As per Institute for Public Policy Research (2018), quality care refers to health care services prioritizing patient needs to improve their health outcomes. Poor quality standards account for high mortality and morbidity rates since the health services must fully address the patient’s needs. While this discussion aims to scrutinize and explain the concept of quality in health care, it will reflect on the health episode and derive recommendations which help in understanding what it entails to holistically address patient needs for better health outcomes. Some key constituents uncovered encamp the critical dimensions of quality care, the stakeholders involved and ways to measure and better health care.
Avia and Hariyati (2019) reinforced the idea of quality of health by emphasizing the need to guarantee better patient outcomes through a collaborative approach that prioritizes healthy therapeutic relationships with patients and their families. The reason is that better patient recovery approaches need to consider holistic criteria for handling patients with unique care needs within the hospital since their recovery entirely depends on informed decisions on managing their care. Quality health care is a vital determinant of patient outcomes; it refers to how well-being services meet or exceed patient needs while observing existing standards through evidence-based practices. Moreover, it is a multifaceted idea incorporating diverse dimensions emphasizing effectiveness, patent safety and experiences. The stated dimensions are significant in evaluating and improving the general level of care delivery. According to Kebede (2016), quality care is one of the most vital principles contributing to better patient outcomes. Presently, well-being quality forms the primary agenda at the local and international levels. Addressing this issue at the national capacity is motivated by diverse reasons that spring from a commitment to ensuring better healthcare services and the renewed concentration on health outcomes based on value-based well-being concepts through the selection of individual quality dilemmas in the healthcare sector. Early explanations of well-being quality were founded on research by scholars and healthcare providers. Regardless, current developments have contributed to the increased focus and acknowledgement of the perception of different stakeholders like patients, the public and healthcare professionals. Institute for Public Policy Research (2018) explained the quality of health as the capacity to attain desired objectives through legitimate approaches. This definition anchors on the idea that quality is not only specific to well-being but also touches on other vital persons in different sectors. In perspective, quality is a term that relates to positive aspects affiliated with hospitals and the services provided by healthcare practitioners. The widespread application of the term; quality of care explains the different definitions of this concept.
According to Darzi (2018), defining Quality of Care is normally problematic because of its multifaceted characteristics due to the diverse perspectives of the stakeholders in the healthcare sector. Regardless, the existing frameworks like the Donabedian model aid in simplifying Quality of Care by focusing on three vital components. The first facet is the component which involves attributes like resource, personal and facility availability. Other considered factors encamp staff qualifications, equipment and the general organizational structure. The next consideration is the process which encompasses actions by the providers to ensure the best care. Primary inclusion entails evaluating if the services meet the threshold of evidence-based approaches and clinical guidance. The outcome of the service provided forms the third description of the Donabedian model. Inherently, it infers to the patient recorded results like functional status and clinical measures like mortality and morbidity rates.
Healthcare consists of vital dimensions that help reflect quality in well-being services like effectiveness, patient safety, and experiences. The described dimensions serve a critical function in guaranteeing high-quality patient care. In perspective, the effectiveness of care is the first dimension, and it centres on the comprehensiveness of healthcare interventions in achieving expected outcomes and its implication for patient well-being improvements. According to Darzi (2018), evidence-based approaches are critical in ensuring the effectiveness of healthcare since they undergo rigorous testing and have shown positive results when managing patient needs. On the other hand, the patient safety dimension focuses on limiting harm during a patient’s medical encounter. The main idea is to ensure that medical errors are avoided since their occurrences pose threats to better patient outcomes. The actualization of this dimension occurs through the inclusion and implementation of safety protocols. Patient experience is also essential since it focuses on bettering their interactions and perception of healthcare services. Positive patient encounters contribute to improved patient gratification and their willingness to abide by treatment plans. According to a review by McKeown et al. (2022), studies have consistently highlighted the importance of patient-centred approaches to improving their experiences. A systematic analysis of multiple research papers found increased satisfaction and patient outcomes due to using patient-centred methods. This evidence proves that including patients in different care improves their health outcomes and perspective on healthcare practices.
Effective communication is also crucial in ensuring patient experience. Studies have evidenced that straightforward communication between patients and heal care experts can positively influence patient compliance with prescribed treatments while bettering their overall satisfaction. For instance, a study by Barry and Edgman-Levitan (2012) evidenced that effective communication skill development aided in better management of patients, therefore, emphasizing the importance of empathetic and respectful interactions in ensuring outstanding patient experiences. The inherent quality of care anchors on the effectiveness of healthcare practices, patient experience and safety. These dimensions are achievable through evidence-based practices prioritising safety approaches, effective communication, and patient-centred care to ensure high-quality well-being services. A particular focus on the three dimensions and their implementation all contribute to managing ailments and positive experiences when addressing patient needs.
