Safety and Quality improvement processes Essay 2800 words APA
The setting is a city acute care surgical environment that will be used to facilitate critical analysis about the impact of organisational culture on a health care organisation that is supported by, but not limited to, the literature that was identified for Assessment Task 1:
Evaluative Summary. (as below)
In this essay, you are required to address an area that is relevant to safety and culture in a health care setting (for example, risk management, safety and quality in health care, quality, improvement processes, application of Australian National Safety Standards to a health care setting), from the perspective of a health administrator.
My original assessment I used the productive ward implementation and staff satisfaction. Additionally, look at the work engagement post the implementation of the productive ward with regards to elements that may impact or interact and whether there is sustainability and success in the productive ward program. The three journal articles below from the evaluative assessment must be the cornerstone of this essay, with extensive critical analysis, I have added several other journal articles for consideration but would appreciate additional literature.
This assessment task will extend the student’s exploration of the
selected topic by applying the findings of the annotated
bibliography to their current work environment (An Australian acute care surgical ward/hospital) in order to analyse the impact of organisational culture on a health
care organisation with which they are familiar. The student will
reflect on their experience and compare and contrast with
relevant literature and research, including the literature chosen
for the annotated bibliography that was sourced for Assessment
Task 1(As below)
The aim of any quality improvement in health care is to bring improvement in patient care and at the same time make the profession more efficient. According to (White, Wells, & Butterworth, 2014; Wright & McSherry, 2013; Morrow, Robert, Maben, & Grif?ths, 2012) the best way to do this is through the program The Productive Ward. Firstly, it is important to understand the three main aims of The Productive Ward program.
• To increase the proportion of time nurses, spend in direct patient care.
• To improve experience for staff and for patients.
• To make structural changes to the use of ward spaces, to improve efficacy in terms of time effort and money
(White, Wells, & Butterworth, 2014. Pp1636).
The main purpose of the three research articles was to discuss challenges, demonstrate evidence of efficiency and understand the implication for nurses and patients with the implementation of a large scale quality improvement program like Productive Ward
Wright & McSherry (2013) research was conducted by interviewing both nurses and patients on one to one basis and divided into different groups according to the grade of the staff. The patient’s perspective was also included and showed that they were satisfied with the improvements. The study was also useful in pointing out the strong points of the program, which encouraged a more inclusive profession with lesser hierarchy. It also pointed out that organisational stability and regular input from the staff is essential for successful implementation of any program. It is important that in the implementation of these programs there is a platform for shared decisions as research indicates that shared decisions have the potential to achieve better health care as well as lowering the cost involved in providing health care. However, it is important that the decisions be made be based on evidence and not on mere assumptions.
Morrow et el (2012) used a mixed-method research design and involved national policy makers, senior hospital managers, and hospital staff, the main purpose of the research was to understand what challenges English hospitals face when dealing with The Productive Ward: Releasing Time to Care program. The four major challenges were namely, “receptivity, the complexity of adoption processes, evidence of the innovation, and embedding change” (Morrow et el 2012, p.239- 249). Most of these challenges are to do with the implementation of the Productive Ward Program, giving the fact that the nurses deal with all manner of patients who has different needs, meaning, that as the needs of these patients vary depending on their type of illness, then sometimes it is overwhelming for the nurses to cater for all these needs of the patient and the program at the same time. Morrow et el conclude that The Productive Ward: Releasing Time to Care program can be an effective tool for quality improvement in the healthcare system, despite the challenges it has and barriers it creates. but there is a need for more research to ascertain the best way of implementing these programs.
Finally, White, Wells and Butterworth assess the impacts the Productive Ward have on job engagement. They utilise a cross-sectional research design to explore the relationship compared with a control group that demonstrated quality enhancement and work engagement depend on one another. The study possesses its fair share of limitations that take away some level of validity and reliability of the information. Regardless of the difficulties, their research acts as evidence that quality enhancement and work engagement depend on one another. (White, Wells, & Butterworth, 2014).
Although Wright and McSherry (2013) research provided evidence of improvement they concluded from the analysis it was not possible to definitively conclude productive ward efficiency of care time, due to the subjectivity of staff and patients’ responses and suggested that more such studies should be conducted which should be much more comprehensive, so that the program may be improved through changes where required.
Although the Productive Ward Program has had positive outcomes from all the researchers it was also stated that further work was needed to determine the impact of productive ward.
For further studies the author would like to research Australian healthcare facilities that have successfully implemented the productive ward program. Additionally, look at the work engagement post the implementation of the productive ward with regards to elements that may impact or interact and whether there is sustainability and success in the productive ward program. Given that the Productive Ward Program have been deemed effective, it is important that there is support for these programs from all stakeholders as a long term plan.
Morrow, E., Robert, G., Maben, J., & Grif?ths, P. (2012). Implementing large-scale quality improvement: Lessons from The Productive Ward: Releasing time to care. Journal of Health Care Quality Assurance, 25(4), 237-253, doi 10.1108/09526861211221464
White, M., Wells, J., & Butterworth, T. (2014). The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the ‘Productive Ward’. International Journal of Nursing Studies, 51: 1634–1643, doi: .org/10.1016/j.ijnurstu.2014.05.002.
Wright, S., & McSherry, W. (2013) Evaluating the productive ward at an acute NHS trust: experiences and implications of releasing time to care. Journal of Clinical Nursing, 23, 1866- 1876, doi: 10.1111/jocn.12435