Like any other industry in the U.S., there always is room for improvement in health care. As technology advances, research progresses and regulations change, tried and true processes need to be updated to keep pace with the changing times and ensure that patients are provided with the best possible care. However, even with the best intentions, making any kind of change to established processes brings its fair share of challenges. Organizations must continually look for ways to improve upon existing methods and technology to improve quality in health care. The Institute of Medicine defines quality in this field as “the direct relationship between the desired outcomes of patients and the level of health service improvements.” With health care reform emphasizing value-based care and tying reimbursements and pay-outs for health care organizations to outcomes, navigating those challenges to provide the highest quality care is perhaps more important now than ever before for medical offices and organizations. As a nursing professional, you have an important role to play in helping to ensure that these changes are made in ways that will improve processes, rather than simply complicate them. Use the following guidelines to facilitate process improvement in your health care organization to maximize efficacy.
Establish an organizational framework
According to the U.S. Department of Health and Human Services, quality improvement in health care is defined as “systematic and continuous actions that lead to measurable improvements in health care services and the health status of targeted patient groups.” To implement improvements in any field, a clearly outlined plan is critical. However, a detailed plan may be even more important in health care, where changes can literally have life and death consequences. In addition, the multiple layers, departments and regulations involved in the field can complicate what may be a simple change in a different organization. If the leadership in your organization has not released a clear plan for changes, do not hesitate to ask your manager for clarification to ensure that you are fulfilling your role properly and meeting any existing expectations. Simply creating a plan is not enough to ensure positive results. The framework needs strong leadership at every point of the implementation process to facilitate the improvements being made. If you are a nurse practitioner or nurse manager, or fill any other leadership role, personally owning components of the process improvement can prove to be very effective for a smooth transition. But regardless of job title, all nurses can play an important part in the implementation process. After all, as the staff members with the most face time with patients, nurses are the front line who will not only implement changes on a daily basis but also see the results play out.
Track progress and measure performance
Unfortunately, creating a plan and assigning effective leaders is not a guarantee that proper implementation and improved results will follow. That is why it is so important to track the progress that is being made and measure performance as the new strategies are used. Tracking quality measures such as readmission rates, complication occurrences and patient satisfaction will help your organization to identify areas where changes in process have proven effective, as well as areas that need additional attention to improve patient care. The U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality reported that measuring these outcomes is critical for assessing the quality of the care that is being provided to patients. The organization recommended asking these four questions when choosing an outcome measure:
- Will the outcome measure accountability or quality improvement?
- What other factors could influence the relationship between the monitored process and measured outcome?
- Can the people and organizations that influence the outcome be clearly defined?
- When is the outcome measured in the episode of care?
Because these measures are so important, some health care organizations have created specific positions dedicated to ensuring quality care. Nurses in particular can pursue specialized careers in this area, which includes jobs such as quality assurance case manager, quality and compliance specialist and director of clinical practice improvement.
Ask for feedback
While some employees and patients are very eager to share their thoughts on the changes your organization has made, you cannot depend on voluntarily offered information to give you an accurate picture of how well the process changes are — or are not — working. There should be a system in place to collect feedback from providers and other staff members. The old fashioned suggestion box has been replaced by a number of online survey options — including some specifically designed for medical staff — that will give your organization a good picture of how staff members are adapting to the changes. In this way, you not only will be able to see the impact that these process improvements are having on patient care but on the work environment, as well. In addition to measuring performance, your health care facility also should be collecting feedback directly from the patients. Patient-reported outcomes are powerful tools that providers and health care organizations are leveraging to monitor quality of care. Combining feedback from providers and patients with the quality measures will give you a more complete picture of how the changes are affecting your organization’s overall health.