The provision os healthcare should be focused on the safety of the patient. As such, it is critical that healthcare interventions that are applied should be intended to improve the state of the patient and not worsen it. It is imperative that improvements are made to the existing practices so that healthcare quality is continuously improved using different interventions and evidence based practices. However, healthcare quality improvement experiences a variety of barriers just like any other change management aspect. These relate to the lack of resources and the lack of skills for the quality improvements. Forecasting on the healthcare needs of the patients is critical in determining the staffing requirement, the infrastructural requirements, as well as the necessary changes that should be made to enhance public health outcomes. There are various researches that have been done on the aspect of improving healthcare quality as well as the impediments that inhibit the implementation of healthcare quality improvement mechanisms.
Improvement of healthcare standards and quality is fundamental for the safety and satisfaction of the patients and their families. Younies et al. (2016) opines that despite the many approaches that have been made in ensuring quality healthcare is improved in public healthcare facilities, there is a need to put more focus on the ratio of beds to the population of the patients. This was after a study that the researchers conducted on the historical data obtained from the public health hospitals in United Arab Emirates (UAE). However, Long et al. (2014) is of the view that the part of healthcare facility that requires improvement in terms of the quality of care is the intensive care unit (ICU). Specifically, they argue that there is need to identify healthcare as well as administrative interventions that will improve the quality of care for patients whose health condition deteriorate in the wards after admission. These arguments were made based on the study done on patients who experienced chronic illnesses and respiratory failure in Seattle-Tacoma area between 2003 and 2008. Agyeman-Duah et al. (2014) who opines that establishing a quality improvement process in relation to healthcare delivery is critical for patient safety and satisfaction supported the same position. This was done after a study was conducted by the authors to establish the priorities of healthcare improvement in The Medical Department of Kamuzu Central Hospital in Malawi.
Despite the critical need for healthcare quality improvement, various factors serve to inhibit the quest to improve any standards that directly affect the quality of healthcare. According to Agyeman-Duah et al. (2014), one of the key factors that hinder the improvement of healthcare quality is the limited resources. In this regard, most of the healthcare facilities do not have adequate resources in terms of infrastructure, healthcare personnel, and staff that can be deployed to improve healthcare quality due to lack of financial resources. This is especially the case in public hospitals where the financial resources arise from the state. Yabuki et al. (2015) who studied the evacuees living in temporary housing after the Great East Japan Earthquake of 11th, March 2011, echoed the same sentiments. It was the findings of the authors that the evacuees experience pain and anguish as well as poor medical services due to failure of resources by the nearby healthcare facilities to offer them quality healthcare. However, Agyeman-Duah et al. (2014) adds that apart from the lack of financial resources, the staff attitudes as well as the shortage of medical equipment is to blame for lack of improvement in healthcare quality. Additionally, lack of knowledge on the best approaches that should be deployed as mechanisms of improving the quality of healthcare as well as the presence of resource limited settings are other obstacles that in the view of Agyeman-Duah et al. (2014) hinder the improvement of healthcare quality.
Renedo et al. (2015) describe lack of participation by all stakeholders in the improvement of the quality of healthcare as one of the issues that hinder healthcare quality improvement. This is because the input of the members of the public is equally important, as they are the ones that consume the healthcare services. According to Renedo et al. (2015), citizens who include the patients and the members of the public should be helped by healthcare organizations to collaborate with other professionals in coming up with interventions that will improve healthcare quality. Yabuki et al. (2015) supports these sentiments by stating that failure to involve the patients will lead to the deployment of quality improvement interventions that will not meet its intended objectives. However, Long et al. (2014) is of the view that nurses and family perceptions should be taken into account before any interventions are taken on the improvement of the healthcare that is offered to the patients. This is because the nurses know the conditions of the hospital facilities while the family members understand the condition of their patients.
An area where the authors have been concerned about is the healthcare department or sector that requires quality improvement of healthcare services. However, most of the authors are of the view that the public healthcare sector is the one that is most affected by poor quality healthcare delivery. According to Younies et al. (2016), a comparison of the private sector and the government expenditures in healthcare shows big differences. Specifically, there is a shift of healthcare investment from the government to the private sector, which has subsequently led to the growth of private healthcare facilities. The net effect of this is poor quality healthcare services for those patients who cannot afford healthcare services in the private facilities. This position is corroborated by Long et al. (2014) who established that many cases of ICU admissions that arrive from the general wards are more prevalent in public healthcare facilities that are deprived of enough resources for improvement of healthcare quality.
Although quality improvement is critical for most of the healthcare departments, there are some of the departments that need more quality improvement interventions than others. According to Agyeman-Duah et al. (2014), the medical department is the one that requires much improvement as it requires material resources that are core in the maintenance of patients health. However, Long et al. (2014) is of the opinion that the ICU department, which handles patients in critical condition, is the one that requires much improvement in terms of quality of healthcare provided to save lives of as many patients as possible. Younies et al. (2016) focuses on the entire inpatient department as they view the department as very critical for patient recovery. These shows that every department should initiate quality improvement mechanisms.
Agyeman-Duah, J. N. A., Theurer, A., Munthali, C., Alide, N., & Neuhann, F. (2014). Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi. BMC health services research, 14(1), 1.
Long, A. C., Kross, E. K., Engelberg, R. A., Downey, L., Nielsen, E. L., Back, A. L., & Curtis, J. R. (2014). Quality of dying in the ICU: is it worse for patients admitted from the hospital ward compared to those admitted from the emergency department?. Intensive care medicine, 40(11), 1688-1697.Renedo, A., Marston, C. A., Spyridonidis, D., & Barlow, J. (2015). Patient and Public Involvement in Healthcare Quality Improvement: How organizations can help patients and professionals to collaborate. Public Management Review, 17(1), 17-34.
Yabuki, S., Ouchi, K., Kikuchi, S. I., & Konno, S. I. (2015). Pain, quality of life and activity in aged evacuees living in temporary housing after the Great East Japan earthquake of 11 March 2011: a cross-sectional study in Minamisoma City, Fukushima prefecture. BMC musculoskeletal disorders, 16(1), 246.Younies, H., Elzenaty, R. J., Gantasala, S., & Nwagwu, E. (2016). Healthcare Forecasting in the United Arab Emirates (UAE). Journal of Health and Human Services Administration, 39(1), 3.
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