Ethical Considerations
One of the most critical aspects of any continuous quality improvement (CQI) effort, especially in healthcare, includes accounting for ethical considerations. The latter is necessary in order to avoid conducting the intervention improvement at the cost of healthcare ethics, which lie at the foundation of advancing human health and wellbeing. A study found that “various kinds of moral deliberation and ethics support could contribute to addressing coercion challenges by offering more systematic ways of dealing with moral concerns” (Norvoll et al., 2017, p. 59). In other words, although the proposed CQI mandates the implementation of specific care protocol changes, these must not be forced by harming an already established functional and beneficial practice.
The CQI plan seeks to reduce the risks associated with nosocomial infections and medical errors, as well as bring enhanced patient safety at the We Care Hospital, but the nursing staff need not to be forced to comply with the changes. Another study suggests that “service delivery could be substantially improved through focused efforts to support health centers with relatively lower documented evidence of adherence to best practice guidelines” (Nattabi et al., 2017, p. 1). Bible states one should “speak evil of no one, to avoid quarreling, to be gentle, and to show perfect courtesy toward all people” (The Holy Bible, English Standard Version, 2001/2016, Titus 3:2). Therefore, even if the goal of a CQI measure is undoubtedly justified, improvements can be made without coercion. No change within the context of the CQI will be forced, but rather suggested as a superior alternative with the use of persuasive method.
Discussion
It is important to note that the goals and objectives of the continuous quality improvement plan are to enhance patient safety, minimize medical errors, and decrease nosocomial infection risks. For the latter, the direct intervention involves investing in personal protective equipment. The changes can be mainly implemented by the healthcare managers and administrative staff since medical professionals will most likely be willing to use better equipment both for their own safety as well as the safety of their patients. It is stated that the latest personal protective equipment tools are better at preventing nosocomial infections due to the pressures caused by the coronavirus (Graham & Woodhead, 2021). Therefore, the investment and provision of such equipment are justified, and it only requires the allocation of resources.
When it comes to the minimization of medical errors, the goal is to achieve a balance between standardization and error management. However, We Care Hospital already has a rigid standardization put in place, which is why the efforts will be focused on providing more flexibility and autonomy. The reduction of such errors and nosocomial infections will contribute to the third objective by improving patient safety. The strength of the project is rooted in the fact that it will likely not cause non-adherence and resistance from the medical staff. The main reason is that offering more freedom for healthcare professionals will be perceived as something positive, which is also true for a piece of updated equipment. Therefore, the interests are aligned across all three major stakeholders, such as patients, healthcare professionals, and managers.
The impact on the people will be mostly manifested among the medical staff members as well as patients. The latter group will experience better recovery and health outcomes due to the reduction in risks associated with nosocomial infections and medical errors. Key processes and systems of the intervention will change significantly for the medical experts since they will obtain a higher degree of autonomy, but it will also mean more responsibility. The project sustainability comes from the fact that better care provided by We Care Hospital will translate into increased patient satisfaction, a lower rate of lawsuits, and higher demand for its services. The latter benefits will recoup the investment into personal protective equipment. In the case of increasing autonomy and flexibility, the intervention will not require financial investments but rather changes in the procedural protocols and provision of a higher degree of freedom for healthcare professionals within the boundaries of the legal framework.
Thus, the recommendation for the next steps should include the overall analysis of the state of personal protective equipment at the moment. The managers need to identify which equipment pieces are lacking, which are outdated or old, and which do not require resupply of new ones. After the latter step, it is important to evaluate the required spending needs for the near future in order to inform the financial department. It is likely that a period of investment or spending will be needed since many forms of personal protective equipment are viable only for a specific number of uses. The following step should focus on revising the standardization processes established at the hospital. It was already established that We Care Hospital has a rigid system of control, which is why managers need to identify the ‘bottlenecks’ of the procedural processes. These steps in the workflow need to be addressed by consulting the legal experts since there are specific national requirements as well.
References
Graham, R. N. J., & Woodhead, T. (2021). Leadership for continuous improvement in healthcare during the time of COVID-19. Clinical Radiology, 76(1), 67-72.
Nattabi, B., Matthews, V., Bailie, J., Rumbold, A., Scrimgeour, D., Schierhout, G., Ward, J., Guy, R., Kaldor, J., Thompson, S. C., & Bailie, R. (2017). Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: Analysis of longitudinal continuous quality improvement data. BMC Infectious Diseases, 17(1), 1-13.
Norvoll, R., Hem, M. H., & Pedersen, R. (2017). The role of ethics in reducing and improving the quality of coercion in mental health care. HEC Forum, 29(1), 59–74.
The Holy Bible. (2016). English Standard Version. Web.
