The Ongoing Quality Improvement Journey, Capstone Project Example

Introduction

A healthcare organization represents a specific strategy and set of operational principles that govern its decision-making and practice model. This process requires knowledge of the organizational structure and other factors that influence patient care in different ways. It is the responsibility of nurses to be mindful of these issues and to recognize the importance of change in supporting an environment in which patient care quality is a critical priority. Therefore, recognizing the key variables within the organization serve as a first step in supporting the desired outcomes. It is important to identify the resources that are available to employees within the organizational system and to determine where weaknesses exist in order to be successful in addressing these challenges and to improve performance. It is important for employees to recognize areas where change is desired and to participate in the development of strategies that will be used to support this process and promote these areas through communication with leadership regarding the necessary changes. This is likely to contribute to long-term change and effectiveness for the organization and in meeting its objectives.

Body

The first step in determining how to promote organizational change is to identify its function as a microsystem and/or a macrosystem. A microsystem examines smaller components of the organization and the intent to provide specific types of services in designated areas, such as cancer care (Lifvergren, Andin, Huzzard, & Hellstrom, 2012).  These specific components across specialty areas must work in conjunction in order to meet widespread healthcare needs and in determining how to best evaluate its operations as a whole (Lifvergren et.al, 2012). On the other hand, a macrosystem examines the larger picture of healthcare practice and identifies the larger intent and purpose of the organization as it serves its patient population. Determining these differences is instrumental in shaping how the organization responds to change and in the identification of areas where change is viable and realistic in the short and long term. My organization is represented by a macrosystem environment with a large portfolio of services that operate in a somewhat bureaucratic state. However, a number of microsystems operate within this environment to provide direct patient care and guidance at the disease level. There is a challenging landscape within the organization that requires ongoing support from all teams in order to be successful in achieving the desired healthcare outcomes at the organizational level and in demonstrating excellence within these areas. Within this organization, decision-making is largely centralized and requires many layers of approval before finalizing these requests; therefore, the concept of change is often difficult for the organization to handle because of its bureaucratic status.

Improving quality within a healthcare system requires a detailed approach and a systemwide buy-in from employees in order to promote the desired level of change (Kaplan, Provost, Froehle, & Margolis, 2012). This reflects the importance of shaping an environment that is grounded in theoretical perspectives and proven success stories in other organizations that could be applied to the organization in question (Kaplan et.al, 2012). However, employees and leaders must identify incentives that will support a change initiative and a desire to improve quality at all levels, such as a reward system that will impact employee performance and overall consistency in achieving higher quality care (Kaplan et.al, 2012). This is likely to encourage employees to support a change effort and to be more successful in the transition phase.

A successful transition to quality improvement also requires a discussion of standards that must be met in order to achieve the intended outcomes. This requires a high degree of reliability within the change effort and to adhere to established standards that specify how quality improvement standards will be met (Chassin & Loeb, 2011). These practices will also demonstrate an ability to recognize the potential of standards-based improvements that will drive employees towards greater motivation and performance so that the needs of the organization are fully met in the desired manner (Chassin & Loeb, 2011). It is believed that this process will also encourage employees to identify areas where successful outcomes might be achieved through standards-based improvements and greater attention to detail to meet expectations (Chassin & Loeb, 2011).

Achieving process improvement also requires an organization to identify models that have been successful in the past and to recognize patterns of improvement that have occurred in other organizations to serve as a starting benchmark for improvement at the process level (Tyagi, Cook, Olson, & Belohlav, 2013). These methods will demonstrate the importance of process change that utilizes technology-based tools and other systems that support change and progress at the organizational level (Tyagi et.al, 2013). Barriers to success are likely within this area because of resistance to change and other challenges; therefore, a widespread support system must be achieved within the organization to improve the potential for long-term success within this area.

Conclusion

A healthcare organization must demonstrate its potential to achieve improvements in quality through change as warranted by trends within the practice setting and the needs of the patient population. Therefore, process improvements, the utilization of technologies, and employee support and buy-in are some of the critical areas where there is a greater likelihood of success and achievement over the long term. This process requires organizations to identify their strengths and weaknesses in favor of successful results and improved quality of care.

References

Chassin, M. R., & Loeb, J. M. (2011). The ongoing quality improvement journey: next stop, high reliability. Health Affairs, 30(4), 559-568.

Kaplan, H. C., Provost, L. P., Froehle, C. M., & Margolis, P. A. (2012). The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare  improvement. BMJ quality & safety, 21(1), 13-20.

Lifvergren, S., Andin, U., Huzzard, T., & Hellström, A. (2012). The path to sustainability in healthcare—Exploring the role of learning microsystems. Organizing for Sustainability, 2, 169-197.

Tyagi, R. K., Cook, L., Olson, J., & Belohlav, J. (2013). Healthcare technologies, quality improvement programs and hospital organizational culture in Canadian hospitals. BMC health services research, 13(1), 413.