Quality Improvement in Clinical Practice

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Quality Improvement in Clinical Practice Free Essay


Health sector is an industry associated with high risk and frequently characterised by failures in equipment functioning, inadequate operational systems, and errors in evaluation of the possibilities of dangerous situations. Therefore, institutions need to meet high standards of safety and efficiency. In this regard, there is a need to develop techniques that can help to improve identification of risks, analysis of incidents, as well as advancement of practice. These techniques will allow health care organizations to manage risks successfully and develop capabilities of identifying new and emerging risks. The following paper provides a quality improvement program developed for Hem Clinic to identify possible flaws, fix them, and prevent errors in the future.

The Theory Used to Support Quality Improvement

The theory used in the Quality Improvement Program is Total Quality Management. This approach will be of great assistance in transitioning to more efficient systems that facilitate the provision of quality services. Besides, TQM principles will be important in creating skills in the area of teamwork, problem-solving, and communication (Dimitriadis & Constantinou, 2012). TQM has a long history of helping healthcare organisations to improve patient satisfaction, increase accuracy, enhance staff productivity, and advance clinical documentation (Palm, Lilja, & Wiklund, 2014). The Hem QI program has ample evidence of application of TQM. Quality has improved across all levels of organisation and reached the standards set to assess quality at each level. Monthly evaluation is being conducted to confirm that the established requirements are followed to achieve high quality in the entire clinic.

Design of Quality Improvement Program for Hems Clinic

I. Introduction

This quality improvement design is the foundation of the commitment of Hem clinic in order to continuously improve the quality of treatment services it offers. The institution is committed to continuous improvement of the quality of care it provides its consumers. Thus, it continuously ensures that:

  • The treatment it provides is in line with evidence-based effective practices;
  • The treatment services fit each consumer needs;
  • The organization minimises risk and errors in the provision of its services;
  • The clinic provides procedures, treatments, and services in a timely manner.

Continuous quality improvement activities

Quality improvement at Hem involve two key activities:

The measurement and assessment of the performance of clinical services through data collection and analysis.

  • Suggesting quality improvement initiatives and taking appropriate actions with the aim of designing new services and improving the existing ones.


II. Leadership and Organization


The quality improvement committee will be selected to provide the ongoing leadership of the continuous quality improvement activities (Gamble & Vaux, 2014). The committee is obliged to meet at least once a month to assess the progress of quality improvement initiatives.

The committee will have the following responsibilities:

  • To develop and advance the quality improvement plan;
  • To establish measures and objectives based on the criteria set for improving the quality of services;
  • To review indicators of quality;
  • To conduct continuous assessment of information based on the indicators;
  • To present monthly reports to the board of directors regarding the progress of quality improvement activities.

Responsibilities of the board of directors

  • Offering support and guidance in the implementation of quality improvement activities;
  • Performing review, evaluation, and approval of the quality improvement plan on the annual basis.

All leaders will be expected to offer support to the QI activities through coordination and communication of the QI activities, efforts, and initiatives as well as sharing of the QI data (Eisenberg & Roche-Nagle, 2015).

Hem staff will conduct communication by means of the following methods:

  • Displaying posters in common areas;
  • Sharing the annual QI plan evaluation of Hem;
  • Distributing newsletters and handouts.

III. Goals and Objectives

The QI committee sets and defines the goals and objectives to be accomplished every year. The objectives include offering training to administrative and clinical personnel on the continuous QI principles and initiatives (Dimitriadis & Constantinou, 2012). Evaluation of the QI activities is performed basin on the level to which the goals and objectives were attained.

The ongoing long-term goals and objectives for the QI program include:

  • Implementation of quantitative measures to assess the main outcomes and processes;
  • Fostering coordination among clinicians, managers, and personnel to review clinical adverse occurrences and qualitative data with the objective of identification of underlying problems;
  • Setting goals for resolution of the identified problems;
  • Offering training to clinicians, staff, and managers;
  • Adoption and development of operation techniques, such as quality indicators and consumer surveys.

IV. Performance Measures

The results produced by the QI program will be subjected to regular assessment. The assessment will involve identification of the systems, processes, and outcomes that are important for service delivery, selection of indicators, and analysis of the information related to the indicators. The necessary actions will be taken based on the results of data analysis (Bilimoria, 2015).

Measurement and assessment will have the following objectives

  • Assessment of the processes stability and evaluation of the outcomes in order to identify any undesirable variations that hinder the attainment of the expected level of performance;
  • Identification of the problems and opportunities to increase performance level;
  • Assessment of the care outcomes;
  • Assessment of the level to which the new operation process meets the expected outcomes.

Measurement and assessment activities include:

  • Selecting the processes and outcomes to be measured;
  • Identifying and developing appropriate performance indicators;
  • Aggregating data for summarization and quantification in order to measure the processes and outcomes;
  • Assessing performance in line with the selected indicators on a monthly basis;
  • Taking appropriate actions to address variances between the real and the expected performance levels;
  • Reporting findings, suggesting actions, and making conclusions on the basis of performance assessment.


Assessment will be conducted by comparing the actual performance with the following measures:

  • Pre-established goals, standards, and expected performance levels;
  • Evidence-based practice measures;
  • Other organisations offering clinical services;

V. Quality Improvement Initiatives

After measuring, assessing, and analysing performance of the processes, the information gathered is used to establish the continuous improvement initiative (Hawn, 2010). Adoption of the initiative depends on the priorities of Hem. The performance of the existing services is then improved or the new ones are designed. Hem will adopt the Plan-Do-Check-Act (PDCA) model.

Plan - the first step involves identification of the preliminary opportunities for improvement. There is a need to analyze data to identify concerns and establish the expected outcomes. The ideas for process improvement are identified at this stage as well. The necessary activities include identification of the affected staff, a compilation of data, and formulation of the solutions.

Do - at this stage, the proposed solutions are being tried. If they appear to be successful, the solutions are implemented on a trial basis as part of the new process.

Check - this step involves the collection of data to assist in comparing the outcomes of the new process with those of the previous ones.

Act – at this stage, changes are implemented to improve the targeted activity. All stakeholders, including the staff, consumers, and program components are incorporated. Act involves the people whom the changes will affect, as well as those who will benefit from the improvement and those whose contribution will be needed to for the full implementation of the changes. Afterwards, the findings are documented and reported, and later, a follow-up activity is instituted.

VI. Evaluation

Evaluations will be completed at the end of each year thus being a culmination of quarterly evaluations. Documentation made will be deposited at the office of public health so as to facilitate clinical certification.

The evaluation process is a summary of the goals and objectives contained in Hem quarterly plans, quality improvement activities of the previous year, new processes, systems and outcomes, data aggregation, as well as assessment and findings (Johnson, 2013). Besides, the process implies the summary of recommendations based on the evaluation and actions proposed to improve the overall quality of clinical service delivery.

Expected Outcomes of Your Implementation

The QI plan is aimed at achieving positive outcomes for customers, personnel, and the entire society. The first expected outcome is offering customers efficient and effective services. The program seeks to meet and even exceed the expectations of both internal and external customers. The second outcome is employee empowerment and leadership involvement. Hem Clinic tries to involve people at all levels in the process of improving the quality of its services. Furthermore, the institutions wants to create strong leadership and offer solid directions in quality improvement initiatives. Finally, it aims at offering data informed practice where data will be used to create fact-based decisions.

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