High-level security of clinical processes should be a basic quality indicator of a healthcare entity.
The purpose is to support system implementation or to deploy some of its constituents in safe clinical processes performance.
It relies on both, offer of matching systems implementation and quality standards or solely tools, methods and lean philosophy. Each case provide successfully implemented project which portrays clinical processes being currently fulfilled in a clarified manner, in order to enable participants and management to plan and react on a specific procedure. Risk assessment allows to minimize erros and build a perfect team.
- evaluation of current quality system
- evaluation of current clinical processes security level
- identification of possible risks, threats to processes
- assessment of desired services quality level by patient/client
- identification of rooms to be improved
In today’s world, medical institutions strive to offer and maintain a high quality level of services. Patients understand quality as providing specialized, effective and permanent medical care. The high quality level leads into the trust of patients towards the National Health Service in Poland, safety and reduction of any risks during hospitalization. In accordance with the Act of 2004 [Act of 27 August, 2004] every citizen of Poland is obliged to insure himself. The public health insurance in Poland increased pro-quality awareness of medical services. Customers of medical institutions started to pay more attention to the type of provided services, their aesthetics and quality. They have the right to use the services of the institution which they consider the best, have confidence in it and feel safe. Mobility and ease of access to other places and possibility to choice service provider from a wide range of services has made patients change their health provider until they are satisfied with the treatment. In addition the importance of Patient Rights has increased. Increasing awareness of consumer about the services provided by hospitals, clinics, and medical centers in general has led to increased competition among healthcare providers. Medical institutions are like big companies that need a customer to function well and efficiently. A customer is a factor that keeps all the processes involved in providing medical services. It is important to take care and respect him, try to meet his expectations and make him want to use only one medical servic
Quality in healthcare
There are many quality interpretations starting with opinion of Aristotle, who argued that quality is not an event but a habit and a feature by which we are able to distinguish an item from another [Łańcucki J. (red.) 2006]. According to Japanese scholars, quality can be all that can be corrected, improved and upgraded through continuous improvement and not stagnation [Skrzypek 2000]. Japanese philosophy Kaizen allows for continuous improvement of products, services and processes because according to this philosophy there will always be an element needed to improve. Customization of product characteristics will be effective only if all employees will accept the company’s objectives and will have motivation to implement them [Skrzypek 2000].
Types of quality
According to Sato [ Dykowska, Możdżonek, Opolski 2010] it is possible to distinguish three types of quality. This is the required quality – it is one that is determined by the external client, i.e. the customer. The customer presents the features that the service should have to satisfy him. The target quality is the one that has been planned and implemented by the service provider and the adjusted quality is the quality that is determined by the management of the organization in agreement with customers so the customer’s expectations were met by the company by collection of interviews among the recipients and creating the products required by the consumer. ISO 9000 standard [Łańcucki 2006] is quality as “the degree to which an ensemble of inherent qualities meets the requirements”. Quality is an element in the management system which to function well require to be co-created by all employees, not only by top management. In today’s world, the quality of both products and services is a decisive advantage in gaining new markets and new customers. It is easier to adjust the product to the customer profile, portfolio and his required features of the product or service than to create a product that will not find affirmation among the society as it will not meet customer needs.
Quality of service is defined as the overall of its properties which is related to the ability of a given service to meet the expected and identified needs of the customer [PN –ISO 8402:1996]. When a patient acquires a service, he confronts his expectations with what he has received. Patient Does not judges service quality only through the prism of the final result but also evaluates the process of service delivery [Wolniak, Skotnicka, 2011]. The process consists of the conditions under which the service was provided, the environment in which it was located, attitude of the medical staff towards the client and time of service delivery. The essence of the service is above all to satisfy the needs of the customer it means satisfying it by doing the right thing.
Satisfaction is a mental state, which is an emotion that expresses satisfaction with the choice made in the purchase act. Satisfaction is an emotion which means it is a transitory and variable experience. Satisfaction occurs when the product / service meets the customer’s expectations and dissatisfaction when it not meet them. In turn the result of a comparative evaluation of two components: experienced service and expectations designed towards it are referred to as perceived quality of service [Bukowska-Piestrzyńska 2011]. Satisfaction occurs when the performance evaluation is at least equivalent to the client’s expectations. In addition the creation of its image on local market is influenced by positive perception of the service provider. Despite advertisements, marketing activities, the recipients have the greatest influence on the opinion building of the provider [Nogalski, Rybicki 2002]. Patient feelings, subjectivism and perception of a medical institution lead to the formation of knowledge about the provider among other patients, although each person is characterized by individual perception. Consumers are increasingly less convinced of the truthfulness of advertisements appearing on television, the internet or radio, therefore, they are more likely to rely on a friend’s opinion, another user of the service who – if satisfied with the service will talk about it positively, recommend it and encourage to use it also if the user is unsatisfied then he will negatively talk about the company and most of his relatives will be reluctant to use the service. This is the so-called perceived quality, i.e. any difference between the expected service and the service received.
Christian Gronroos- a representative of the Nordic marketing school proposed the separation of quality into two categories. Quality related to the technical performance of the service is technical quality, while the function of the service, its expression, method of execution, environment conditions, staff behavior and communication – it’s functional quality. In the Christian Gronroos model the role of service quality is a dominant feature of service delivery strategies.
“Health benefit are actions to preserve, rescue, restore or improve health and other medical activities resulting from the healing process or separate regulations governing their execution” [ Act of 15 April, 2011].
The variability of health services is due to specific legal regulations concerning all permits and concessions to provide services and public health insurance obligations which affects all citizens [Nowotarska-Romaniak 2008 ]. The range of services is also dependent on the management, which know the resources and financial capacity of the hospital and which services can’t be introduced because it involves a high amount of money for the purchase of new equipment, machinery (medical equipment) or lease of additional rooms and buildings. Interest in health services also increases from the demographic situation, i.e. the prolonged life of people. In the years 1952-1999 a decrease in the birth rate per 1000 population was observed [GUS 2010]. In addition increase of pro-health awareness results in more health care, frequent visits to the doctor for advices and preventative activities against the diseases of potential patients of the hospital.
The condition necessary for the implementation of health services is the existence of institutions such as hospitals, clinics, healthcare facilities, doctors, nurses and specialists such as: physiotherapist and psychologist.
- Law from 27 of august 2004 r. About Provision of health care funded by public resources. Dz.U.nr 210, poz. 2135
- Łańcucki, J.(red.), 2006, Basics of complex quality management TQM, Publisher Economic Academy in Poznan, Poznań
- PN –ISO 8402:1996, Quality management and quality assurance.
- Skotnicka, B., Wolniak, R.,2011, Methods and tools of quality management, theory and practice, University of Technology, Gliwice
- Bukowska-Piestrzyńska, A.,2011, Health care services marketing- from forming medical unit image to client satisfaction, Publisher CeDeWu, Warsaw
- Nogalski, B., Rybicki, M.,2002, Modern management of healthcare unit, first edition, Publisher Wydawnictwo „Dom Organizatora”, Torun
- Law from 15 of april 2011 About medical activity, Dz.U.2011, nr 112, poz.654 http://www.fizjoterapeuci.org/media/ust_zoz.pdf
- Nowotarska-Romaniak, B.,2008, Marketing of health care services- concept and practice, Publisher ABC Wolters Kluwer business, Warsaw
- Central Statistical Office, 2010, Basic data of health in 2009 r. Warsaw