Contents

Introduction 2

Quality and safety in Australian health care 2

Clinical care activity 4

Information on process and outcome 5

Conclusion 6

References 7

Introduction

The National Safety and Quality Health Service (NSQHS) Standards are based on quality and safety in healthcare and each oft eh standard cover a different area of care quality and safety. The government of Australia developed this standard with the help of the Australian Commission on Safety and Quality (ACSQHC) to prevent hard and improve the quality of health care offered in the health care setting in the country. There are eight standards in total which focus on the different adverse event associated with health are services which increase the risk for the patient and affect their safety negatively (ACSQHC, 2017). These adverse events are chosen for inclusion in the standard not only because of the risks they represent to the safety of the patient and the overall quality of health care but also the high incidence of the events. This standard helps provide a standard baseline for safety that is consistent across the different health systems across the country and helps develop the expectations of the service users regarding the safety and quality of the different health service offered by the various associated organization operating within the country. The comprehensive care is the fifth standard that is included in the 2017 directive of the ACSQHC. The essay focuses on the standard for comprehensive care that is centred upon one specific clinical care activity that is fall prevention. The process and outcome data is also included in the discussion to understand the impact of the standard on the quality of health care and safety of the patient enabled by the application of the standards.

Quality and safety in Australian health care

Quality of care can be defined as the degree to which the treatment affects the patient’s odds of accomplishing the ideal outcomes and lowers the possibility of unwanted negative outcomes, based on the development of the health system and the health of the patient. This addresses many dimensions of health care that are deemed essential for providing quality health care to any patient that includes access, outcome, timely intervention, effectiveness, efficacy, patient satisfaction, safety equity and patient-centric orientation (Braithwaite, Matsuyama & Johnson, 2017). Therefore, it is clear that a variety of strategically chosen measures are needed to understand the quality and safety of health care services especially considering the diversity of the different organizations providing health services across Australia. Quantitative measures, like mortality or readmission, are straight forward but many such variables can be used under different circumstances to measure the quality of a health care organization. This makes the process of evaluating the safety and quality of the health care organization across such a vast location complex. The main organization that addresses the evaluation of the health care quality in Australia is the National Health Performance Committee (Birkhäuer et al., 2017). This committee is a part of the Australian Health Ministers’ Advisory Council whose sole responsibility to provide standard evaluation framework for measuring the performance of the health system across t the country and establish an acceptable baseline for quality.

The Audit and feedback is a universal measurement methodology that is applied in the Australian healthcare swatting to a degree. Audit and feedback mechanism is a framework for improving both the quality and safety of health care that can be applied from various perspectives. This is an instrument that is used to enable proficient execution and improve the quality of health care and patient safety by examining previous incidents of negative outcomes and continuous improvements in the existing system (Moran, Burson & Conrad, 2016). While this is applied mostly as in internal mechanism there are standard established by the NSQHS that help in its execution form an external perspective that allows for better clarity while reducing the possibility of bias.

The main factor in the assessment of the health care system is based on retaining the accessible data from various organizations. It is improbable that an individual health expert could stay up to date with this development in information (Hanefeld et al., 2017). In any case, there have been significant advances in the information technology, investigation and reporting of findings on quality of care. Collection of information into a cohesive framework and, specifically, orderly audits have taken care of through wide application of health innovation and the creation of evidence-based practice standards that are accessible to professionals informing the people working at all levels of the national health frameworks to acceptable standards of care. Another important facet of the standards is based on the capacity of self-evaluation for both professionals and organizations (Akachi & Kruk, 2017). Research literature demonstrates that healthcare professionals may not be able to accurately evaluate their performance. While there are tool and techniques that can assist them with this task, external contribution might be essential making the role of the National Health Performance Committee important in the Australian context.

