What Is Quality Management in Health Care?

by Kyra Sheahan; Updated September 26, 2017
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Quality management in the health care field ensures that patients receive an excellent provision of care. It is a function that health care organizations (such as medical clinics and hospitals) are responsible for performing to show their due diligence to taking optimal care of their patients. By employing quality management applications to a health care business, doctors and administrators can benefit from identifying ways to improve internal processes that will ream more “quality” outcomes for their patients.

Guiding Principles

Most health care organizations establish standards, or guiding principles, that flush out their service expectations. For instance, a guiding principle may be the expectation that patients shall not wait more than 24 hours to get a phone call returned by their doctor. Quality management plays a big role in establishing guiding principles. According to the U.S. Department of Health and Human Services, the health care field is full of legal regulations (such as HIPAA, a confidentiality law), so quality management departments are responsible for identifying which statutes apply to their organization, and developing guiding principles for their company to adhere to.

Monitoring Compliance

One major function of health care quality management systems is that of monitoring compliance. Compliance is monitored as part of the quality management’s assurance that processes are being followed and patients are receiving optimal care. There are different ways to monitor compliance; the most popular method being quality audits. Audits, according to Iowa State University, are the act of checking documentation against standards, reviewing data and scoring the outcomes. Audits use a quantitative approach to measure statistics that are captured and put into a compliance report.

Risk Management

Quality management in healthcare helps manage, minimize and mitigate risks. Risk management is an integral part of keeping patients safe and ensuring that the care they receive does not threaten their health or safety. In the health care world, prescription medication has the potential to be a risk management issue. Patient allergic reactions, adverse affects and even fatalities can be the result of too many medications, not enough medications or a hazardous combination of medications. Quality management efforts can help keep patients safe, and reduce their exposure to health threats by regularly monitoring things like how many medications a patient is taking.

Process Improvement

Health care organizations benefit from quality management functions because areas of weakness are identified through compliance audits. Knowing where organizations have the potential to improve is important for companies to ensure their viability. Weaknesses hinder success and growth, so quality management efforts are beneficial to a health care organization’s administrators so that they can institute the improvements necessary to bring their company up to par.

Technical Assistance

When errors or weaknesses are found during audits or observations, the quality management team will work with the particular employee (or entire department) to make things right. Technical assistance trainings may be provided so that employees can gain an educational background on the compliance areas, as well as ask questions to the QM staff.

About the Author

Kyra Sheahan has been a writer for various publications since 2008. Her work has been featured in "The Desert Leaf" and "Kentucky Doc Magazine," covering health and wellness, environmental conservatism and DIY crafts. Sheahan holds an M.B.A. with an emphasis in finance.

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