For this Assignment, review Case 3, “Barriers to an Effective QI Effort,” in Chapter 11 of the text, Managing Health Services Organizations and Systems. Reflect on how you as a current or future health care administrator might address strategies to implement a quality improvement initiative. Consider the following questions: What considerations should you keep in mind to address quality? How does one measure quality and identify strategies to improve quality in an HSO? Then, review the Week 6 Case Questions document in this week’s Learning Resources to complete the Assignment.

The Assignment (2–4 pages):

  • Complete the case questions presented.
  • Be sure to provide support from the literature in completing the case questions. 1. Use the principles of QI to outline a basic effort to improve quality in the ED
    Example to answer this question. Outcome measures (indicators) focus attention on a coordinating body, which here could be established only for the ED—even though a hospital wide effort is preferable. The coordinating body sanctions establishment of cross-functional QI teams to understand processes and recommend improvements. Intradepartmental teams may be established too. Individual ED workers who are process owners may be assigned to monitor and improve a process. The coordinating body would approve all major changes and expenditures. Details about The Joint Commission’s approach to quality/productivity improvement (Q/PI) are found in the Comprehensive Accreditation Manual for Hospitals
    2. Identify some control measures that Lester could use.
  • Example how to answer of control measures that Lester could use include output control (ED admissions and discharges, patient satisfaction surveys), process control (times for key quality characteristics from ED process[es], staffing issues), and input control (relationships of ED MDs with EMTs and RNs [RNs have low morale, high turnover, and low retention]). The expanded control model shown as Figure 11.2 can be used to understand application of these control points. Recruiting a physician director of the ED must be a top priority because the leadership, decision making, and stability such an appointment will bring should reduce instability considerably. An obvious solution is for DH to contract with an ED group that will be the sole provider of physician services.

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