Clinical care activity

The standard 5 of the NSQHS covers the area of comprehensive care that indicates the ability to offer coordinated care delivery ensuring quality care of the patients. This ensures the satisfaction of the patient’s health care needs and the effect those needs might have on their general wellbeing like exposing them to new risks. This also includes the minimization of the risk of harm during healthcare delivery which is specifically focused on this exercise. The risk of falls is very high for the patient under health care is one of the main reasons for an extended hospital stay and a negative impact on the recovery time for the patient (Walsh, 2017). The evaluation of the screening and assessment processes identified in the NSQHS guidelines is focused solely on the risk of falls in this assessment.

The falls within the health care setting is a major safety issue as the incidence of falls for patients regularly increase the severity of the issue they were initially diagnosed with and length of stay at the hospital. The research literature indicates that patients with different health issues have a high risk of falling bringing about an injury that affects their health negatively (Berry et al., 2017). The risk of falls is different for patients utilising healthcare services based on their issues. For example, any illness affecting the coordination to the mobility of the individual increases the risk of injury due to falling several folds. The measures taken in the quality and safety standards to guarantee that falls in patients doesn’t bring about severe injury are demonstrative of steady improvement which sets the target for the health framework interventions that prevent the risk of falls by taking precautions or at least minimising the negative health impacts for the service users (Lord & Close, 2018). The rate for falls are not exclusive to health care setting is often the risk is carried over the patients recovering in their home. This poses the threat of readmission due to fall-related injury that is also included in the standard. The incidence of falls in health care facilities and readmissions due to the same cause is comparatively better than expected and has been declining consistently because of the constant progress of preventive techniques facilitated by the standard.

The preventive measures and risk assessment techniques that have been successful to some degree but the risk is not equally distributed among the patient population requiring special attention. The strategies used for reducing the risk of injury from falling in the elderly without any cognitive issues are ineffective in forestalling falls in dementia patients (Travers et al;, 2018). A comprehension of the parameters of the guidelines is therefore necessary for specific application making the awareness and training of the professionals regarding the assessment of risk and important facet of the prevention (Cummings, 2019). Therefore, the standard incorporates the patient-specific risk and assessment of risk on understanding the hazard and follows up on the appropriate techniques to be implemented to minimise the risk.

The significance of an exact appraisal of the hazard applies to the physical and cognitive capacity of the patient. This emphasizes the need for inclusion of the patient-specific criteria in the standard as the risk of falls is different for patients.

Information on process and outcome

The process and outcome are the best way to prove the effectiveness of the strategy used for addressing a specific medical problem. The structure of the assessment framework is essential as the structure is needed for establishing a better process which in turn leads to a better outcome. There has been an exponential development in the volume of clinical research in recent decades. Albeit numerous effective appraisals of quality are relevant to the prevention of falls for patients, one significant imperative stand out as important (Callis, 2016). The more prominent clinical process and outcome measures are based on the different individual needs of the patients like mobility issues affecting the risk. The insufficient information in the framework set up to help assessment is detrimental for facilitating patient-specific prevention plan in the comprehensive care. Accordingly, there is a wide range of literature significant to the quality of health care regarding the risk of falls in different pate tins based on their individual needs like cognitive decline, mobility issue or coordination issues (ACSQHC, 2017). The standard extends from the organization that is tended to solely at the organizational level, through regions which have embraced regular arrangements to ensure quality and safety checks to prevent the issue of falls affecting patient safety.

One such factor is the change in the environment that is used to prevent falls for the patient in a health care setting. This includes assistive devices like walkers and handrails that provide both support and mobility aid (Tricco, Thomas & Veroniki, 2018). The process, in this case, can be considered as the implementation of the changes in areas with high fall risks like stairs bathrooms and the expected outcome is a modest reduction in falls. However, the actual evidence does not show any significant change in the rate of fall in health care stings which has been explained through either poor reporting standards or low adherence to the preventive practices (Bergen, Stevens & Burns, 2016). Therefore, some factors cause a discrepancy between the expected outcome and actual outcome from a process used to increase the quality and safety in a health care setting. This is only one example and there can be many others like these that indicate the shortcomings of the quality and safety standards.

