Introduction
Health care is the prevention of diseases and injury and their diagnosis and treatment in the event of their occurrence. This is a social service that is very critical in any society. Good health care forms a crucial foundation for people to have fun in life and function well in society (Kovner, Knickman, and Jonas, 2011). Good health is a very basic human need. In this case, health care service is of paramount importance to human existence.
Without good health, life could be threatened. Poor health means that people will be predisposed to diseases that can threaten their lives. Therefore, the provision of quality health care is critical for the survival of society. Good health care service in a society is dependent on the access, quality, and cost of these services. The health aspect of society can be affected in numerous ways. In this case, the quality of health care services should not be compromised.
The cost of health services should also not be extremely high. When the cost of healthcare is deemed extremely high, it becomes prohibitive to individuals. In this case, health care services become a preserve of the elite and the middle class in society. This is because the majority poor cannot afford the health care services since they do not have the resources to acquire these services. In essence, the accessibility of healthcare services is an important aspect for the good of society. This paper looks into the various aspects associated with continuous quality improvement and risk management in the provision of health care services.
Quality Improvement
The quality of health care services provided in a society is determined by various factors. Some factors that define quality health care include the fact that it should be patient-focused, there should be a commitment by the entire organization to provide enhanced health services, and that the healthcare should use quantifiable methods to measure and evaluate the services provided among others (Scott, 2005). In organizations where quality health care services are observed, high-quality performance is celebrated and rewarded.
Quality healthcare is more than just technical or the performance professionally. Moss (1995) says that quality healthcare combines the appropriate and competent technical care with a chance for patients to open up to the health practitioners about their fears, and concerns. This means that quality health care is of a wholesome kind that takes care of a patient from an all-around perspective. The dimensions of quality in healthcare are; appropriateness, access, acceptability, efficiency, effectiveness, and equity.
The quality of healthcare improvement is the process whereby there is a continuous increase in the quality dimensions of health care being provided to society.
The appropriateness, access, acceptability, effectiveness, efficiency, and equity of health care in a society should be in continuous improvement. Peden (2012) says that continuous quality improvement is the process of creating a good environment for the management and workers of an organization to improve the quality of their performance and services to clients. Continuous quality management is characterized by accountability in the organization, good management, teamwork, frequent review processes, teamwork, and input from every member of the organization. All these qualities contribute to the improvement of services in an organization since there is improved accountability, staff morale, flexibility, and creativity. Continuous quality improvement is of paramount importance for the provision of quality health services.
Risk Management
This aspect is critical in health care organizations, just like in any other business. This is the process that involves the identification, assessing, and prioritizing of different risks that might affect an organization and the creation of a plan to eliminate them. Where risks cannot be eliminated the management seeks to alleviate their impacts on the organization. The goal of risk management is to minimize the potential risks that may disrupt the provision of effective healthcare services. Risk management is also aimed at maximum utilization of the available opportunities in promoting health.
Healthcare facilities always work to provide a safe, supportive, and completely functional facility for all the stakeholders involved including patients, personnel, visiting family, visitors to the facility, and volunteers (Kavaler & Spiegel, 2003). Particularly, the healthcare facility management should always strive to identify the potential risks and control them, provide and maintain a safe environment for everyone, and prevent accidents as much as possible.
Effective risk management in a healthcare facility is a process that involves various steps by the facility. Such steps include planning, monitoring the resources that provide safety for clinical services, and providing education to its members on safety measures. No management can ensure safety and security from potential risks in a healthcare facility on its own all members have to be involved (Oleske, 2009).
Common risks in the healthcare organizations that the management should look out for include; accidents at the facility, natural disasters, unauthorized access to personal data, fraud cases, and other financial risks. The goal of risk management usually is to protect the organization from being vulnerable to these risks and the members of the organization from feeling the impact of such risks. Risk management also looks to take care of the most important stakeholder in health organizations, the patient. This is because if these risks are left to linger they might put the lives of these patients in jeopardy. Health organizations deal with matters of life and death where great caution should be taken to ensure that the goals of healthcare which are; to save lives and alleviate human suffering are not compromised due to existing risks.
