Questions:

Assignment 1

1. Why is it important to get patient’s assessment about health care quality? Does a patient have
the expertise to judge the health care he or she receives?

Mosadeghrad (2013) defined quality healthcare as “consistently delighting the patient by

providing efficacious, effective and efficient healthcare services according to the latest clinical
guidelines and standards, which meet the patient’s needs and satisfies providers”.

The board of New Central Hospital resolve to shift the strategies to patients, care givers and
public as the main source of information for assessment is the best. By knowing what users
value, the management of the hospital gets an edge over competitors in plugging the gaps
between current practices of quality and the expected improvement. Patients’ assessment of
quality leads to cost reduction, employees’ morale boost and incidences of malpractice amongst
the physicians addressed accordingly.

The advertisement carried on newspaper in 1997 by New Central Hospital regarding its
capabilities could not achieve much as opposed to a pragmatic approach of patients view. Patient
should not be treated as a passive receiver of care but rather as an active contributor in service
improvement which result to quality and increase in profitability as a result of repeat clients and
referals.Managers, academicians and clinicians can always have a view as to patients satisfaction
but the final result will rest with the patient as to whether their expectations are met.

As Robert Francis says: Individual experiences that lie behind statistics and benchmarks and
action plans that really matter and that is what must never be forgotten when policies are being
made and implemented. Further Ethron & Vorhaus (1997), have argued that increase attention to
quality assessment and improvement in health care is essentially important in increasing
competitive health care markets.

B) There are various ways a hospital can measure quality. Whether they are direct measures or
a guide to what quality entails is explorable.Donabedian (1980, 2003) talks of

I) Structure:-The features and environment within which health care occurs speaks a lot.

ii) Structural attributes:-Talk of organizational structure, equipment, and personnel i.e. medical
staff qualifications says a lot about quality of the hospital.

iii) Process: - Involves the procedures that produces results during care giving.
iv) Process attribute:-Process of seeking care, the formula used, treatment and activities
Undertaken including diagnosis.

v) Outcomes:-Made up of patients experiences, preferences and values.

Clancy & Eisenberg 1998)

VI) Outcome attributes:-It includes general status of the patient after discharging regarding
perception.

Vii) Health perception:-Where a patient notes symptoms experienced

Viii) Patient Satisfaction:-The patient is able to evaluate and give a recommendation as to the
hospitals quality measures.

Assignment 2

3. How can the value of a human life be included in the cost of quality control?

The value of human life should be included in cost of quality control planning as part of
measuring total Quality culture within the Hospital and costs as a result of quality failure.
Cost of quality as estimated by most researchers ranges within 15-40%.The aim of
Quality control is to provide services of quality in a cost effective manner.

The value of human life inclusion in planning stages of quality control will ensure that appropriate
feedback or information is received to assist in evaluating the effectiveness
and accuracy of the New Central Hospital quality areas, problematic and as well improve on
opportunities.

The Hospitals planning should focus on both internal and external aspects.
Internal aspects likely to compromise quality like usage of expired drugs issued unknowingly
from the personnel in the pharmacy, Wrong dosage, Misuse or default of equipment like in
laboratory, testing of the samples and the duration it takes, the cost of Ex-ray, handling by
clinicians and diagnosis, time taken before admission, excess charges by pharmacist on prescribed
drugs. The New Central Hospital can reduce this by using appraisal cost for example checking
quality of supplies, regular check on quality of services offered by the personnel and
interdepartmental conflicts resolution contributing to failure in realizing good quality health care.
External aspect or failure can be based on the patients view and feedback. The level of satisfaction,
patients loyalty, view on productivity of the Hospital are necessary to assess quality control levels,
gauge share in the market, opportunities not seized, strategic positioning and as well allocate costs
effectively.

4. Select one department in the hospital and elaborate how quality standards could be
developed.

New Central Hospital should increase quality at the emergency department. The first sight and
front line team handling techniques cannot be ruled out in any hospital setting. It should be
patient friendly ranging from large workforce, infection control requirements, capacity to handle
major incidences, level of responsiveness to local demands, accessibility and privacy.

The management of New Central Hospital should further focus on

i) The needs of patients:-The environment ought to be conducive and encouraging with a sense
of efficiency, safety, caring and wellbeing. Close family and friends is also a factor to be
considered.

ii) Staff requirements:-It requires a multidisciplinary team, able to work around the clock in
shifts with a good working environment. The team should include clinicians and ambulance
staff.

iii) Site of the emergency:-The accessibility to ambulance or vehicle entering must be easy
good temperature and lightning with natural ambient is necessary especially at night with
full air conditions.

iv) On and off signage:-Emergency department signposts from the main roads should be visible
and separating pedestrian and ambulance or vehicle access accordingly.

v) Functional requirements:-The Emergency department should focus on good

infrastructure, equipment, IT support, Security and Administration.

In conclusion, frontline team requires quality of care check combined with specific standards
accepted for monitoring and evaluation. There should be protocols regarding procedures for
surgical and non-surgical services. Service quality needs not be compromised and therefore be
indoctrinated to the Emergency department staff members for them to be the intermediary
especially between the patient and the general administration.