Measurement of Quality Care
Measuring quality in healthcare provision requires a collaborative approach involving diverse stakeholders; this makes the process complex, necessitating diverse measuring techniques. The fundamental basis is to guarantee that well-being services achieve required thresholds like ensuring effective care, patient safety, and better experiences (Aiken et al., 2021). Measuring quality, in this case, involves using qualitative and quantitative metrics to give a comprehensive insight into healthcare quality. The method encamps measuring clinical outcomes by assessing the effectiveness of healthcare interventions on mortality and disease-specific outcomes. Apart from this approach, using patient experience surveys through questionnaires aid in collecting patient feedback concerning their experience in areas like communication and satisfaction. Assessing the efforts of healthcare providers to ensure evidence-based care in their clinical practices is also a vital measure of quality (Karaca & Durna, 2019). Other approaches include the use of practical measures which focus on determining the care delivery process, like timely access to coordinative services and resource availability. This action is also complimented by employing structural measures that aim at evaluating the health facility’s infrastructural characteristics, like staffing levels and safety protocols.
The collaborative decision-making process involves the healthcare team, like doctors and nurses, who bring in their clinical experience and insight to guide health determinations (Karaca & Durna, 2019). The team’s expertise is vital in identifying improvement areas and implementing strategies that lead to quality care. Healthcare administrators are also crucial in the decision-making and measurement of health quality due to their role in resource allocation, policy establishment and development of organizational priorities. Moreover, patients and policymakers are essential stakeholders in measuring health quality and decision-making since their feedback on quality improvement shapes the actions of legislators and regulatory bodies when making and enforcing guidelines. In essence, researchers and experts in quality improvement are also vital since they employ insight from research findings to introduce informed choices in choosing interventions that promote quality health. Therefore, the decision-making is collaborative and integrates many stakeholders who communicate and exchange ideas to establish shared goals that lead to continuous improvements.
The health system’s complexity is a significant deterrent factor in measuring quality. The understanding is that providing health care services incorporates diverse variables and facets that can impact patient outcomes. For instance, social health determinants and external influences can limit the ability to predict better patient outcomes. Another challenge is the unavailability of accurate data. The reason is that getting reliable information that effectively guides quality improvement is affected by the interoperability and standardization in the health care system. Limited resources are also a significant obstacle since quality improvement requires skilled personnel and structural development, which most healthcare institutions cannot achieve due to resource constraints. Resistance to change impedes improving quality since most organizational cultures need help to adopt new practices that necessitate fostering a continuous improvement culture among healthcare stakeholders. Another impactful challenge is the struggle to balance diverse quality dimensions. While efforts to ensure quality care may focus on one dimension, it is vital to guarantee that the strategies do not affect other healthcare aspects (Recio-Saucedo et al., 2018). Despite the stated challenges, diverse healthcare systems strive to ensure diligent efforts to measure and ensure quality improvement. These efforts incorporate collecting reliable data, resource investment, considering the insight from different stakeholders and implementing evidence-based practices. Addressing these challenges and championing continuous improvements will lead to better outcomes.
Personalized care is a significant determinant of quality care since it entails tailored well-being services that meet specific patient needs (Sullivan, 2016). This personalized method recognizes unique preferences and patient values. Therefore, personalized care links to quality since it directly correlates to enhancing patient outcomes. Personalized care is, therefore, essential since it grants appropriate treatments that lead to the best achievable outcomes while addressing patient conditions. This method is possible considering factors like medical history, culture and lifestyle. This scrutiny helps in the customization of care plans that help optimize outcomes while minimizing the possibility of adverse events. Hence patients will have their unique preferences and needs addressed, leading to better adherence to medication plans; this improves trust and communication with healthcare providers forming a lasting therapeutic relationship.
As frontline caregivers, nurses have a pivotal role in guaranteeing the quality of care. The reason is that nurses have a unique chance to ensure personalized care since they continuously interact with patients. Therefore, when tailoring personalised plans, nurses can influence quality through care planning and collaborative approaches with patients and their loved ones. The influence is also possible through educating and supporting patients suffering from different ailments. This knowledge empowers patients and inspires their active participation in personal care through informed decisions. Nurses’ monitoring and constant advocacy for quality improvement help improve the application of evidence-based practices in areas that require improvements.
