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The initial concepts of quality improvements were in fact concepts from the manufacturing industry striving to improve the quality of their products and ensure efficiencies in their productions processes, reducing wastages. In 1910, Ernest Codman led the idea of improving hospital care by following up on patients to ensure treatments were effective. Codman’s ideas laid the groundwork for the American College of Surgeons to develop a “minimum standard” of care, which generally focused on improving care provided in the hospital.
By 1924, Walter A. Shewhart had developed the first known control chart, which later becameknown as the Shewhart Cycle. The Shewhart Cycle linked related quality improvement and statistical approaches to manage effectively and continue the improvement processeswithin businesses, thereby better developing and controlling how final products were fabricated.
Quality improvement became a serious subject when US entered the Second World War and after the defeat of Japan, when Edward Deming assisted the rebuilding of Japan and sharing his knowledge allowing for the Japanese to be industrial leaders in several industries post world war 2. Whereas manufacturing industries are highly mechanized, specialized and automated, health management requires human touch and interaction to function. Health management relies a lot on the latest technologies just as manufacturing industry, technology however is just complementing the practitioners who interact and diagnose the patients and initiate the treatment. Quality is the new niche market in the health care sector. Where there is quality health care, there will be a demand, and in areas where there is no quality health care, losses will be incurred and liability high. As technology has evolved, particularly in the health care industry, people’s life span tends to be longer now. Similarly, healthcare has also evolved from being just a scientific and social issue to being an economic issue as well. Economics of health means costs, dollars and cents and this is in my view is the biggest challenge to health reforms right now. Justifying the cost of health care is an going debate at all levels between consumer, provider and legislation. In addition to the cost, the other challenges are accessibility and of course quality. Performance indicators are also a major issue for health care. Why? There are too many variables and each institution have developed their own unique indicators of how it will measure performance. Within a health care facility itself, different departments will have their own measure of performance as well as consolidated indicator(s) for the institution as a whole. As a result, the key indicators are narrowed down to certain key factors, (i) quality (ii) cost & customer satisfaction to name a few. Unfortunately, there is no one solution to fixing the health sector.
There is no quick fix. Thus, it is important that quality improvement programs are implemented in the diverse health care sectors, this improvement programs will also need to evolve also. The health sector will need to think outside the box, evaluate finance sector quality improvement programs, adopt relevant indicators from there, and replicate this screening, copy and paste scenario throughout other sectors like the tourism industry, defense and ICT sectors in order to stay in sync with the developments and adopt effective indicators which it can add to its quality improvement programs. An area most important to health sector reforms in my opinion is cost. Reducing the cost of health care means accessibility for all spectrums of the population.
An affordable, staggered health plan that encompasses all economic sectors of the economy is needed. Affordable health care means more subscribers and users, generates economies of scale, creates positive ROI for institutions. Positive ROI results in additional health sector investments, more technological and scientific advancements and better quality of health care for all.
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