Within the social and health care industry, the quality of delivering services is of high importance. It is a sufficient feature to the service providers as well as the users and other stakeholders. The attempts to improve services and decrease financial tensions are the usual efforts commonly made to motivate better treatment in the care environments and prevent expensive charges. Organizations must develop different methods to evaluate various systems and further perform the guaranteed quality service. Inventions in the linkage of data, for instance, have made it feasible to harmonize the systems for protecting models of social and health care services. Facilitators assured to utilize assessment methodologies that proceed with a large amount of managerial information on care provisions and help to improve the efficiency of social and health care. These diverse methods must fall under the service model to implement and evaluate these processes properly.
The current report aims to describe the management of quality in health and social care. It presents the findings of the study of the ways in which stakeholders of health services manage, measure, and improves the quality of care, and the hardships they face while implementing the tasks. The review considers the key points affecting the quality of health and social care services in the Royal United Hospital Bath NHS Trust. The following paper is aimed at describing the problems in the Hospital and proposing the significant steps that should be taken to support the improvement of quality measurement and management.
It should be mentioned that social care services attempt to maximize the quality of life of individuals who are not fully capable of long-term self-care. However, their aim is generally not to improve or remediate the underlying impairment, but rather to compensate the person for the impact of their impairments on their physical and mental functioning. Specifically, the main purpose is to maintain a person’s quality of life or physical and mental functioning.
Before proceeding with the report further, it is sensible to understand the terms used in it, and their definitions are as follows:
Stakeholders who are the people interested in the quality of health care highlight their perspectives regarding the quality of the Royal Hospital services. First of all, patients value the ability of health care providers to help them receive optimal treatment and to meet their personal goals. Secondly, the clients expect to achieve transparency of information, evidence, and existing treatment options. Finally, patients want to experience person-centered treatment and a sufficient amount of attention from the staff working at the hospital.
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As for the external agencies, their main function is to sustain and monitor the quality of health care. “They usually set certain standards for the health care industry to stick to them. Standards are for all stakeholders in services – purchasers, providers, users, carers, other agencies, members of the council, and members of the general public who pay for them – but they are written for users and carers” (Whiteley & Younger-Ross Devon 2006). Moreover, they operate as the quality auditors and defenders of the interests of stakeholders. The environments of health and social care amalgamate the experts of diverse external agencies. Good examples of them and their impact on the monitoring of health care include While Healthcare Inspectorate, Care Quality Commission, as well as Medicines and Healthcare Products Regulatory Agency. The functions of these institutions also consist of monitoring and inspecting the activities in the health and social care, and in such a way ensuring that hospitals are providing patients with safe, efficient, and high-quality services.
It is essential to pay proper attention to the influence that poor quality services have on the stakeholders. In particular, they lead to a decrease in patient care and mislaying of the money that is usually spent on the usage of care services. The issues which make the services limited at the Royal United Hospital Bath NHS, in particular, include scant reporting process, dishonest operation of funds, and non-compliance with health care requirements. To improve the situation, the Royal Hospital Trust must pay specific attention to maximizing the usage of financial resources. Finally, amelioration of the quality assists in leading the high-quality delivery, this reinstates confidence in the Royal Hospital services.
The standards that exist in health and social care and are applied in measuring the quality are essential for assuring daily living and guarantee a high level of health care. These norms include the rate of control, audit, and management made in this sector, and also the functionality of the services. “Quality assurance, control, and audit, in particular, are instrumental in countering the discrepancies within these modes of services” (Malley & Netten 2008). However, it is important not just to establish the standards, but also to implement them in the system of health care. The only way of delivering standardized health services is to work in the direction of executing the standards in life.
Another significant fact in measuring quality is the relationship between standards and indicators. Indicators of feedback need to be organized in accordance with practice standards, clinical evaluation, and audit data. This relationship highlights the following principles of indicators:
Social and health care provisions have to cooperate directly with the well-being care department regarding the number of programs, which can correlate thus helping to manage the services in a better way better. Focusing on the provision of better health outcomes, social and health care facilities have to make all the possible attempts towards improving the delivery of quality services. The Royal Hospital’s experience of giving social and health care amenities is supported by their orientation to enabling the welfare of patients and improving the conditions of their staying in the health centers. The above standards relate to the CQC report, stating the conditions, that hospitals should use to provide clients with safe and efficient services.
The quality systems suggest an understanding of the quality of the service using the examples of quality assessment in care situations. The Total Quality Management approach is utilized to analyze data. It is an efficient instrument for auditing, monitoring, and reviewing performance indices. In the systems of social and health care, TQM is applied interchangeably with the Continuous Quality Improvement approach. Particularly, the latter is pivotal for evolving hospital practices, and bases on the principle that tremendous opportunities exist for the improvement in care processes and facilitation. Another approach is Quality Assurance, which focuses on the affairs identified by accreditation regulation of organizations, including reviewing, supervision processes, and documentation. It appears that the TQM attitude is the best for the Royal United Hospital Bath NHS Trust because it considers the descriptive analysis of the operations that provide efficient data analysis. This approach aids the management in functioning, planning, and control procedures to guarantee the highest quality of the facility.
