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What is Quality Improvement in Healthcare Management?

Posted in Healthcare

Last Updated | November 15, 2021

Overview: what is quality and performance improvement in healthcare?

With the demand for healthcare superseding capacity, coupled with an increasing focus on improving patient experience and ensuring patient satisfaction, all healthcare organizations need to apply formal, data-driven, evidence-based techniques for continuous quality and performance improvement in healthcare. Especially at a time when hospitals across the country are contending with a bevy of challenges, such as clinical variations, delays in patient discharge, haphazard workflows, fatalities due to medical errors, lack of organization of patient data, and hospital acquired infections, healthcare organizations need to redesign themselves to efficiently address patient needs, offer the highest level of patient care, and bring about a sustained quality improvement in the healthcare system.

Quality improvement in healthcare can be defined as monitoring, assessing, and improving the standards of quality healthcare and implementing a string of rigorous, systematic, organization-wide processes that lead to measurable improvement in health care services. It is about doing what is right for the right people at the right time. Similarly, performance improvement can be thought of as the constant evaluation and adaptation of the functions and processes across a healthcare organization to improve the occurrence of positive outcomes and boost patient care. Continuously upgrading healthcare activities from traditional modes to more technology-savvy ways, such as implementing Practice Management System, software, EHR/EMRs, Care Coordination Software, can improve organization efficiency and generate better quality results.

What Is the Purpose Of Quality Improvement In Healthcare?

When we talk about healthcare organizations, quality improvement (QI) activities help to bring about an improvement in the general population health, ensure more positive patient experiences and outcomes, reduce organizational costs, and enhance the provider experience. There are numerous other benefits of improving quality in healthcare.

For instance, a systematic and organized approach to healthcare helps organizations reduce preventable fatalities and optimize patient care. QI promotes a culture of transparency and accountability that is the hallmark of quality care. A marked improvement in organizational activities and processes prevents the risks of redundancy and failure. A streamlined healthcare system is driven by data, rather than anecdotes. By enhancing clinical processes, caregivers are given more space to offer value-based and patient-centric care.

By gathering and analyzing data in key areas, Data-driven processes allow you to anticipate and mitigate problems before they even surface. Not to mention, streamlined processes and activities help to bring down the overheads associated with human errors, redundancies, and poor outcomes. Furthermore, digital processes are easier to maintain, with less room for error. All in all, quality and performance improvement in healthcare allows organizations to enhance care delivery and ensure more positive patient outcomes and improved efficiency of staff.

What Is A Quality Improvement Plan In Healthcare?

A Quality Improvement Plan is a written set of quality commitments that a healthcare organization makes to its staff, patients, and community as a whole to improve quality and performance in healthcare via systematic processes and actions. Through a Quality Improvement Plan, healthcare organizations, nursing homes, and clinics define how they will bring about the improvement in the quality of care they deliver to their patients. The QIP focuses on priority improvement areas and makes sure that everyone related to the organization is on the same page when it comes to spearheading improvement efforts. A QIP is written with the aim of reimaging a high-performing health care system and serves as a road map for all quality activities, both operational and clinical. The QIP is usually developed by executive and clinical leadership and approved by the board of directors. The QI plan includes an evaluation of the quality of services offered to patients and pursuing opportunities to improve services and resolve identified problems.

What Are Examples Of Quality Improvement In Healthcare?

After experiencing several accounts of medical errors and poor quality of healthcare, Beth Israel Medical Center initiated a quality improvement program aimed at introducing more systematic processes to deliver patient-centric care. As per the Quality Improvement Plan, the healthcare organization replaced critical leaders, introduced industry-leading policies to ensure transparency, collaboration, and patient safety, and encouraged its staff to follow best clinical practices in healthcare. As a result, the organization witnessed a significant reduction in re-admissions, hospital stays and overhead costs, as well as fewer incidents of complications and fatalities.

Sepsis takes many lives in the USA each year since it proves challenging to recognize and diagnose, given that two patients may not exhibit the same symptoms. Mission Health center in North Carolina had previously implemented evidence-based processes for identifying patients with sepsis but the problem with that system was that the data was highly fragmented, which resulted in delayed diagnoses and more complications. However, by switching to a data-driven sepsis identification system, the organization has been able to accomplish timely recognition and effective treatment of the condition. Due to early recognition and timely treatment, the organization has achieved a 9% reduction in mortality rates due to Sepsis.

Similarly, 1 in 110 babies born in the United States each year has a congenital disease. The Pediatric Cardiac Critical Care Consortium wanted to improve the quality of care for these patients through transparent data sharing within organizations so that hospitals can evaluate their own outcomes and learn through collaboration. The quality improvement plan included the collection of clinical data based on treatment plans and outcomes, Continuous improvement based on empirical analysis, and constructive feedback to caregivers. The drive reduced the postoperative mortality rate by 24% and time on a ventilator by 13%.

In another example, Memorial Hospital at Gulfport was constantly facing a loss of revenue due to disbursements. The organization was looking for cost-effective patient care to boost revenue and make up for their losses. The organization realized that reducing the length of stays of patients, and subsequently cutting down on the cost of care, and utilization of resources and staff, would automatically enhance both financial clinical outcomes. They improved care coordination and met their objectives by switching to a data-driven approach to patient care.

Quality Improvement Tools In Healthcare

Quality improvement tools are data-driven methodologies or processes that can help you better comprehend, analyze, or communicate your quality improvement efforts. Quality improvement tools help you manage performance improvements as well. There are numerous QI tools, such as the Cause and Effect Diagram, which helps you analyze the root causes contributing to an outcome, or the Failure Modes and Effects Analysis; a systematic approach helps you identify risks and their impact on the organization as a whole.

