Quality of health in healthcare is an important issue. There is a big difference between what is called quality in one context and what is called quality in another context. For example, some people are comfortable using medical jargon and others don’t. There are different concepts for quality, and healthcare organizations want to be consistent in applying the concepts across the board.
Quality of health care usually refers to patient outcomes. What is quality of care? Quality of care in the context of health care includes quality of the process, tools and services provided to the patient, along with the outcomes of those quality elements. It also includes the quality of relationships the care recipient has with his or her care providers. Quality of life is often considered an outcome as well, but quality of life is not necessarily linked to patient outcomes.
Deming’s Approach To Quality Of Health Care Deming developed a 5-pronged approach to quality improvement that he used in the Japanese organization where he worked as an adviser. The approach was based on two powerful concepts. The first, called the principle of similarity and variationlessness, held that there can be no such thing as quality if there is no comparison. The second, called the principle of consistency, allowed him to argue that only by combining both concepts and comparing the results of changes from any source can we get a clear idea of quality improvement. Deming’s approach to quality of health care had several critics who challenged his assumption that there could be no such thing as improvement.
Quality improvement is important for several reasons. The first of these is the avoidance of costly over-shoot. If we know what we are doing and have the data to show us when we are doing a good job, there will be little need for worry about quality improvement. However, this need arises when the quality of the end product is not known until the process is under way. Thus, measuring quality and variability at the early stages of a process is necessary.
Another reason for quality improvement is to get as much improvement as possible for the least amount of cost. Deming’s five-pronged approach tries to find the maximum result at the lowest cost. This involved designing projects in areas most likely to experience improvement before moving on to more difficult projects. This was not always possible, but Deming’s approach made it possible.
The development of new knowledge and new practices is only possible through research, but research requires funding. The Deming approaches allowed research to go ahead quickly and without much interruption. The result was a variety of PDSA cycles that could be implemented as the need arose. This ensured that improvement efforts were not put on hold because of lack of funds.
There were some problems associated with the speed of implementation, but this was not because of the quality of health care or healthcare overall. The problem was more to do with lack of understanding of the concepts involved in making good quality improvements. PDSA cycles are easy to understand, but it takes a trained person to implement them properly. Once the processes are understood, improvements can then come much more rapidly. If the correct tools are used, then there is no excuse for a slow improvement effort.
The meaning of quality of health is very much connected to its relation to statistical methods. When data sets from statistical studies are combined with knowledge from expert practitioners and managers, improvements in health and healthcare will be easier to identify. In addition to using PDSA cycles, systematic reviews, evidence based practice guidelines, exchange of information principles and other important concepts will all help practitioners make quality improvements. The importance of transparency in health care cannot be overemphasized. If practitioners cannot maintain high standards of transparency in their work, then the value of quality assurance processes, MFI and pdsa improvement cycles will be compromised.