According to a study by the Institute of Medicine, 49,000 to 98,000 people die every year from preventable errors in the hospital. In 2010 inadequate handwashing caused 247 deaths each day in the U.S. In order to protect patients' lives, it is key to understand the essentials for effective quality improvement in healthcare.
1. Humane, Compassionate Treatment - Patients need to feel that they are still human beings. It should be equally important that the patient receives kind, humane treatment as it is for a patient to be given the proper dosage of medication. This requires a full, well-trained staff. When nurses are overworked, tired and under-appreciated, their patients will not receive adequate care. According to a Pain News Network online survey of over 1,250 acute and chronic pain patients, when asked to rate only the quality of their pain treatment, over 52% said it was poor or very poor; 25% rated it fair, while only 23% rated it good or very good. One patient commented: "I was in the ER once, crying because I was in so much pain, and I had a nurse tell me to shut up and cut the act. Never been treated so inhumanely." In order to monitor humane treatment, hospitals must have a system in place to keep nurses and doctors accountable. Things like online surveys and patient feedback are helpful tools to maintain a sense of whether or not patients are treated with respect and human decency.
2. Perpetual Curiosity/Proactive Care - It is essential to avoid complacency in the medical field. There must be an attitude that there are always ways to improve, new methods to explore and new goals to set and surpass. Mentor programs can be very helpful to foster this type of attitude. If there is a superior to impress or learn from, there is less danger of complacency. Quality improvement in healthcare cannot be done in a reactive state. In order to be proactive, clinicians must be willing to continually change and adapt. In order to implement this type of attitude, clinicians need to be adequately informed of why certain changes need to take place. Staffs are more likely to support improvements if they are given proper understanding and motivation for the changes necessary.
3. Make Improvements Measurable to Increase Motivation - Accountability is a key motivator in the medical field. Pennsylvania conducted a survey of primary care providers across the State in order to determine what support was needed most. One of the main needs mentioned included applying evidence-based guidelines. In order to put quality improvement goals into action, there must be a plan of accountability through measurable data. Whether this is something as simple as a sign-in sheet to improve efficiency or a chart indicating positive patient feedback, improvements need to be measurable in order to be sustainable. It is not enough to have regional or nationwide averages to compete with professionally. There should be measurable data by which each individual can monitor their performances. Individual hospitals, doctors' offices, etc. should have a way of measuring the improvements made by their staffs. Measurable data equals accountability and reliability for both doctor and patient.
4. Shared Learning - One of the most efficient and cost-effective ways to improve the knowledge of clinicians is to foster shared learning amongst staffs. Hosting in-house workshops where fellow clinicians can swap knowledge and experiences has the potential to educate clinicians on every level of hierarchy. It also fosters comradery and an atmosphere of sportsmanship where the patient matters most, rather than the doctor with the highest salary. It is also important to emphasize the importance of independent learning. Providing information and resources for workshops and conferences and even allocating required hours of independent study can help keep clinician knowledge up to date and perpetually improving.
5. Improving Self-Knowledge of Patients - In order to implement truly proactive medicine, it is essential to educate the patient. By giving the power to heal back to the patient, you also grant improvement to the clinician and the medical knowledge they represent. When the patient is properly informed of how to prevent recurrent injuries or illnesses, they can decrease or even eliminate unnecessary care in the future. This allows clinicians to be more available and present for patients who truly need extensive and immediate care. On top of educating patients, it is also important to instill proper motivation. In order for the knowledge provided to be acted upon, the patient needs a reason for wanting to improve. Often this will require some physical or mental therapy to help get the patient started in the right direction. Again, it will be important for the patient to have a means of measuring their improvement in order for their goals to be sustained and surpassed.
Though healthcare continues to change and adapt, these essentials will always remain. In order to succeed in both care of patient and care of the clinician, quality improvement must be prioritized.