Quality Improvement In nursing, patient care and safety is the main goal. Quality improvement is one way to help ensure that patient care and safety remain the number one goal in healthcare. Quality improvement (QI) is the process in which quality of patient care is continuously monitored for effectiveness. All disciplines of the healthcare team should be involved in QI to ensure the best outcome. “The major premises of QI are as follows: focus on organizational mission, continuous improvement, customer orientation, leadership commitment, empowerment, and collaboration/crossing boundaries, focus on process, and focus on data and statistical thinking” (TAYLOR 334).
As with all sentinel event a Root Cause Analysis (RCA) is automatically activated when problems like this occurs. In this
Chapter 2 2. Literature Review Root causes analysis is simply a tool designed to help incident investigators describe what happened during a particular incident, to determine how it happened and to understand why it happened. The definition of a root cause varies between authors and root causes methodologies, with different ‘levels’ of causation being adopted by different systems. Figure 1 illustrates the different levels of cause that can be ascribed to an incident. The root causes lie at level 1 which inevitably influence the effectiveness of all the risk control systems and workplace precautions that exist at levels 2 and 3.
Stakeholders have an interest in an organisation and they are affected by all decisions and actions taken by an organisation to attain its objectives. Stakeholders can be internal or external to the organisation. Stakeholder relationships are categorised in to the following four categories participative, collaborative, informative and defending. (Anon., 2017) Stakeholder engagement is a process of engaging with the relevant stakeholders (Morphy, 2015-2017). Stakeholder engagement is about addressing problems by providing strategies, infrastructure and processes.
According to Freeman, “a stakeholder in an organisation is (by definition) any group or individual who can affect or is affected by the achievement of the organisation’s objectives.” (Freeman, 2010, p. 46). This is the most cited definition in literature. (Mitchell, Agle, & Wood, 1997, pp. 853-886). Since a stake can be defined as “something of value, some form of capital – human, physical or financial – that is (placed) at risk, either voluntarily or involuntarily” (Clarkson, 1998, p. 2), organisational stakeholders can be understood as “individuals or groups who incur and/or impose risk in their relationships with the organisation.” (Vidaver-Cohen, 2007, pp.
Variation in performance would often produce unexpected and undesired adverse outcomes, including the occurrence or risk of a sentinel event. A root cause can be defined as one of the most fundamental reasons of failure, or a situation in which performance does not meet expectations. The word cause in the context of root cause analysis should not imply or assign responsibility or a factor to blame for a problem. Instead, the cause should focus on a positive and preventive approach and refer to the potential relationship between the responsible factors that result in a sentinel event. Root cause analysis usually performed retrospectively, and it evaluates the reasons for the bad outcomes or for sentinel events that have already occurred.
Root cause analysis is an approach to problem interpretation to identify the fundamental cause of an issue that happened (Cerniglia-Lowensen, 2015). (Lee et al, 2012) stated that the whole root cause analysis process includes three vital components which are “what”, “why” and “how” to curb the situation and root cause analysis is usually used in conditions whereby major injury or death happens or in situations that are barely avoided. Applying to my case, my patient had a high chance of falling which can lead to unforeseeable circumstances. (Lee et al, 2012) also mentioned the four stages of effective root cause analysis which is step one, recognising the issue which includes a thorough non-sentimental charged meaning of the process. Step two, detailed collection of information, information collected must come from various origins depending on the actual incident including staffs who witnessed the incident.
Those undertakings in the hotel industry included accommodations, meeting space rentals, restaurants, leisure, and community involvement. Altinay and Miles (as cited by Appiah, 2016) suggested that stakeholders are a uniform group who display individual forms of stakeholder relationships. Many theorists have identified stakeholder groups, along with the expectations they hold according to Connolly; Johnson & Scholes; Kuratko,
Quality improvement Juran, et al. (1999) and Mohsen (2009) concluded that improvement in quality is defined as the creation of valuable change to achieve unmatched levels of performance. Quality improvement can be calculated by viewing increases in income and meeting organizational goals through planning. Meeting needs of customers can be helped by efficient “quality planning”. The organization must identify the customers, their needs, and use that information to create a product or service that is tailored to meet these needs.
Internal stakeholders are the individuals or bodies within a business (e.g., employees, managers, the board of directors, investors), while external partners are elements that are not within the business but rather think about or are influenced by its execution (e.g., customers, suppliers). 2.3 STEPS IN ENGAGING WITH STAKEHOLDERS Following the (AccountAbility, 2011) model, the steps involved in engaging with stakeholders are: Recognize Stakeholders and Key Issues Profile stakeholders to perceive their interests, knowledge, and ability to engage and categorize or outline stakeholders in view of their impact on the organization. These are no impact, low impact, some impact or high impact. Alternative dimensions that can be utilized to outline stakeholders include reliance on the organization, proximity and so on. This can be refined through rating scales or different strategies proper for the organization and context.