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Assessment Summary of Risk and Quality Management

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As I was reading about Duke University Medical Center and here is what it said about quality improvement it is a “formal approach to the analysis of performance and systematic efforts for improvement” (2005). In different industries quality improvements are constructed differently. quality improvement is used in the field of medical it focuses on the safety of the patients and the employees that work at the facility, avoid or reducing the mortality and morbidity rate, and reducing the medical errors. Since the nineteenth century the health care organizations have been looking for ways to improve the quality of care. A obstetrician by the name of Ignaz Semmelweis “introduced hand washing to medical care, and Florence Nightingale who determined that the poor living conditions was a leading cause of death of soldiers at the army hospital” (Chassin and Loeb, 2013).

When a group of individuals get together to talk about the health care industries they automatically think of hospitals and it is the first thing that the group thinks of. The hospitals use quality management to accomplish the long and short term goals that will improve the patient’s safety and the quality of care a patient receives. There are different program titles that represent quality improvement. There are a lot of different concepts, policies, and factors that a place needs to have for a successful organization. I will be talking about them within my paper. Key Concepts and Names of Quality Management

There are different words to use to represent quality management programs. For instance there is Continuous Quality Improvement, Quality Assurance, Quality Control, and Total Quality Improvement. It just depends on the group what title of program that will be used. “TMQ more often refers to industry based programs and CQI typically refers to the programs that are designed for clinical settings” (McLaughlin and Kaluzny, 2013). A clinical setting would be a hospital; the programs that they would use will have the title of Continuous Quality Improvement and/or Quality Improvement. “Quality Assessments are planned systems that review and Quality Control programs are a routine system used to measure and control quality” (Ipcc, 1996).

When it comes to performance management programs they can be considered quality improvement programs in certain facilities, but they are mainly used in a strategic performance plan that are connected to quality management. The key concepts of quality management is improving the quality and the safety of the patients, improving strategic plans and finding ways to control infections and preventing them, ways to manage private information, training the staff, education for employees, new ideas for improvement, and analyzing the current processes. As stated “Organizations embark on CQI for a variety of reasons, including accreditation requirements, cost control, competition for customers, and pressure from employers and payers” (McLaughlin and Kaluzny, 2013). The main goal is to have quality management in the hospitals to improve the care and safety of the patients and by doing so this will represent the quality care by achieving and maintaining the standards of accreditation. Long-Term and Short-Term Quality Improvement Goals

Quality Improvement is to work forward to reach the long and short term goal that is associated with quality improvement. One long term goal in the health care field is to have a “high reliability” organization. As stated “high reliability organizations are those that maintain a consistent performance at high levels of safety over a long period of time” (Chassin and Loeb, 2013). One of the goals starts with assessing the company’s current state and what assessments that can be a short term goal for the organization of health care. One more long term goal could be to come up with a culture of safety. To accomplish this goal the company should set short term goals for instance training and education for the employees. As stated “Organizations rely on a particular culture to ensure the performance of improved safety processes over long periods of time and to remain constantly aware of the possibility of failure” (Chassin and Loeb, 2013). If place of businesses or organizations knows there is always a chance of failure then they can prevent any failures before they happen and become an issue.

The last long term goal for an organization in the health care field would be compliant and to achieve and maintain the accreditation. This can be accomplished by going through with the short and long term goals. If all of the short term goals of implementation, education, and assessments are accomplished then organizations or place of business will be successful with the quality management program. The individual that is over top of everyone should be the one who tells the fellow employees about the success and be certain that all policies and procedures are kept and maintained. Internal and External Factors that Influence Quality Outcomes There are several external and internal factors that influence the quality and the outcomes of an organization. One of the internal factors would be how it affects quality management and what the outcome will be in the organization. It is very important to have leadership and have prosperous outcome with quality management because if there is no support from the leadership then the organization will not be successful.

“This commitment must be shared by the board of trustees and all senior clinical and administrative managers and understood that it is a long-term process” (Chassen and Leob, 2013).One of the most important things is to have leadership because it is one the most influential parts of quality management program. When it comes to leadership it can do one or another either helps the company with support or can fail them if the company does not support and go with the process. For the internal factor there is another factor that influences the quality management is the review committee. As stated “utilization review committees were established to identify whether hospital medical staffs were providing appropriate clinical services and to prevent fraud” (Chassen and Leob, 2013). As part of the Medicare requirements the committees where put there to over- look things at the facility.

