Social Determinants of Health
Quality Improvement and Risk Management in Health Care
A health care system is an institution or organization of people using resources to deliver health care services to meet the target population's health needs. There are many health systems worldwide with many organizational structures and histories. Different countries have various systems that support their health system planning such as trade unions, governments, market participants, charities and religious co-ordinate bodies who deliver health care services that are planned and evolutionary. Risk management entails the proper strategies that reduce possibilities of specific losses in health organizations (Spath, 2009).
The systematic utilization and gathering of data are very important to the practice and concept. The programs of risk management consist of both reactive and proactive components. The reactive components include the actions, which are in response to adverse occurrences while proactive components include those activities done to prevent adverse occurrences such as losses. In both reactive and proactive, the process followed includes diagnosis, assessment, prognosis and management. Diagnosis means the process of identifying the risk or potential of the adverse effects. Assessment means the calculation of the possibility of the adverse effects that can be a result of the risk situation (Spath, 2009).
Prognosis means the estimation of the impact that the adverse effect may have in the institution. Management means the exercises taken to control the risks from taking place. All health institutions and organization need to address their particular risks. Risk management techniques are vital in an institution because they help reduce the possibilities of adverse effects results and improve the quality of patient care in the practice of medicine. The key goal in risk management is to reduce the risk of liability exposure of health care providers, harm to patients and financial loss to the organizations and institutions (Marco, 2011).
Quality improvement on the other hand is mainly necessary to help improve the clinical, financial and operational outcomes, which are all interrelated. For example, quality improvement involves receivable accounts collected in a consistent organized manner and at the right time. This means also investing on well trained and highly paid staff, which in return serves to improve on the care given to patients and performance of caregivers; also referred to as patient flow efficiency or operational outcome and clinical outcome. A well-organized and professionally run organization will encourage a wide variety of informal and formal quality improvement practices and efforts that will address both small and large matters (Barry, 2002).
Quality improvement majorly focuses on processing issues because a bigger percentage of the errors and inefficiencies in institutional and organizational settings are caused by the failure in processes. These failed processes are identified then corrected more positively in institutions and organizations that work hard towards empowering their staff. While employees ought to understand that they are accountable for every process that they implement, managers need to be able to provide their workers with the right resources needed to fulfill the responsibilities assigned to them. They also need to learn to exercise the authority to address arising issues in the organizations (Marco, 2011).
For example, the processes involved include medication administration programs, medical record documentation, and utilization of clinical protocols, patient education and patient admission. The efforts applied in quality improvement involve monitoring every process to predict the outcome, identify the challenges and develop new solution that will encourage improved performance. When these processes are improved, there is prevention of adverse occurrences through the development and practice of quantifiable indicators, or precautions. This will gauge the effectiveness and identify potential problems in terms of medical care (Barry, 2002).
Quality and important risk indicators should be developed in the outpatient setting because it will help monitor the performance of caregivers. These indicators should not be limited to patient's serious medical conditions or death, adverse reaction to drugs, failure to document or report test results, failure to perform tests and unplanned visits to hospitals. Caregivers ought to be encouraged to analyze the processes implemented during medication and identify any flaws when the indicators are triggered. This will provide them with chances to identify constructive changes and quality care practices that can be implemented to also ensure the efficiency of the institutions and organizations (Marco, 2011).
In addition to this, an important diagnostic tool such as a pictorial, flow chart or diagram which are designed in a designated sequence are necessary for the continuous monitoring of performance and growth of organizations. This is because by using a diagram to identify flaws, caregivers and the management can redesign...
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