Primary care is medical care provide to patient on first contact with the medical system (primary care definition). Essential primary care provide health care for most of the simply illness before the patient need reference to a specialist. The actual health care environment has to deal with rapid constant changes. Changes that also affect the primary care practice, this means change how doctors, nurses and health care professionals practice medicine and improve their service. The purpose of this paper is provide an overview and opinion of how the primary care could improve the quality of the service and the health of the patients.
Quality Improvement in Primary Care Report Summary In the recent years the concern for the service provide by the health care system has increase and reports from the Institute of Medicine (IOM) support this concern in 2001 report Crossing the Quality Chasm. The report quotes “Between the health care we have the care we could have lies no jus in a gap, but a chasm”. This show the health care system needs change. Had been several attempts to improve the service provide by primary care. HMOs in the Twin Cities tried to improve the primary care with a project named IMPROVE (Improving Prevention through Organization, Vision and Empowerment).
The project involved forty two clinics which received support from the leadership, training on Continuous Quality Improvement and prevention system. The process of the IMPROVE project was identify the problem, collect data in order be able to understand the process and customer’s needs, analyze the data and identify the root causes, develop an action plant to try to solve the problem, implement the action plan, evaluate a new process and continue to improve. The improvement project did not go right as many would like.
Many factors contributed to not achieve the desired changes as commitment to change, low ability to manage the change, lack of evaluation, slow pace to improvement, and low efficiency to manage the project time. Even all the problems with IMRPOVE, the project provided data of the health care organizations as clinics, process and delivery of preventive service. The IMPROVE project helps to clinics increase their involvement to improve and open to the change. IMPROVE was a good attempt to improve the primary care, the project help to understand that primary care practices are complex systems and change systems like this are challenging.
There are key elements to the success of any program of continuous improvement in this case the implementation of the quality improvement in primary care some of the key elements are the leaders should be motive to the change, the change program or project should with the resource requires for the change, also have a clear understand what are the reason for the change outside of the practice, including the healthcare environment and community and opportunities for the change this means how the leaders understand the change options.
Changes are not easy and leaders before to start any quality improvement initiative should understand that changes are affected by the interaction of factors inside and outside the practice. In order to improve the primary care the change should start by change the culture. There are many initiatives that leaders could use to change the culture as: • The culture cannot be change without the participation of the employees. Therefore they play an important role in this process.
The only way to gain the commitment, support and ownership of the employees, the leaders should treat everyone as an equal, make them feel that she or he a team player; listen the employee’s ideas, and implement best ideas and always give credit to the employees for their contributions. • Leaders and managers should have an open communication with their employees. The employees should have the confidence that any time can approach the managers and discuss their ideas, and concern.
This is not usual practice in all organization. • Leaders and managers should support the culture of respect. Culture where the employees respect to each other and respect for the patients and customers. • Leaders and managers should support the practice of smile. A simple smile can gain more than many words. A customer or patient feels better when they get in an office or clinic where they are received with a smile and treat with respect.
Conclusion. Quality improvement activities in Primary Care could cover many areas as health care service as accessibility of services, how effectives are the professional and/or clinic and how effective is the communication between physicians and patients and the other areas is related to the system which include coordination of the care, continuity of the care and approach of the care this means it is preventive or curative service. Whatever the area of the Primary Care, the focus of the quality improvement in the Primary Care is the care for the individuals.
Effective quality improvement initiatives require leaders must be present and credible, clear define quality improvement strategy, and identify quality improvement initiatives and promotion of motivation. The change process will take time and great effort by all employees, and they should keep in mind it is not one more program that will be implement that has a beginning and end. This is a change in how people work and it is looking for the constant improvement and seeking for the safety and welfare of the patients.
McLaughlin, C. P & Kaluzny, A.D. (2006). Continues Quality Improvement in Health Care 3rd Edition Jones and Bartlett Publishers, Inc.
“Primary care definition” Retrieved November 20, 2010 from http://wordnetweb.princeton.edu/perl/webwn?s=primary%20care