During my placement, a notable encounter in a busy surgical ward revealed the challenges of caring for a patient having complex needs due to disagreements among family members about discharge plans. The patient was admitted because of an infection that was successfully treated. However, her condition worsened as she started displaying symptoms of confusion which pointed out to the early development of dementia. The patient’s mobility and liveliness were outstanding; however, it was not advisable to give her discharge due to safety concerns since she once lived alone; her family believed she needed constant care. The patient’s continued stay at the ward resulted in her contracting MRSA and Covid 19, possibly caused by her interaction with different patients. The prolonged stay led to discomfort due to the patient’s behaviour, as she was medically fit for a discharge. The delayed discharge resulted from the family’s lack of consensus concerning her placement. The nurse in charge mentioned that her children were not settled on where their mother would go after the discharge. Finally, the patient’s daughter agreed to take her mother home temporarily as they deliberated on lasting arrangements.
This episode was notable due to its revelation of significant issues, like the patient’s prolonged hospitalization. The patient’s continued stay led to the wastage of vital resources that would assist other patients. A patient’s extended stay also limits the availability of hospital beds contributing to a potential delay of health care services to persons requiring urgent attention (Ocloo et al., 2020). Again, the patient’s presence led to her susceptibility to hospital-acquired ailments jeopardizing her well-being and other patient safety. These concerts provided a strong emphasis on the relevance of timely patient discharge frameworks that prioritize resource allocation and contribute to the minimization of the vulnerability to infections contracted in health settings. Lack of consensus on the patient’s discharge impacted the patient’s health outcome. This episode exposes the need for more streamlined communication channels for making informed decisions concerning patient discharge. The family’s conflicting opinions concerning her placement after discharge contributed to unwarranted stress. Communication is vital in ensuring patient outcomes since it allows all stakeholders to agree on the best approaches to cater to patient needs. Studies by Rawling (2022) found that a coordinated approach in discharge planning requires a collaborative approach through clear communication.
Another significant aspect that deserves attention is the poor involvement of mental health experts in evaluating and managing the patient’s impairment. The delays imply that the patient did not receive the required support to handle her mental health. This action affected the patient’s mental health outcomes and strained the nurses and available resources since her safety required extra allocation. Prioritizing patient needs should form part of the critical intervention strategies (Eze et al., 2020). In this case, the patient requires immediate strategies for managing her mental health. The conflicting opinions delayed her access to mental health interventions as the following approach in ensuring her recovery. Expert advice was vital in this case; this would allow the patient’s family to agree on the best place that would continue her treatment.
As mentioned, the patient contracted MRS, which is a hospital-acquired infection. Hospital-related infections pose a significant threat to patients within health institutions. According to Knight et al. (2022), hospital-associated infections can lead to poor health outcomes and, therefore, a critical problem that demands immediate attention. In this case, the patient’s contact with contaminated materials forms some factors that compromised her health. Pathogen transmission in healthcare surroundings is complex and can occur due to contact with contaminants or health workers. Consistent strategies have existed to limit hospital infections, like enhancing hand hygiene and contact precautions. In perspective, these infections are associated with high morbidity rates and usually contribute to hospital annual losses. The most effective approach to avoid such infections is to limit any transmission of infectious agents. Nurses play an essential function in this prevention due to their consistent patient encounters. The hand washing routine and ensuring adherence to set guidelines for infection are vital in infection prevention.
The episode of care was significant since it highlighted several areas that need improvement in the hospital. These recommendations will aid the management in ensuring that patients receive the best possible care while optimizing their care plans. The first change should include developing a structured plan for discharging patients (Eze et al., 2020). As part of the process, it is vital for stakeholders like the health specialist’s family members and social workers prior to the discharge date. This strategy is actionable through clear communication, which should address any disagreements among the patient’s family members, preventing unwarranted delays during the discharge process. The next vial recommendation is the need to strengthen existing infection control approaches. Hospital-acquired infections can negatively affect a patient’s recovery process. As such, it is essential to institute actionable plans that help isolate patients suffering from ailments with the potential risk of infecting people within their surroundings (Nguyen & Nagase, 2019). This measure is possible through regular training of health personnel on infection prevention measures with constant audits to help monitor compliance while identifying areas needing improvement.