The process of risk management can take various forms. A healthcare facility can decide to wait for the inevitable consequences of a certain risk. The healthcare facility may also choose to budget for the risk, especially when it is beyond its power to mitigate. Another strategy would be to pass the consequences of the risk over to another body to take care of, as an insurance company. Avoiding the risk in question is also another way of dealing with risks in a healthcare facility. In this case, the management can completely shut down a high-risk area hence totally avoiding the consequences that might come with such a risk.
The last form of risk management would be efforts to reduce the impact of the consequences of the risk. For instance, the management can install fire extinguishers at strategic points in buildings to ensure that the effects of a fire are minimal, just in case one occurs.
Implementation of continuous quality improvement and risk management techniques
Implementing continuous quality improvement and risk management strategies in healthcare facilities assure the provision of quality health care service to society. However, these facilities do not exist in a vacuum. The internal and external environment of the facilities affects the effective implementation of these strategies. The environment is made up of factors that influence the efforts to implement organizational strategies of management. They include social factors, cultural factors, and political factors among others.
Social factors
Health care is not about the duty of health care services to provide medical services to society, but it is a social activity too since it has a social aspect in it (McLaughlin, Johnson & Sollecito, 2012). Health care facilities do not just provide physical treatment to their patients, but they tend to their social wellbeing too. Social factors that can influence the success of a health facility in the implementation of continuous quality improvement include personal beliefs and values; community security and safety; economic status; and the urbanization level. These social factors affect both the healthcare organization and the patients.
Social factors and healthcare organizations
Economic Status
The economic status of the country that a healthcare organization is located contributes majorly to the quality of services provided and the risk management strategies it employs. The value of healthcare services in a certain country is directly proportional to its economic status (Kronenfeld, 2003). For instance, stable economies will certainly have enhanced and modernized social amenities, which include health facilities, while poor economies will struggle to provide medical services to their people. Stable economies will set sufficient funds aside to support continuous quality improvement of health services in their health organizations.
The risks in these health organizations are reduced and managed appropriately hence health services there are of high quality. However, poor economies have limited funds hence implementing and maintaining a continuous quality improvement in health care organizations becomes quite difficult. With the limited funds also, comes increased risks and fewer risk management implementation strategies.
Urbanization of health care organization
Urbanization has to do with the proximity of a health care facility to modern facilities and amenities. Urbanization is the closeness of these organizations to modernization and access to technological innovations and support. A health care organization that has access to modern technology is more likely to provide quality medical care to its patients. This is as opposed to the one that is far from modernization.
Technology is dynamic, and each innovation enhances the quality of services and their efficiency. Urbanization also enhances the access and equity of health services which are important dimensions of quality health services. Risk management is also highly facilitated by urbanization and technology. Health facilities far from urbanization are likely to compromise on the quality of services offered and are likely to face the consequences of more risks than those in urban areas.
Security
Security issues also play a major role in the implementation of continuous quality control and risk management in health care facilities. Healthcare facilities in hostile environments may not be able to maintain a continuous quality improvement policy. Also, the efforts to manage risks may be thwarted every other time. Security has to do with natural disasters, crime rates, among others. Health care organizations in areas that are prone to disasters like earthquakes or tornadoes may have a problem maintaining continuous quality improvement. This is as opposed to those organizations in perfectly normal areas.
This is because most of their equipment might be destroyed during these disasters or they may also lose valuable staff. Crime is another great threat to health care organizations. The resources of these health care facilities might be vandalized. This may leave these facilities stripped of the facilitation to maintain continuous quality improvement and risk management.
Social factors and the patients
Economic status
Living standards of individuals always influence the choice they make concerning issues like health, education level, leisure, security, and others. The economic status of a country directly influences the living standards of its people. This means that an economically stable country provides better health services to its people. The economical differences amongst individuals differentiate the levels of quality health care services that individuals get. People with high standards of living can get continuously improving quality medical services, and they have better risk management strategies, like insurance, unlike those with lower standards of living.
Urbanization
Individuals living in modernized economies have better access to high-quality health care services than those in the rural and marginalized areas. It is the responsibility of individuals to seek medical care when they need it. However, their efforts to do so may be restricted by the social amenities in the area. Urban areas have better infrastructure and are abundant in health care facilities. However, some marginalized areas may have poor roads and insufficient health care services where people have to go and get health care services. Normally, this is the case with most third-world countries. Risk management in urban areas is efficient and easy as there are many insurance providers unlike in the rural and marginalized areas.
