Maximising the Quality Factor
Quality in health care has been defined as ‘doing the right thing, the first time, in the right way, and at the right time’ (NSW Health 2002). Consumers of health care expect that the services provided will be safe, effective, appropriate, consumer-focused, accessible and efficient. The challenge for providers of health care is to monitor and improve systems continuously to satisfy these expectations.
Advances in scientific understanding, therapeutics and technology in recent decades have resulted in better care, but these improvements have also introduced higher levels of complexity into systems without a companion system of evaluation—a system of evaluation that ensures the best possible care for patients. In addition, the complexity of modern health care has increased the opportunities for system failures and human error. The concerns expressed by clinicians, consumers, governments and the media have resulted in an increasing focus on quality and safety in Western health-care systems over recent years.
The nurse manager is the pivotal person to lead the way in improving services within his or her area of responsibility. The establishment of standards of professional nursing practice, and the maintenance and evaluation of these standards, are central to the role of manager. As a professional, the nurse manager is required to be accountable for the quality of nursing services in his or her area of responsibility. This involves ensuring effective staff management, accountability of shift leaders after hours, relationship management with other members of the health-care team, financial management, client and staff satisfaction, and service planning and implementation. The concepts inherent in any quality-improvement framework are applicable to all aspects of the nurse manager’s role.
- The nature of quality improvement
- Clinical governance
- Consumers and customer service
- Beginning the process
- The PDSA cycle
- Defining the problem
- Setting goals
- Understanding why the problem is occurring
- Sustaining improvements