Part of the comprehensive care quality standard refers to the minimization of patient harm as the expected outcome. When viewing it from the context of the fall prevention, this can be interpreted as identifying the risks fall for patients and take appropriate measures for the prevention of the fall event based on the nature of the risk (Ogoh, 2019). However, the process does not guarantee the expected outcome as discussed above and therefore there is a clear need for regular evaluation and improvements based on patient needs to be included in the comprehensive care plan. The process can be divided into several steps like the risks assessment for individuals patients evaluate the potential methods applied to prevent harm for the patient and monitor the patient condition for making improvements. Therefore, the process and outcome are based on the implementation of the best practice strategies that can evolve as the needs of the patient population changes.

Conclusion

This is undeniably an essential aspect as unlike the other more generalised standards this standard focuses on the individual care of the people availing the healthcare service. This is done through risk assessment and identification of possible dangers to minimise the potential harm to the people in the identified area (ACSQHC, 2017). The literature indicates that h risk of falls differs based on the patient condition that needs to be considered in the implementation of a fall prevention strategy which is part of the comprehensive care plan. The process and outcomes examples indicate support for the need for constant monitoring and evaluation for enabling improvement over time which is essential as the expected outcomes are not always met in the different scenarios. The policies also need to be based on age groups and specific characteristic like the cognitive ability of older adults which seems to affect the success of the comprehensive care plan significantly.

References

Part 2

1. Akachi, Y., & Kruk, M. E. (2017). Quality of care: measuring a neglected driver of improved health. Bulletin of the World Health Organization, 95(6), 465.
2. Birkhäuer, J., Gaab, J., Kossowsky, J., Hasler, S., Krummenacher, P., Werner, C., & Gerger, H. (2017). Trust in the health care professional and health outcome: a meta-analysis. PloS one, 12(2).
3. Braithwaite, J., Matsuyama, Y., & Johnson, J. (2017). Healthcare reform, quality and safety: perspectives, participants, partnerships and prospects in 30 countries. CRC Press.
4. Moran, K. J., Burson, R., & Conrad, D. (Eds.). (2016). The doctor of nursing practice scholarly project. Jones & Bartlett Publishers.
5. Hanefeld, J., Powell-Jackson, T., & Balabanova, D. (2017). Understanding and measuring quality of care: dealing with complexity. Bulletin of the World Health Organization, 95(5), 368.

Part 3

1. Cummings, P. (2019). Exercise to prevent falls in older adults. Jama, 322(14), 1415-1415.
2. Lord, S. R., & Close, J. C. (2018). New horizons in falls prevention. Age and ageing, 47(4), 492-498.
3. Berry, S., Kiel, D. P., Schmader, K., & Sullivan, D. (2017). Falls: Prevention in nursing care facilities and the hospital setting. UpToDate. Waltham (MA): UpToDate.
4. Walsh, W. A. M. (2017). Falls risk assessment and prevention in the acute hospital setting (Doctoral dissertation).
5. Travers, C., Henderson, A., Graham, F., & Beattie, E. (2018). CogChamps: impact of a project to educate nurses about delirium and improve the quality of care for hospitalized patients with cognitive impairment. BMC health services research, 18(1), 534.

Part 4

1. ACSQHC; (2017) Australian Commission on Safety and Quality in Health Care. National Model Clinical Governance Framework. Sydney: ACSQHC; 2017.

2. Bergen, G., Stevens, M. R., & Burns, E. R. (2016). Falls and fall injuries among adults aged≥ 65 years—United States, 2014. Morbidity and Mortality Weekly Report, 65(37), 993-998.

3. Callis, N. (2016). Falls prevention: Identification of predictive fall risk factors. Applied nursing research, 29, 53-58.

4. Ogoh, N. E. (2019). Effectiveness of a Fall Prevention Educational Program for Long-Term Care Nursing Staff (Doctoral dissertation).

5. Tricco, A. C., Thomas, S. M., & Veroniki, A. A. (2018). Interventions to Prevent Falls in Older Adults—Reply. Jama, 319(13), 1382-1383.

The post Quality and safety in Australian health care appeared first on My Assignment Online.