Implementing Long-Term Quality Healthcare

The Facility of Choice

The facility of choice is the Country Villa’s Woodman facility located in Los Angeles, California. The facility is a nursing home that provides long-term care to its residents.

Quality Improvement Plan for Country Villa’s Woodman Facility

The current quality improvement plan undertaken by the facility is dubbed the On-Time Quality Improvement for Long-Term Care Initiative. The main objective of the facility’s quality improvement plan is to enable the facility’s staff to intervene before the residents develop serious health conditions. The facility claims that this can only be achieved if the staffs are able to recognize small changes in the residents’ behaviors such as eating or sleeping habits. Before the plan was introduced, this objective was almost impossible to achieve because the facility’s staffs lacked immediate access to essential information that could have helped them intervene before any grave health condition developed (AHRQ, 2007).

The main areas covered by the quality improvement plan of the facility include: more efficient recording of care, reduction in the occurrence of pressure ulcers, and enhanced satisfaction among the staff by actively involving them in the care process. The plan is used by the facility’s staffs to record consistent information regarding each of the residents’ vital signs such as blood pressure and heart rate. In addition, the plan is used by the staffs to record the residents’ daily activities. This is useful for the staff in recognizing any changes in the resident’s normal activities and behaviors. Other factors which are useful in recognizing a resident’s risk of developing pressure ulcers are also recorded. All these data are stored in a web-based database from which reports about each resident’s history, behavioral changes and potential health risks are generated.

The facility’s staffs are actively involved in the quality improvement initiative. This is done by engaging them in the actual documentation of the residents’ data as well as the generation of the residents’ reports when required. This quality improvement plan has resulted in more positive residents’ outcomes such as significant reductions in the prevalence rates of pressure sores and enhanced job satisfaction among the staffs (Calomeni, Solberg & Conn, 1999).

Other Areas that Need to be Included in the Plan

The facility’s plan is focused on process and outcome improvements but leaves out structure improvement. Structure improvement needs to be included in the facility’s plan because it serves an important role in any quality improvement initiative. Structure refers to the particular organization responsible for providing care. It is characterized by elements such as “staffing patterns, programs, finances, facilities, and size of the organization,” (Wong & Chung, 2005, p. 360). Elements of structure that would support the quality improvement efforts of the facility include: supportive organization’s vision and mission; a committed leadership; open communication lines between all levels of employees (employees on the lower levels should be able to communicate directly with those on higher levels); cooperation among all employees; and adequate resources to implement the project’s recommended measures, including both financial and human resources.

Quality Improvement Model used by the Facility

The facility uses Total Quality Management (TQM). Total quality management is part of daily operations for every member of a healthcare organization. Although CQI and TQM are similar, they have a slight difference. The TQM framework for quality improvement that is used in this facility is based on the following principles: management commitment, employee empowerment, fact-based decision making, and continuous improvement.

Management commitment

The TQM model requires total commitment from the facility’s management. The management of the facility demonstrates its commitment by developing the strategies for undertaking the initiative based on the vision and mission of the facility. Management commitment is also demonstrated through the creation of the TQM team that oversees the quality improvement initiative. The commitment of the management is important because it serves as an example for the rest of the facility’s partners to follow. Commitment from the management also guarantees the motivation of the entire facility’s members to work towards the success of the QI plan (Narine & Persaud, 2003).

Employee empowerment

The empowerment of the employees is another determining factor of the success of the QI plan. Employee empowerment takes various forms such as education, training and staff development (Wong & Chung, 2005). For this QI plan, the facility empowers its employees through regular education and training sessions through which employees learn about the importance and ways of providing quality care to patients. Empowerment is important because enables the employees to make the right decisions serve the best interests of the residents.

Fact-based decision making

Quality improvement through TQM involves continuous data collection and analysis to determine the performance of the medical staff as well as the effectiveness of the quality improvement program. In this particular facility, data are collected on a regular basis from which different reports are generated to monitor the health changes of the residents. Based on the reports, appropriate actions are taken by the facility to improve the residents’ health (Calomeni et al., 1999).

Continuous improvement

Continuous improvement is part and parcel of TQM. It entails doing the same things but in better ways. The facility strives to improve the manner in which the healthcare services are offered using the same resources. Continuous improvement is an undertaking of the entire facility’s team (Narine & Persaud, 2003). Continuous improvement enables the facility to address the changing needs of its residents and ultimately enhance the quality of care provided to them.

Awareness Creation among the Facility’s Staffs

The facility holds weekly meetings for all of its staffs. The meetings are used to discuss the merits and challenges of the quality improvement plan. They are also used to discuss the reports generated for the residents as well as the actions that need to be taken to improve the residents’ health. The staffs also use the meetings to give feedback on their use of the initiative. Through such meetings, the staff members learn more about the quality improvement and are thus actively involved in the process. Most importantly, the meetings facilitate team work among the staffs in regard to the quality improvement plan.

Education of the Managers and Staff about Quality Improvement Methods

Managers and staff at the facility were educated about quality improvement methods before the QI plan was put into practice. The education was conducted by a team of external experts who were hired by the facility. The facility also hired an expert in QI who conducts lectures and training sessions on quality improvement methods on a quarterly basis. This helps the facility’s employees to be proficient at quality improvement of the services they provide as well as to be part of the facility’s QI efforts.

Review and Update of the Facility’s Plan

The facility conducts a review and update of the quality improvement plan on a semi-annual basis. Discussions are held during the reviews on the progress made by the facility as far as improving the health services offered is concerned. Most importantly, the facility accepts feedback not only from its staff but also from the residents and their family members. Necessary actions are then taken on the plan based on the feedback.

Reference List

AHRQ. (2007). On-Time Quality Improvement for Long-Term Care. Web.

Calomeni, C., Solberg, L., & Conn, S. (1999). Nurses on quality improvement teams: How do they benefit? Journal of Nursing Care Quality, 13(5), 75-90.

Narine, L., & Persaud, D. (2003). Gaining and maintaining commitment to large-scale change in healthcare organizations. Health Services Management Research, 16, 179-187.

Wong, F., & Chung, L. (2005). Establishing a definition for a nurse-led clinic: structure, process, and outcome. Nursing and Healthcare Management and Policy, 53(3), 358-369.

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