When attempting to deliver quality health and social care services, the management of the Royal Hospital encounters certain barriers. Some of them include huge demand for clinic services, the problems with surgical procedures, and the failure to meet the standards. These challenges frequently result in patients’ aggressive behavior. As for the external barriers, they mainly relate to financial hardships. ‘The trust was not meeting standards and were compliance actions following several CQC inspections for respecting and involving service users, care, and welfare, safeguarding and assessing and monitoring the quality of service provision” (The Royal United Hospital Bath NHS Trust 2014). Due to the failure in meeting the standards, the Royal Hospital risked being closed, or to experience a decrease in the number of clients. The busiest season in the hospital was when “there was a high demand for trust services, and the trust did not have sufficient capacity to cope with emergency admissions” (The Royal United Hospital Bath NHS Trust 2014). On the other hand, the lack of health insurance resulted in the inability of health departments to adjust the program to all the citizens. Poor financing resulted in management not being able to handle the hospital’s needs, namely purchasing the necessary items to satisfy all the patients.
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Evaluation of the effectiveness of the systems, policies, and procedures used in the Royal United Hospital Bath NHS Trust revealed that their services are safe, efficient, and qualitative. The organizations utilized in the clinic are diverse; for example, the management tries to shorten staying in the hospital. “The staff has introduced measures to reduce patients’ length of stay in the hospital” (The Royal United Hospital Bath NHS Trust 2014). The nurses work using the caring system individually required by patients. “The Trust has increased its knowledge and skills for supporting people who were vulnerable” (The Royal United Hospital Bath NHS Trust 2014). Basing on the previous mistakes, the hospital implemented the system of infinite availability. “There was sufficient medical staff and consultant staff was on a call out of hours and at weekends” (The Royal United Hospital Bath NHS Trust 2014).
Currently, the Trust’s doctors follow the person-centered policies. Quality health and social care organizations assist the Trust in achieving the successful implementation of the new policies namely better health care coordination, the use of non-physician sustainers as nurse practitioners, and the ordinary physicists, including the setting of patient-centered therapeutic houses. Along with the policies, the Royal Hospital conducts various programs such as the disease management programs, which receive support from the federal legislation. The goal of the program is to improve the care quality and reduce the costs of treatment.
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Other factors that influence the achievement of quality at the Royal Hospital include quantifiable and positive outputs and outcomes. Besides, the provision of quality services at the Royal Hospital demonstrates the value of money to commissioners and funders. The Royal Hospital Trust also seeks to supply increased plausibility with stakeholders during its struggle for quality achievements. Evidently, organizations that do not have a formidable raft of standards fail within internal systems which leads to miserable quality.
Analyzing the existing problems in the Royal Trust, it is possible to suggest several ways for resolving the hardships and improve the services. Firstly, the hospital should move in the chosen direction seeking improvements. Secondly, the staff must be available anytime during day or night, and the Trust must become a real home for those who have to stay there for a long time. Furthermore, doctors should execute their duties at a high level of professionalism to save people’s lives and improve the quality of their life. The clinic also has to purchase more of the most advanced equipment to ease the growing users’ demands. Finally, the management has to expand the infrastructure employing more personnel to accommodate the always growing community of patients and resist congestion.
Methods of assessing health and social care service quality are rather diverse. They can be either external or internal. “The analysis of the impact of CQC evaluation of external quality is by examining its application in care environments” (Manjunath & Arun 2013). CQC aids in documenting external elements within social and health care substructure. However, considering the inner nature, TQM rummages in financial operation, the behavior of customers, and the effects on the environment. Internal factors form the basis for change when external factors suffuse the conditions for change. The absence of needed evaluation mechanisms usually results in health care barriers. Studies conducted in relation to health and social care claim the positive influences of the TQM on patients’ satisfaction, as well as on financial performance and behavior of customers in general.
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The impression of the users of services is important in the evaluation process but has its advantages and disadvantages. It aids in evaluating efficiency, accessibility, and equity of the relevant services, yet it is not always objective. Nevertheless, this approach is useful in the assessment and improvement implementation, since it creates the ground for auditing care systems and encourages consumer-oriented social and health care reforms. The Royal Hospital also has to expand its facilities to house more patients addressing the issue of congestion. Finally, the clinic must follow an interdisciplinary approach to enlarge social and health care provision.
The quality of services in the Royal United Hospital Bath NHS Trust is rather high, yet has some problems that require consideration. There are many challenges concerning measuring the quality of social and health care. However, important advances have been recently made, peculiarly in the development of frameworks and instruments. The personnel in the Royal Hospital performs the duties qualitatively in accordance with all the rules of safety. The levels of staffing are safe, although they need amelioration in several areas, particularly in the neonatal units and critical care. All the patients feel safeguarded, but the majority of the staff require up-to-date safeguarding training to protect children. Another part of the personnel experiences hardships with an understanding of patients’ rights of independence, especially those who are in danger of wandering. Some patients complain that they should wait for the planned operations, and they meet outpatient appointments. Patients with complex needs experience discharge delays. Overall, the staff is caring, although during busy times and in hectic areas, the needs of patients have not always been met.
There are several aspects relating to the Trust that requires improvement. First of all, the organization must reconsider the operating systems to monitor and evaluate the provided services regularly and further provide improved and proper treatment based on the previous harm incidents. Secondly, the services must be available anytime regardless of the season and the business of the institution. More stuff should work in the occupied areas and during the busy periods of the day. Moreover, the time clients have to wait for pain management and consultation should be reduced. Thirdly, the training of the stuff must be more professional since the employees must meet accredited standards in health and social care. Patients frequently complain about the unbiased attitude of the workers, so the latter must behave and treat patients in a more sensitive way.
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