Agency for Healthcare Research and Quality also offers a plethora of ready-to-use tools that help organizations measure and improve their quality of healthcare. For instance, their Quality and Safety Review System leverages the structured clinical information recorded in medical health records (EMRs) to generate feedback about patient safety. Similarly, the Health Literacy Measurement Tools can help you assess of health literacy of the public for research, training, or program planning purposes.

The American Medical Association also provides safety, advocacy, measurement and education tools to healthcare organizations. Folio3 Custom medical software Development Company also designs various tools for quality improvement in healthcare.

What Are The Steps In Quality Improvement?

Recognize Improvement Opportunities

It could be anything from lack of documentation of discharge planning teaching to fragmented patient data within an organization.  Before you can initiate a healthcare quality improvement plan, you need to analyze your own data and outcomes and identify processes that aren’t yielding positive outcomes. Scrutinize trends and statistics from EHR records and other sources to identify key areas in need of improvement.

Define the Improvement Objectives

Set concrete and measurable outcomes based on your research and findings. Once you have outlined the areas that need improvement, you can outline your aims for improvement. As a rule of thumb, your planned goals should be aimed at preventing injuries from medical errors, deliver patient-centric care while respecting each individual, reducing redundancy and waste, lessening wait times and response times, and close gaps in healthcare.

Create a Team

If you wish to bridge ethnic and racial gaps in healthcare, you should aim to build a diverse team, comprising of members from different backgrounds. When we talk in terms of healthcare, individuals hailing from different races and cultures have unique skills and experience levels that can do wonders for improving patient care. In addition, a strong team needs an effective leader who can provide oversight, make informed clinical decisions, and lead the way forward.

Implement Processes and Streamline workflows

Before undertaking any initiatives to improve quality, you should also factor in the limitations, abilities, and possibility for error. As such you should aim to standardize procedures, encourage the use of medical software and checklists, ensure compliance, and reduce reliance on memory. Staying mindful of the human factors results in better collaboration between medical staff, reduces medical and IT errors, ensures more efficient patient care, and guarantees a better comprehension of the patient’s condition.

Start Planning

Now that you have set measurable goals and factored in human errors in the design of your healthcare system, it is time to create an achievable improvement plan. You have to set measurable KPIs, implement a strategy for meeting those goals, and specify a data gathering and analysis methodology. There should be a proper system for gathering, organizing and measuring data.

Communicate Goals Organization-Wide

Even the best of plans fall through the crack if people aren’t on the same page. Make sure to communicate any plans or strategies with your team. All goals and milestones should be communicated across the entire organization. Make sure people feel like a part of the change and feel like they are contributing to the progress.

The idea to Improve the Health Care System?

In our opinion, the best way to improve the healthcare system is to let patients get involved in their own healthcare journey. It falls upon primary caregivers to teach their patients to be proactive healthcare consumers. It will prove to be a challenging task but the emergence of Folio3 EHR/EMR integration and patient portals are making it easier for healthcare providers to see a complete picture of a patient’s healthcare journey, educate patients regarding symptom management, and ensure there are no missed appointments. Through the patient portals, patients are able to view their entire treatment plans, diagnoses, medications, contraindications, and even communicate with physicians on the go. Folio3 telemedicine solutions even allow patients to seek remote guidance online. In fact, patient care should extend to include family members and caregivers in the healthcare journey. Custom medical software and healthcare app development services can encourage communication between families, physicians, other care providers, and insurance providers, under one umbrella.

Does HL7 Epic Integration Improve The Healthcare Systems?

With EHRs, the healthcare providers gain quick access to medical history, treatments, medications, and lab results in a digital form. These EHR systems allow secure and automated patient record access. With the wide adoption of these systems, Epic has become the leading provider of automated solutions. That being said, over 45% of the healthcare facilities in the U.S. are using Epic integration for storing medical records.

Currently, healthcare facilities can leverage HL7 Epic integration to standardize and streamline healthcare across different healthcare systems. However, such integration can be complicated because two healthcare providers may not have similar configuration systems. For the most part, if HL7 Epic integration is done right, it can improve the healthcare systems, but three factors have to be considered, including;

  • The first consideration is to identify the messages and critical events to ensure the Epic is designed according to unique data fields and functionalities of healthcare facilities
  • The second consideration is understanding the message specifications (it uses HL7 standards), which means it can be used in healthcare facilities
  • The third and last consideration is understanding the message handling. This is because Epic has endpoints for receiving and sending messages in HL7, so consider if your healthcare organization is capacitated for such message handling.


What is CQI in healthcare?

Continuous Quality improvement in healthcare is a structured organizational process where every employee, be it caregivers, nurses, physicians and other staff, plans and implements ongoing proactive improvements in patient care to improve health care outcomes and initiate activities that are responsive to community needs. CQI involves a culture of continually identifying, analyzing, developing, and testing/implementing improvement initiatives, such as care coordination, health literacy, and self-management, to improve processes and solutions even further.

What Are The Benefits Of Continuous Quality Improvement In Healthcare?

CQI helps healthcare organizations optimize clinical care by reducing costs, preventing fatalities, meeting regulatory requirements, and enhancing the quality of care delivered to patients. CQI efforts help healthcare organizations identify problematic areas, analyze and monitor corrective actions, study their effectiveness, and make changes accordingly.

What Is Quality Improvement In Healthcare In Australia?

Quality improvement in Australia is all about pursuing improvements in population health, such as enhancing the patient experience of care, lessening the per capita cost to the health care system, improving care coordination and patient care, and promoting work-life balance in health care providers.

can UX help improve healthcare quality?

Yes, a proper UX for healthcare can help improve the patient experience and streamline healthcare productivity. This is because an effective UX creates an intuitive system that allows doctors to focus on the patient’s care and needs.