scholarly journals Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care

2019 ◽  
Vol 43 (2) ◽  
pp. 126
Author(s):  
Sandra G. Leggat ◽  
Cathy Balding
Keyword(s):  
Health Service ◽  
Health Services ◽  
Care Delivery ◽  
Quality Care ◽  
Successful Implementation ◽  
Evidence Based ◽  
Quality And Safety ◽  
Quality Systems ◽  
High Quality ◽  
High Quality Care

Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services. Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review of the quality and safety goals and strategies outlined in the strategic and operating plans of the participating health services was also undertaken. Results This paper focuses on the data related to the leadership role of health service boards in ensuring safe, high-quality care. The findings suggest that health service boards are not fully meeting their governance accountability to ensure consistently high-quality care. The data uncovered major clinical governance gaps between stated board and executive aspirations for quality and safety and the implementation of these expectations at point of care. These gaps were further compounded by quality system confusion, over-reliance on compliance, and inadequate staff engagement. Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers. What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation’s pursuit of high quality care. What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps. What are the implications for practitioners? Based on our research findings we outline five evidence-based actions for boards to improve their governance of quality care delivery. These actions focus on an organisational strategy for high-quality care, with the chief executive officer held accountable for successful implementation, which is actively guided and monitored by the board.

Effective quality systems: implementation in Australian public hospitals

2018 ◽  
Vol 31 (8) ◽  
pp. 1044-1057 ◽  
Author(s):  
Sandra G. Leggat ◽  
Cathy Balding
Keyword(s):  
Quality Improvement ◽  
Quality Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Quality Systems ◽  
High Quality ◽  
Content Type ◽  
High Quality Care ◽  
Self Evaluation ◽  
Focus Group Data

Purpose The purpose of this paper is to review the implementation of seven components of quality systems (QSs) linked with quality improvement in a sample of Australian hospitals. Design/methodology/approach The authors completed a systematic review to identify QS components associated with measureable quality improvement. Using mixed methods, the authors then reviewed the current state of these QS components in a sample of eight Australian hospitals. Findings The literature review identified seven essential QS components. Both the self-evaluation and focus group data suggested that none of the hospitals had all of these seven components in place, and that there were some implementation issues with those components that were in use. Although board and senior executives could point to a large number of quality and safety documents that they felt were supporting a vision and framework for safe, high-quality care, middle managers and clinical staff described the QSs as compliance driven and largely irrelevant to their daily pursuit of safe, high-quality care. The authors also found little specific training in quality improvement for staff, lack of useful data for clinicians on the quality of care they provide and confusion about how organisational QSs work. Practical implications This study provides a clearer picture of why QSs are not yet achieving the results that boards and executives want to achieve, and that patients require. Originality/value This is the first study to explore the implementation of QSs in hospitals in-depth from the perspective of hospital staff, linking the findings to the implementation of QS component identified in the literature.

scholarly journals Updated framework on quality and safety in emergency medicine

2020 ◽  
Vol 37 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Kim Hansen ◽  
Adrian Boyle ◽  
Brian Holroyd ◽  
Georgina Phillips ◽  
Jonathan Benger ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Quality Care ◽  
Safety Net ◽  
Local Context ◽  
Quality And Safety ◽  
High Quality ◽  
International Consensus ◽  
Patient Journey ◽  
High Quality Care

ObjectivesQuality and safety of emergency care is critical. Patients rely on emergency medicine (EM) for accessible, timely and high-quality care in addition to providing a ‘safety-net’ function. Demand is increasing, creating resource challenges in all settings. Where EM is well established, this is recognised through the implementation of quality standards and staff training for patient safety. In settings where EM is developing, immense system and patient pressures exist, thereby necessitating the availability of tiered standards appropriate to the local context.MethodsThe original quality framework arose from expert consensus at the International Federation of Emergency Medicine (IFEM) Symposium for Quality and Safety in Emergency Care (UK, 2011). The IFEM Quality and Safety Special Interest Group members have subsequently refined it to achieve a consensus in 2018.ResultsPatients should expect EDs to provide effective acute care. To do this, trained emergency personnel should make patient-centred, timely and expert decisions to provide care, supported by systems, processes, diagnostics, appropriate equipment and facilities. Enablers to high-quality care include appropriate staff, access to care (including financial), coordinated emergency care through the whole patient journey and monitoring of outcomes. Crowding directly impacts on patient quality of care, morbidity and mortality. Quality indicators should be pragmatic, measurable and prioritised as components of an improvement strategy which should be developed, tailored and implemented in each setting.ConclusionEDs globally have a remit to deliver the best care possible. IFEM has defined and updated an international consensus framework for quality and safety.

