Survey of Quality Assurance/Quality Improvement Practices in Various Practice Sites - Essay Sample

Introduction

Quality measure informs how a healthcare system is performing. In its performance, weaknesses are identified, opportunities prioritized, and probably it can point out what works and what does not to trigger improvements (Gupta & Kaplan, 2020). In the exposition of QA/QI, a study was done in various practice sites like outpatient practice and CABC accredited centers. The survey targeted urban, suburban, and rural locations where the practices took place. The model types which were surveyed included; APRN-led, which is the care given as caseload with APRNa/Midwives. Secondly, combine practice models which are care offered in combination with doctors so than women may get attention from either the midwives or physicians regardless of their risks. Lastly, the share practice model whereby care is provided by both physicians and midwives. Performance across sites show outpatients practice gaining more references, and thus QA/QI seemed to have been complied more on such sites. The paper aims at unpacking the existence complexities of Quality assurances and improvement targeting suburban locations and outpatient practices.

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Commission for the Accreditation of Birth Centers Standards

Interdisciplinary meetings with the focus on clinical issues are one of the quality assessment tools as provided by CABC standards of operation. The goal of the plan is to give patient care in a seamless scale. The goal is achieved by analyzing treatment objectives and goals, hence formulating grounds for terminating interventions. From the data, the meeting to review the literature and evidence-based clinical issues a majority records that in the past one year, it was not held. Alliman (2017) from the guidelines stipulates that meetings be conducted regularly (3 times annually), either facilitated by the board members or delegated authority to the administrative staff. With 60% pointing to none implementation of quality improvement practice, it sends some signals that the Center is poorly undertaking its roles. As an indicator of compliance, the team must have evidence of regular meetings of either governing body or even its delegate to take governance tasks for the operation of the birth center.

Adherence of the practices to the set standards in CABC, standard 7. On annual review on policies, protocols, and procedures, the Centre recorded 53.33% of none compliance. From the study, there is a level of respect that does not make it to half. Moreover, the more significant percentage lies on the non-compliance. The guideline on CABC standards has it that at least members should have an annual review of the policies. An evaluation of the performance of clinical practitioners working I the Center reveals that it is up to 80% could self-evaluate.

The majority of the surveyed sites had high compliance with the requirements of CABC standards seven on the effectiveness of data collection. With better service utilization at 86.67%, indicates that the sites utilized all the available measures of services in the Centre. Besides, evaluating client's satisfaction is also well featured across the sites after it recorded 73.33% of its utilization. Consequently, it is prudent to conclude that the Centre complies through an effective system of data collection and analysis.

Joint Commission Standards

According to Joint Commission International, & Joint Commission Resources, Inc. (2012), organizations should undertake case reviews as a form of tracer in its operations. From the surveyed Centre, 60% indication that interdisciplinary meetings took place. From the response, it is clear that the frequency of the meetings where more than three in a year a record which is relatively at per with the JC standards. However, the Center fails on the review of the closed clinical records. 53.433% of non-review of clinical records reveals the laxity in implementation of the JC standards, which calls for at least 50% review.

On data, used to monitor performance and identification of improvement opportunities. From disease management audit to medication reconciliation at every visit (60% & 93.33% respectively), there is a considerable adoption of data in making such decisions. As a requirement by the JC standards, arrangements should be informed empirically by data. Thus, it is evident that the Center follows the guideline to the latter. On quality metrics in reporting, the site surveyed employs quality metrics like Age, which accounts for 73.33% for tobacco users as one of the parameters. However, there is a significant drop to 20% when it comes to quality metrics on imaging studies and incidences of Episiotomy.

Priorities for Full Compliance

In CABC, interdisciplinary meetings need to be prioritized across all sites. As a leadership priority, it is from the meetings whereby all the reviews, evaluations and deliberations can be done. According to CABC, meeting on matters, clinical issues should be prioritized either from the board perspective to the administrative delegated authority. JC leadership priorities should focus on the usage of data to make a decision. Data helps in reducing errors in medication by enhancing financial and administrative performance and minimize readmission. For instance, data on referrers ensure appointments are well scheduled and kept. Thus, with data usage as a priority, it is easier to understand various tracers and make prudent choices.

Toolkit

Run charts present an ideal toolkit that cuts across both CABC and JC leadership priorities. A run chart is a tool used to study collected data for patterns or trends of a given period. For instance, in JC, the run chart helps in comparing measures before and after the implementation of solutions or interventions to measure impact. Besides, to track the frequencies of interdisciplinary meetings, run charts can help in the prediction of trends, Thor et al. 2007). From the diagram below, a run chart can visually show the level of compliance and at which week and possibly the impacts caused by several interventions.

Conclusion

QA/QI are very vital in assessing, critiquing, and enhancing processes of healthcare delivery in an institutional setting. With a survey being done on QA/QI, from various practical sites and locations, there was gross compliance to CABC and JC standards. However, with some areas of dominance in either of the criteria, a run chart would be a fundamental tool to leverage and enhance efficiency and effective compliance with the set standards.

References

Alliman, J. I. L. L. (2017). Birth center regulation in the United States. Freestanding birth centers: Innovation, evidence, optimal outcomes, 207-226.

Gupta, M., & Kaplan, H. C. (2020). Measurement for quality improvement: using data to drive change. Journal of Perinatology, 1-10. DOI. https://doi.org/10.1038/s41372-019-0572-x

Joint Commission International, & Joint Commission Resources, Inc. (2012). Joint commission international accreditation standards for long term care. Oakbrook Terrace, IL: Joint Commission Resources http://www.worldcat.org/oclc/795310192

Parchman, M.L., Anderson, M.L., Coleman, K. et al. Assessing quality improvement capacity in primary care practices. BMC Fam Pract 20, 103 (2019). https://doi.org/10.1186/s12875-019-1000-1

Thor, J., Lundberg, J., Ask, J., Olsson, J., Carli, C., Harenstam, K. P., & Brommels, M. (2007). Application of statistical process control in healthcare improvement: a systematic review. BMJ Quality & Safety, 16(5), 387-399. DOI. https://doi.org/10.1136/qshc.2006.022194