Sunday, September 6, 2015

Reflective Journal- Week 2


            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

No comments:

Post a Comment