Security
The security situation of any neighborhood certainly determines the frequency of healthcare services an individual will need. In areas where security is stable, individuals may only have diseases and accidents to necessitate health care. In areas where security levels are low, this may be due to natural calamities of crime factors. Here, individuals are likely to make significant trips to the health care facilities to nurse injuries and wounds that sometimes could be fatal. Risk management also tends to be more expensive in areas where security is lacking. Insurance cover for individuals in such areas is usually very costly, sometimes too costly for most households to afford.
Culture
Culture describes aspects of the life of a certain group of people. It is what is considered the norm in a certain place. The area where culture is found may differ in size from as small as a household unit, such that a certain family has a way of doing things; to as large as a country, such that a certain country has values and beliefs in which they believe. Culture largely influences the way a certain group of people views issues and how they react and respond to them. Since culture is quite a cohesive factor in a certain society, it is usually a very hard thing to break. Cultural factors that influence the implementation of continuous enhancement of strategies in health care facilities include; personal feelings and ideas, religion, beliefs, and ideologies, among others.
Cultural factors and health care organizations
Health care organizations are societies of patients, personnel, family members of the patients, volunteers, and visitors to these centers. The people in these organizations follow a certain way of life that is a norm to them. Culture in a healthcare organization has to do with the organization’s internal environment. In this case, culture takes the form of interactions between the members and their flexibility to change.
Interactions
How different people within a healthcare organization interact is critical for the realization of development in the organization. The organizational culture is very important, and it determines what the organization is capable of achieving. An organization with a culture where the human resource is strong and active caters for the welfare of the personnel and fosters good relations between the management and its employees (Harris, Society for Health and Administration Programs in Education & Australian College of Health Services Executives, 2006). Such an organization is easy to run, and policies like continuous quality improvement of services and risk management are easy to implement. An organization where the employees are always at loggerheads with the management is quite difficult to run. In this case, all efforts to implement certain policies will always be sabotaged from the inside of the organization. Risk management is also quite difficult in such organizations.
Flexibility to change
Flexibility to change can also be part of the culture of an organization. A healthcare organization should be led by management that is open to change. The term continuous quality improvement denotes continuous change. Times, technology, strategies, and policies have to be dynamic. A rigid culture denies itself the chance to develop and grow. A health care organization that is open to change will have no problem implementing strategies on continuous quality improvement and the best risk management available, unlike an organization with rigid management ideologies.
Cultural factors and patients
Patients are also affected by cultural factors that influence the implementation of enhancement of strategies related to health issues. Issues that affect them are beliefs and values, personal feelings and opinions, among others.
Beliefs and values
Where one comes from is critical in defining the culture of individuals. Different groups of people have different values and beliefs that dictate the way people perceive issues and life in general. Affluent cultures that root from high living standards believe in getting the best of everything in life and hence, people from such cultures will go for high-quality health care, unlike the lower cultures here people only get what they can afford. Sophisticated cultures also have better risk management strategies than the lower ones.
Opinions and personal feelings
Individuals are entitled to their opinion especially when it comes to personal issues. At the same time, different people have different opinions about different issues. Nonetheless, the origin of individuals is what matters most. Sophisticated cultures have certain ideas about health care while simple ones have different ideas. Differences between these ideas are felt when someone crosses over to the other culture and experiences what is known as culture shock. Affluent cultures will most likely access high-quality healthcare and better risk management options while the reverse is true for the lower cultures.
Political factors
Political issues in a country affect every organization and business in the country. Health care organizations are also affected by political factors (Aiken & Catalano, 1994). The implementation of strategies to do with continuous quality improvement and risk management is controlled by the political conditions in the country. Political factors that influence the implementation of these strategies include; legal issues, stability, internal politics, and economic standing.
Political Stability
Political stability within a country is very crucial for overall development in a country. Countries that are stable politically have more time to concentrate on public service and allocate funds towards the same. Social amenities in such countries are thus state of the art and highly improved. Therefore, health services in these countries provide quality health care services to the citizens. Politically unstable countries spent most their time-solving political conflicts and usually, there is mismanagement of resources. The health services, like other amenities, are usually poorly delivered. This means that there is no continuous quality improvement is almost non-existent in such countries. The risks in such countries are also very high, and there is little management of these risks.
