat470.shtml
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