Questions healthcare boards should ask senior leaders about risk

2018 ◽  
Vol 31 (6) ◽  
pp. 223-229
Author(s):  
Polly Stevens ◽  
Annette Down ◽  
Jordan M. Willcox
Keyword(s):  
Quality Care ◽  
Evidence Based ◽  
Healthcare Organizations ◽  
Senior Leaders ◽  
High Quality ◽  
High Quality Care ◽  
The Core ◽  
Healthcare Insurance ◽  
Recommended Practices ◽  
Guiding Questions

Drawing on strong ethical and evidence-based principles, Healthcare Insurance Reciprocal of Canada, in collaboration with healthcare leaders, has developed guiding questions to help boards of healthcare organizations carry out a critical governance function—the oversight of key organizational risks. The resulting list of 21 questions is the first of its kind for healthcare and focuses on the core mandate of healthcare organizations which is providing high-quality care. Recommended practices accompany each question.

scholarly journals Translating Knowledge to Optimize Value-Based Occupational Therapy: Strategies for Educators, Practitioners, and Researchers

2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Lisa A. Juckett ◽  
Monica L. Robinson ◽  
Julie Malloy ◽  
Haley V. Oliver
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Quality Care ◽  
Successful Implementation ◽  
Evidence Based ◽  
Client Outcomes ◽  
High Quality ◽  
Value Based Care ◽  
Therapy Strategies ◽  
Payment Models

With the continued evolution of health care reform and payment models, it is imperative that the occupational therapy profession consistently and clearly articulate its distinct value. As payment models shift from paying for the volume of services provided to paying for the value of services, the field of occupational therapy must be sure to implement high-quality care by translating evidence into practice and facilitating improvements in client outcomes. Yet the process of translating evidence-based interventions and programs to real-world settings can be quite complex, and successful implementation often requires active collaboration across occupational therapy stakeholders. In this Health Policy Perspectives article, we provide occupational therapy educators, practitioners, and researchers with key recommendations for how the profession can translate evidence into practice, ultimately leading to the improvement of client outcomes and the provision of value-based care.

Collective leadership for cultures of high quality health care

2014 ◽  
Vol 1 (3) ◽  
pp. 240-260 ◽  
Author(s):  
Michael A. West ◽  
Joanne Lyubovnikova ◽  
Regina Eckert ◽  
Jean-Louis Denis
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Quality Care ◽  
Quality And Safety ◽  
Healthcare Organizations ◽  
Collective Leadership ◽  
High Quality ◽  
Quality Health Care ◽  
Content Type ◽  
High Quality Care

Purpose – The purpose of this paper is to examine the challenges that health care organizations face in nurturing and sustaining cultures that ensure the delivery of continually improving, high quality and compassionate care for patients and other service users. Design/methodology/approach – Based on an extensive review of the literature, the authors examine the current and very challenging context of health care and highlight the core cultural elements needed to enable health care organizations to respond effectively to the challenges identified. Findings – The role of leadership is found to be critical for nurturing high-quality care cultures. In particular, the authors focus on the construct of collective leadership and examine how this type of leadership style ensures that all staff take responsibility for ensuring high-quality care for patients. Practical implications – Climates for quality and safety can be accomplished by the development of strategies that ensure leaders, leadership skills and leadership cultures are appropriate to meet the challenges health care organizations face in delivering continually improving, high quality, safe and compassionate patient care. Originality/value – This paper provides a comprehensive integration of research findings on how to foster quality and safety climates in healthcare organizations, synthesizing insights from academic literature, practitioner reports and policy documents to propose clear, timely and much needed practical guidelines for healthcare organizations both nationally and internationally.

Process and outcomes in general practice consultations: Problems in defining high quality care

1995 ◽  
Vol 41 (7) ◽  
pp. 969-975 ◽  
Author(s):  
Helen R. Winefield ◽  
Timothy G. Murrell ◽  
Julie Clifford
Keyword(s):  
General Practice ◽  
Quality Care ◽  
High Quality ◽  
High Quality Care
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