It did not affect the quality of care because of the internal factor because there were no guidelines to go by. I am going to talk about the external factors that influences the quality of care that is for the organizations is called Office of Clinical Standards and the Quality for the offices of Medicare and Medicaid Services. It is stated as follows “Identify and develop best practice techniques in quality improvement and they develop requirements of participation for providers and plans in the Medicare and Medicaid programs” (Conway, 2013). When it comes to Office of Clinical Standards and the Quality it will have either a negative or a positive affect with the success of the health care facility when it comes to the quality improvement management. If the health care facility works good with Office of Clinical Standards and the Quality it could benefit the facility but then again it could also harm the facility and is not complained about. I found another external factor it influences how the quality outcomes which is the Institute for Health Care Improvement.

The Institute for Health Care Improvement is located in Cambridge, Massachusetts “it is an independent not-for-profit organization that focuses on motivating and building the will for change; identifying and testing new models of care; and ensuring the broadest possible adoption of best practices” (Healthcare Improvement, 2013). At this facility they offer programs to individuals that are designed with techniques and designs that will show them how to get along to share knowledge, work in the same environment at the facility, and were to improve better health care. At this Institute they are committed to finding ways to improve quality outcomes and are associated with different heath care settings and this even includes the hospitals.

When it comes to accrediting agencies the Joint Commission they can be very stressful when it comes to hospitals and all the health care agencies but the quality is very beneficial when it comes to the patients. In the year of the late 1990’s The Joint Commission was founded they were known to survey the hospitals that were outside of the United States by doing this it will create better business medical tourism. “The Joint Commission performs external peer assessments of processes, policies, and procedures of health care organizations” (Quality Digest, 2010, Para. 1). When it comes to accreditation it is one of the best accomplishments a facility could receive because this means that the patients will receive the best care. “Accreditation has many benefits for health care organizations such as providing them with a competitive edge, strengthens community confidence, improve quality and risk management, and strengthens the organizations culture of safety for patients and staff” (Quality Digest, 2010, Para. 4). Fundamentals of Quality Management Policies

When it comes to the quality management policies they are very essential for the success of a quality management program for an organization or a facility. Whatever is used to get the policy of quality management started it should be covered in depth in the whole policy and give a good meaning about goals and the expectations. As stated “certain information requirements are to be included in the content of the quality management policy” (Epa.gov, 2001, pg. 8). In the Quality Management Plan it must include: “the organization’s mission; description of specific roles, authorities, and responsibilities of management; clear description of the appropriate means of communication; outline of processes used to plan, implement, and assess the work involved with quality management with a description of how information will be measured; and a plan for continuing their education” (Epa.gov, 2001, p. 9).

It is very important that the management team and the staff at the facility understand what each of the requirements are and what is expected of each employee. The facility needs to minimize the risk and have a quality outcome. If the staff at the facility gives their all to giving quality care and reducing the risk, then it will be a positive outcome for health care. The Relationship between Risk Management and Quality Management “As the risk management and quality improvement functions in hospitals focus on patient safety initiatives, professionals from both fields indicate that their activities overlap” (ECRI Institute,2013). When it comes to these two programs risk management and quality assurance they both work together when it comes to improving the patient’s safety when it goes through the analysis system. When these two work together they will eliminate and point out any issues that could cause trouble for the patients.


Centers for Medicare and Medicaid. Advancing Care for People with Medicaid and Medicare. (2011). Retrieved from: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/index.html Chassin, M and Loeb, J. (2012). Health Affairs. The Ongoing Quality Improvement Journey: Next Stop, High Reliability. Retrieved from: http://content.healthaffairs.org/content/30/4/559.abstract

Duke University Medical Center. (2005). Retrieved from: http://patientsafetyed.duhs.duke.edu/module_a/introduction/introduction.html EPA.gov. (2001). EPA Requirements for Quality Management Plans. Retrieved from: http://www.epa.gov/quality/qs-docs/r2-final.pdf

Institute for Healthcare Improvement. (2013). Healthcare Risk Control. Retrieved from: http://www.ihi.org/about/pages/default.aspx
Martin, D. X. (2012). Risk and the future of quality. The Journal for Quality and Participation, 35(3), 9-12. Retrieved from: http://search.proquest.com/docview/1153311895?accountid=35812 Quality Assurance and Quality Control. (2013). Retrieved from: http://www.ipcc-nggip.iges.or.jp/public/gp/english/8_QA-QC.pdf Quality Digest. (2013) A Guideline for Quality Accreditation in Hospitals. Retrieved from: http://www.qualitydigest.com/inside/health-care-article/guideline-quality-accreditation-hospitals.html Sollecito, W. A., & Johnson, J. K. (2013). McLaughlin and Kaluzny’s Continuous Quality Improvement in Health Care (4th ed.). Sudbury, MA: Jones and Bartlett. Williams, R., Bertsch, B., Dale, B., Ton van, d. W., & al, e. (2006). Quality and risk management: What are the key issues?The TQM Magazine, 18(1), 67-86. Retrieved from: http://search.proquest.com/docview/227627062?accountid=35812

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