Performance Improvement approaches in Healthcare: The challenge of departmental improvement =ALL is not WeLL”

Performance Improvement approaches in Healthcare: The challenge of departmental improvement. “ALL is not WeLL” If something goes wrong it will.It implies the need for anticipation (Murphy,s law). Has our Healthcare Become Safer Than We Think? Learning From the Past; Prospects for the Future-with perceived obstacles and requirements, the process of patient safety perceived in our healthcare need a paradigm shift., We need to discover our blindfolds on concepts in performance measurement. A time of transition for Implementing and Measuring Up ,patient safety and accountabiliy culture change in health care in theory and practice. - • ALL is WeLL.truth is truth hurts .The common denominator motivating all public reporting on healthcare quality is the principle of transparency. Though our state faces many problems in health care. EXPECTING tremendous results in upgrading the infrastructure and improving the service in shortest time must have stunned any quality professional in healthcare. All of our story tellers are calm, news for the common man because the elite already know . • Who wouldn’t like to join the chorus of “Aam aadmi “in praising the leaders ? ,-“Well done ,sir, I appreciate the thought and effort you and your men have put into this but in the end do we hope improvement in our state Health Care is defined well. • TRUTH OVER POPULISM;. Healthcare Performance Improvement (HPI) provides proven methods for building and sustaining a culture of safety. All decisions are based on information derived from reliable data. Politicians debate different ways to pay for our broken system. In quality we measure strcture,process; outcome with measurement tools called indicators. Reporting Health Care performance with Public sharing of performance data at national level in a competitive bench marking for changing the behavior of healthcare consumers, professionals or organizations can be a “strategic Solutions for Tough Times” but If analysis is not done utmost precision ,the danger of over interpreting data plays a crucial role in future plan for improvement project ,and God forbid if or when things go wrong, or if pushed again in FMEA- failure modes and effect analysis it can be labeled as a serious mishap on patient safety program. Traditionally politicians depend on feedback of their professional advisors for their statements in professional matters; hopefully ,and I pray that our improvement measurement indicators( data) substantiates our tall claims -What you are experiencing now in ,GB pant like situation is the sweet or bitter fruit of policies/ decisions /hype-statements of the past masters , hierarchy of our previous poorly conceived Healthcare/Hospital policy.The most important question that is pivotal now after such acclaimed position definitely we are liable to be public inquiry or scrutiny of quality care professionals especially in a situation where bad doctors. Prescription errors,Surgical slips. Medical mistakes ,machinery failures injure or cause death in patients every year and in particular international patient safety goals have not taken practical shape. • Healthcare Performance Improvement - Making Reliability a Reality.. What we are trying to accomplish? How will we know change is an improvement? What changes we can make that will result in improvement? One approach to successfully making dramatic changes in the way they do in problem solving and to treat patients often called Model for Improvement and testing change is using PDCA( Plan-Do-check -Act () cycles. Most good hospitals use this approach. This scientific model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement. • Effectiveness & Efficacy; are very important for any organization to perform better .Unchecked poor performance and unmonitored problem behaviors eroded the standards in our health care units eventually resulted in disasters like “GB pant hospital or allegations of high mortality in SKIMS. Failure to correct a performance or work habits problem, or lack of policy of appreciation or encouragement of those employees who are meeting these standards can also have far reaching effects on each member of health care team. If one employee fails to produce as expected or breaks established work rules, it's not fair to others who must pick up the slack or who rightfully expect everyone to follow the rules. To Ensure that the operation of the organization meets the expectations of its clients, management needs to get the right people with proper Job Descriptions, Primary Duties and Responsibilities, to implement the organizational policies; • Patient satisfaction as the major objective in any healthcare. While the other points of the quality compass address the needs of the hospital, physician , and community,, the patient's need to be heard is best met by an assessment of satisfaction. Often, the data gathered from this expression of satisfaction or dissatisfaction is useful for the institution to gauge itself and its success not only in providing a minimum standard of care, but also in meeting the customer's requirements. Thus, it behooves the institution that wishes to maintain its number one status has to focus on keeping as many people satisfied with their care as possible. Appreciably, Govt has woken up-hope with different mind set and refreshed policy of patient satisfaction and safety. • Checks and balances”- if something can go wrong it will,”( Murphy’s law )it implies the need for anticipation . The use of IHI global "triggers," or clues, to identify adverse events (AEs) is an effective method for measuring the overall level of harm in a health care organization so that we don’t wake up in disasters. As variation of performance is normal we have to set limits i.e triggers after which we need to perform root cause analysis to recommend changes as appropriate on the basis of incident /error reporting(OVR –observation, variance reporting) system as per standard clinical practice guidelines and pathways ;The process of -- accreditation, validation and certification of standards periodically by any Governmental or non- governmental organization creates a check and balance system for the accurate delivery of health services. Unfortunately —we lack this concept in our health care, hence disasters like GB pant catch us unprepared and Mortality Morbidity in our premier institution surpasses trigger level. • Don’t Harm Me – Heal Me – Be Nice to Me .Getting quality health care can help you stay healthy and recover faster when you become sick... That’s what your patients want and in that order. Safety is fundamental to our healing mission and the foundation of the exceptional patient experience. When it comes to safety in health care, the only acceptable goal is zero events of harm.or zero tolerance to advers/sentinel events.. • Aligning culture to support quality;Till the bagging of –state of states award Our health-care system definitely was never envy of the world, as it always faced serious challenges of, “Standards and Accountability”.The figures of Morbidity and Mortality of our teaching institutions published in media had raised questions locally,and at National level regarding our strategic planning, management, and safety environment prevailing in our health care services. • Think big;.start small;act now .Quality varies depending on where you live. Quality can vary from one State to another, and it can vary from one doctor’s office to politician’s public reporting across the street to another. Health care quality deserves professionalism..As per my latest communiqué with my colleagues more than 3500 health professional of Directorate of health services , Kashmir have been trained in BLS (basic life support)by dedicated team trainers and process continues. Our honest and dedicated friends are holding stewardship for our premier institutions. With few aberrations exceptions undoubtedly we would like to think that every doctor, nurse, pharmacist, hospital, and other care provider gives high-quality care, even under unfavorable circumstances they deserve encouragement, real impetus will come from above when genuine obstacles and barriers are removed in this program. For Continuous Improvement a paradigm shift in policy is needed from the blame game towards system overhaul and work culture motivation.–A Call to Action' is thought-provoking policy and ultimately hopeful challenge to establish standardized safe and sustainable health care system. • (feedback fiazmfazili@yahoo.com0Dr Fiaz Fazili is a Certified Quality Assurance expert on Healthcare, and Surgery Chapter leader for Joint Commission for Accreditation of International Hospitals.)e