Frances Pittman
Quality in healthcare
Quality in healthcare is a paramount concern and can be defined as the degree to which a product, service, or process meets or exceeds customer or stakeholder expectations and requirements. It encompasses various dimensions such as safety, effectiveness, efficiency, timeliness, patient-centeredness, equity, and accessibility. Achieving and maintaining high-quality outcomes is a fundamental goal in healthcare, as it ensures safe, effective, and patient-centered care delivery.
Applying Quality Theory to the Work of Donabedian: A major quality theorist in healthcare is Avedis Donabedian. Donabedian developed the framework of quality assessment and improvement, known as the Donabedian model or the structure-process-outcome model. According to Donabedian, the quality of healthcare can be assessed based on three interrelated components: structure, process, and outcomes. The structure refers to the characteristics of the healthcare system, such as resources, facilities, and personnel. The process involves the activities and interactions that take place in healthcare delivery. The outcomes are the effects of healthcare on patients' health status and satisfaction.
Wasteful practices
One practice problem that can be improved by eliminating wasteful practices is excessive documentation in nursing. Excessive documentation can lead to inefficiencies, decreased time spent with patients, and increased nurse workload. To address this issue, evidence-based strategies have been suggested. For example, the use of standardized documentation templates has shown promise in reducing redundancy and unnecessary paperwork (Blackwood et al., 2017). Additionally, effectively utilizing electronic health records (EHRs) and streamlining documentation processes can help optimize workflow and enhance direct patient care (Keenan et al., 2018).
Streamlining documentation practices not only increase efficiency but also positively affects patient outcomes and satisfaction. Research suggests that excessive documentation can divert nurses' attention from direct patient care, potentially leading to communication breakdowns and errors. By reducing documentation burdens, nurses can devote more time to patient interaction, assessment, and intervention, resulting in improved patient experiences and outcomes (Scholl et al., 2018).
In conclusion, addressing wasteful practices in nursing, such as excessive documentation, is crucial for enhancing the quality of patient care. Through the application of strategies like standardized templates and optimized EHR utilization, nurses can streamline documentation processes and allocate more time to direct patient care. Ultimately, this can lead to improved patient outcomes, increased satisfaction, and better utilization of nursing resources. By incorporating evidence-based approaches and focusing on the structure, process, and outcome aspects of healthcare quality, healthcare organizations can continue to strive for excellence in nursing practice and patient care.
References
Blackwood, J., Cummings, G., Espin, S., & Scott, S. D. (2017). The impact of electronic health records on nurses' productivity: An interrupted time series analysis. Journal of the American Medical Informatics Association, 24(3), 596-601. doi:10.1093/jamia/ocw152
Keenan, G. M., Yakel, E., Tschannen, D., & Mandeville, M. (2018). Nursing workflow and environmental disruptions: A qualitative study using EHR event reconstruction. AMIA Annual Symposium Proceedings, 2018, 684-692.
Scholl, I., Zill, J. M., Härter, M., Dirmaier, J., & Ansmann, L. (2018). Documentation of patient involvement in decision-making in medical encounters: A systematic review. Health Expectations, 21(3), 539-553. doi:10.1111/hex.12644
