How definitions of quality have changed in the health care arena.

The U.S.’s current health care infrastructure is under some heavy pressure and is facing immediate and severe challenges, here of late. These issues that surrounds the industry, comprises not only cost and quality of service , as it relates to patients, but caregivers are also burdened with the cost of equipment, regulations and varied list of liabilities. In addition, there are bigger growing problems with issues like policies, laws, or regulations that govern the larger health care system. “The current health care environment with a myriad of policies, laws, and regulations imposed by government agencies, private sector insurers, and institutions, challenges both nurses and patients who are often caught between the cross currents of cost constraints and access to appropriate quality care.” (Abood, S. (January 31, 2007) However, one of the most important and significant issues that we are faced with is the rising cost of health care service to patients. These health care woes that we are experiencing have always been latent, but continuously ignored. The health care industries in the U.S. have reached its climatic point. The lack of good sound leadership is evident, in the fact that we can feel and witness the devastation and impact of a failed strategic approach. The need for control mechanisms as it were, has propelled the U.S. health care industry into a new path or direction. As a result, of such an array of problems we have significant increase in demand for a dynamic leadership with the ability and skill set to create a systematic process that will allow them to design and implement effective interventions to promote quality in health systems. Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups. What has changed and is of great magnitude, is that quality is more centered around the patient, whereas not so long ago it was primarily centered around the caretakers’ wallet, if you will. Secondly, the World Health Organization (WHO) states, Quality of care: a process for making strategic choices in health systems. The latest technologies used in health care, for example less invasive techniques or informatics has advanced our methods of quality healthcare. In addition, research and development teams are on a constant mission looking for solutions and for ways to improve the quality of services being offered. The latest advancements or innovations in health care do possess the ability to lower the cost and also increasing access to quality health care. Thirdly, there are several “quality gurus” that have made a significant impact and contributions to our communities and our society as well as abroad. Dr. Deming, according to references for business in an online article noted that he is most renowned for reminding management that most problems are systemic and that it is management's responsibility to improve the systems so that workers (management and non-management) can do their jobs more effectively. According to online business reference, one of Deming's essential theories is his System of Profound Knowledge, which includes appreciation for a system, knowledge about variation (statistics), theory of knowledge, and psychology (of individuals, groups, society, and change). Fourthly, on the other hand, according to business reference, Crosby makes the point that it costs money to achieve quality, but it costs more money when quality is not achieved. Crosby espoused his basic theories about quality in four Absolutes of Quality Management and are as follows: 1. Quality means conformance to requirements, not goodness. 2. The system for causing quality is prevention, not appraisal. 3. The performance standard must be zero defects, not "that's close enough." 4. The measurement of quality is the price of nonconformance, not indexes. There are three major three basic strategies that are used to improve quality: A. Inform - Making sure that high quality is available on which clinical and management decisions can be based. B. Change - Realigning services so that they are based on sound evidence of results and cost effectiveness. C. Monitor - Constantly assessing and reassessing services to ensure that change results in improvements. These three basic strategies that can not only can be beneficial in the medical arena, but also has some form of leverage in many other business models as well. By taking the initiative and informing the people of important business matters demonstrates your desire for transparency, thus creating a more trusting atmosphere. This is the most prominent selling point. Furthermore, promoting your idea or your plan of change to improve quality requires a bit of skill to encourage the members of your team to buy-in, as it were. Although, it is not the most important, change is difficult in most situations. Most people are somewhat reluctant because they fear the unknown. In addition, during this very fragile phase, either the people will support your cause or throw it to the wind. Lastly, your skill to plan, design and implement control mechanisms that are fit to monitor the progress of your strategic plan, is paramount. Monitoring your changes, to determine whether or not things are good or needs improvements will help you to be able to gage more efficiently the needs of your organization. In conclusion, although quality and quality management does not have a formal definition, most agree that it is an integration of all functions of a business to achieve high quality of products through continuous improvement efforts of all employees. Quality revolves around the concept of meeting or exceeding customer expectation applied to the product and service. It is possible, to improve the quality of the health care system by fostering change in the process of care and in the performance of nurses and other medical staff members. Besides, if we take into account some of the more profound usages of the terms quality health care which consists of such characteristics as efficiency, efficacy, effectiveness, equity, accessibility, comprehensiveness, acceptability, timeliness, problems in quality can relate to the structure, process or outcomes of care appropriateness, continuity, privacy and confidentiality we would be able to see the thing clearer , that we have a long way to go as far as trying to meet the highest quality standard. “It is pivotal to medical staff efforts to improve quality and safety, yet the quality assurance process model that has prevailed for the past 30 years evokes fear and is fundamentally antithetical to a culture of safety.” (Edwards, M. T. (2013) References 1. Abood, S. (January 31, 2007). "Influencing Health Care in the Legislative Arena". OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1, Manuscript 2. DOI: 10.3912/OJIN.Vol12No01Man02 2. Barnett, K. (2011). Quality Improvement Strategy. 3. Edwards, M. T. (2013). A Longitudinal Study of Clinical Peer Review's Impact on Quality and Safety in U.S. Hospitals. Journal Of Healthcare Management, 58(5), 369-384. 4. McLaughlin, C. P., & Kaluzny, A. D. (2013). Continuous quality improvement in health care. Sudbury, MA Jones and Bartlett. 5. Kern, L. M., Edwards, A., & Kaushal, R. (2014). The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care. Annals Of Internal Medicine, 160(11), 741.