Legal issues
Various legal issues affect the implementation of strategies in health care organizations. Continuous quality improvement techniques in health centers may conflict with certain set policies that govern organizations or certain laws in a country. This means that, in such countries, continuous improvement will be limited. The approaches to manage risks may also be limited in such countries unlike countries that have accommodating policies and laws.
Economic standing
The economy of a country is very crucial when it comes to the implementation of certain strategies in organizations. The economy is influenced by issues going on politically and is a direct reflection of either good or bad governance. Politically sound countries have stable economies that reflect development strategies within the country. Health organizations in politically stable countries have enough funds to manage and maintain continuous quality improvement and good management of risks. Those in poor economies and unstable political environments face difficulties in implementing continuous quality improvements, and they face more risks too.
Internal politics
The internal politics within health organizations is also very crucial. The organizational structure of the health organizations plays a major role in determining whether or not the management will support the implementation of these strategies. The leadership style by organizational leaders in such organizations also makes up the organization’s political environment. The dictatorship style disregards opinions from those being led. Also, it tends to be rigid such that implementation of new strategies in continuous quality improvement and management of risks becomes difficult.
Political factors and the patients
Political factors also have effects on the patients. The issues affecting leadership usually have a domino effect that somehow gets to the patients. Some of the political aspects that impact patients have been discussed below.
Economic issues
Political factors in a country that eventually affect its economy affect the ordinary citizen. When economic strains hit, health care can only be accessed when necessary. This means that the majority of the population is hard hit by the economic conditions, and only a few get quality health care services. Strains in the economy also lead to an increase in the risks that these people face and management of these risks becomes very costly. Insurance companies increase monthly premiums and the majority of the population make do without.
Internal politics
The internal politics in health organizations have a way of bursting out of proportion sometimes and negatively affecting the patients. This happens when such politics cause tension in health organizations. At such times, the services in these health organizations are compromised, and the quality goes down. This means that patients do not get the quality services they deserve. Sometimes, the tensions may escalate to levels where the person may have to go-slows and strikes, meaning that patients will be left unattended. At such times, the quality of health care is compromised, and the patients are exposed to many risks, which they cannot manage properly.
Conclusion
Continuous quality improvement and risk management in health management in health care organizations are very important. Ideally, each health care organization should strive to attain total implementation of the two strategies.
Health is a very critical aspect of society and needs to be regarded with seriousness. Internal and external factors that hinder the implementation of continuous quality improvement and risk management are of social, cultural, and political nature. Each society is characterized by its version of the social, cultural, and political hindrances to the implementation of continuous quality improvement and risk management. Once continuous quality improvement and risk management are compromised, fatal results like loss of life can be experienced in these health organizations. Such results are devastating in any society.
Therefore, this means that each society should sort out its health care system. This will ensure that appropriate health care services are provided to the population. Also, it means that the available risks are managed as much as possible or done away with where possible. This will result in a worldwide continuous quality improvement in health care services and eventual elimination of most of the risks that threaten human life.
Reference List
Aiken, T.D. & Catalano, J.T. (1994). Instructors’ guide for legal, ethical, and political issues in nursing. Philadelphia: F.A. Davis.
Harris, M.G., Society for Health and Administration Programs in Education & Australian College of Health Services Executives. (2006). Managing health services: Concepts and practice. Marrickville, N.S.W: Elsevier Australia.
Kavaler, F. & Spiegel, A.D. (2003). Risk management in health care institutions. Sudbury, Mass: Jones and Bartlett Publishers.
Kovner, A.R., Knickman, J. & Jonas, S. (2011). Jonas & Kovner’s health care delivery in the United States. New York, NY: Springer.
Kronenfeld, J.J. (2003). Reorganizing health care delivery systems: Problems of managed care and other models of health care delivery. Amsterdam [u.a.: Elsevier.
McLaughlin, C.P., Johnson, J.K., & Sollecito, W.A. (2012). Implementing continuous quality improvement in health care: A global casebook. Sudbury, Mass: Jones & Bartlett Learning.
Moss, F. (1995). Risk Management and Quality of Care. Web.
Oleske, D. (2009). Epidemiology and the delivery of health care services: Methods and applications. New York: Springer.
Peden, A.H. (2012). Comparative health information management. Clifton Park, NY: Delmar, Cengage Learning.
Scott, R.W. (2005). Legal aspects of documenting patient care for rehabilitation professionals. Sudbury, Mass: Jones and Bartlett Publishers.