Next, the management should ensure the mental health experts’ prompt involvement in cases of cognitive impairments. The early detection and management of mental health diseases help counter the effects of medication on patients while tailoring care that prioritizes their needs (Rawling, 2022). As such, the hospital management should create actionable yet clear care plans that identify such patients and ensure that they get comprehensive assessments. The collaboration between the healthcare team and psychiatrists should help ensure a holistic method of patient care for clients with unique needs (Ocloo et al., 2020). Further, to ensure timely delivery, the health care institutions should develop partnerships with care homes having specialized wards. This collaborative effort will enable temporary patient placement as they await discharge. While waiting for the next option, the hospital will ease the burden on its resources while guaranteeing the patient’s safety during this transition.
All these plans are possible through the use of technology. Therefore, leveraging technology will help establish a streamlined communication framework that eases the coordination process (Barry & Edgman-Levitan, 2012). Again, it will help in the regular training of healthcare staff on infection prevention and handling patients with unique care needs, improving the quality of care. Providing education that helps support families with complex care is also essential in ensuring such people receive the best achievable healthcare (Kebede, 2016). This awareness will help them make informed choices about their loved one’s health and alternative care options. This plan is possible by including social workers in guiding the diction making process to avoid extended hospital stays.
In conclusion, the main focus explained is the logic of quality of care. Its explanation was possible by reflecting on the healthcare episode and establishing recommendations for future practice. As explained, measuring the quality of care is possible through qualitative and quantitative metrics that gauge the dimension of health. In perspective, patients’ needs are vital in their recovery process. However, challenges from the hospital and decision-making on their health plans can negatively influence their recovery process. Therefore, it is critical to ensure patient-centred approaches through the integration of insights of stakeholders from the health care team and family members. In this particular case, help from social workers was necessary.
Aiken, L.H. et al. (2021) ‘Patient satisfaction with hospital care and nurses in England: An observational study’, BMJ Open, 8(1). doi:10.1136/bmjopen-2017-019189.
Avia, I. and Hariyati, Rr.T. (2019) ‘Impact of hospital accreditation on quality of care: A literature review’, Enfermería Clínica, 29, pp. 315–320. doi:10.1016/j.enfcli.2019.06.003.
Barry, M.J. and Edgman-Levitan, S. (2012) ‘Shared decision making — the pinnacle of patient-centered care’, New England Journal of Medicine, 366(9), pp. 780–781. doi:10.1056/nejmp1109283.
Darzi A.W. 2008. High Quality Care For All NHS Next Stage Review Final Report [online]. Accessed 14.3.22. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/228836/7432.pdf#Links to an external site.
Darzi A.W. 2018. The Lord Darzi Review of Health and Care: Interim report [pdf]. Institute for Public Policy Research. Accessed on 19.07.22. Available through: lord-darzi-review-interim-report.pdf (ippr.org)Links to an external site.
Eze, N.D., Mateus, C. and Cravo Oliveira Hashiguchi, T. (2020) ‘Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation’, PLOS ONE, 15(8). doi:10.1371/journal.pone.0237585.
Karaca, A. and Durna, Z. (2019) ‘Patient satisfaction with the quality of nursing care’, Nursing Open, 6(2), pp. 535–545. doi:10.1002/nop2.237.
Kebede, S. (2016) ‘ASK patients “What matters to you?” rather than “What’s the matter?”‘, BMJ, p. i4045. doi:10.1136/bmj.i4045.
Knight, G. et al. (2022) The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020 [Preprint]. doi:10.21203/rs.3.rs-1140332/v1.
McKeown, E. et al. (2022) Acceptability and impact of an educational app (Icare) for informal carers looking after people at risk of pressure ulceration: A mixed methods pilot study (preprint) [Preprint]. doi:10.2196/preprints.36517.
Nguyen, T.L. and Nagase, K. (2019) ‘The influence of Total Quality Management on customer satisfaction’, International Journal of Healthcare Management, 12(4), pp. 277–285. doi:10.1080/20479700.2019.1647378.
Ocloo, J. et al. (2020) ‘The importance of power, context and agency in improving patient experience through a patient and family centred care approach’, Health Research Policy and Systems, 18(1). doi:10.1186/s12961-019-0487-1.
Rawling, P. (2022) ‘Evidence-based Operating Department practice’, Fundamentals of Operating Department Practice, pp. 9–14. doi:10.1017/9781108876902.003.
Recio-Saucedo, A. et al. (2017) ‘What impact does nursing care left undone have on patient outcomes? review of the literature, Journal of Clinical Nursing, 27(11–12), pp. 2248–2259. doi:10.1111/jocn.14058.
Sullivan, M.D. (2016) ‘Patient-centered care or patient-centred health?’, Oxford Medicine Online [Preprint]. doi:10.1093/med/9780195386585.003.0002.