Discuss risk and quality management in a health care organization.


Risk and Quality Management 9

Risk and Quality Management

(Health Care Organization)





Risk and quality management principles are effectively used in different fields or areas of business and government. They can as well as apply in sectors like finance, insurances, occupational safety, public healthy and many other areas. Although there are examples of the use of quality risk management in pharmaceutical industry today, they are limited and do not carry out or represent the whole process that management can offer. It is commonly known that risk is a combination of probability of a certain occurrence of harm and how bad or worst is that harm to the current situation. Achieving the understanding in application of risk management to different stakeholders is so hard because each stakeholder has different view on potential harms place different estimates of probability on each harm occurring and attributes different severities.

Basic concepts of risk and quality improvement

In healthcare industry, quality of care is just more than a concept that should be concern with at all cost. It has become so important and essential to patient well-being and financial survival in the entire industry. When the discussion on quality in health care is placed on table, different parties have different views depending on the perspective of the constituent for example patients, healthcare providers, families, professionals, insurers, regulators and employers. Improving quality of care in the healthcare industry is still a working progress that requires a milestone to accomplish it. Quality consist of a degree to which services for individuals and population increase the livelihood of desired health results (quality principles) which always are in consistent with current professional knowledge (practitioner skill) and also should meet the expectations of healthcare clients (market place). These quality concepts or principals to be followed are:

Concentrate on clients.

A client satisfaction is one of the important area that every business enterprise should concentrate on. For every business individual to maximize profit there should be an aspect that drive him or her to check on requirement and demand that customers require in day in day out. Having an idea in mind that some healthcare organization might be free doesn’t give a room to disregard a customer. Why should you devote yourself to certain task or job if in the essence of doing it doesn’t bring satisfaction to your client? These give an answer that; if it is business then you should concentrate on improving the relationship between your clients and your business. Every organization should embrace a good customer relation and making sure that there is maximization of profits and positive picture of the company. Maintaining these strategy comes in two ways, company gain a lot and propelled forward and as well as customer satisfaction is delivered. At the course of the day achieving this requires a lot of dedication and commitment from employees who should employ a good or friendliness where a client is in an environment to express her or himself freely.

Continuous improvement and learning. Learning is one of the most essential factor in a business world and in any other field. It has no ending as far as you can still take up the chance to do so. It only happens when someone take up an existing opportunity and decide to learn. It goes by the chances that are available and inner motive to do it. Since healthcare is also a business entity like any other, much is invested in getting new information about diseases which is an essential part of its improvement. When employee start his career in the field, there are different season to encounter, either good or bad. These seasons are not meant to scare them away or intimidate, but it is meant purposely to make them learn and gain more experience in the game. It is this motive and strong willingness to endure the tough times and learn that will enable them to bring their organizations to verge of improving and propelling to high level.

Participation and teamwork: there is no individual who can remain a standalone system, at the course of the day you should be reliant to one thing or another to survive. Teamwork or working together is one of the most important cultures that everyone should learn to adapt and live with it. By working together in a team, you get a chance to learn new things that might have been a problem on your area but to other person it is simple. In our institution during our studies and research we are always advice to work together to achieve our goals objectives and this is the logic behind this behavior. The culture or rather behavior should also apply to healthcare sectors by employees. They should interact and settle with experience and try to make worth of each one being presence in the organization. The aspect of participation also is very important to an organization. This is a situation where one is willing to engage in an extra job beyond his jurisdiction. By doing this one is in a position to learn and assist in the areas where production is low making the organization to grow and propels the need of quality improvement.

A commitment to the healthcare challenges. In everyday life, there is nothing that workout on itself without a challenge. Challenges in every industry are categorized differently basing on their magnitude and a position solution to solve it. Healthcare, like any other organization has some challenges that to be taken care of by committing to them. Every day is a challenge that always leave an experience employs wondering what to do and new employ feeling that should have engage themselves in the same field. Management should strive to manage and make sure that any challenges arising are allocated much attention. Also they should be in a position to motivate their employees to give their best in making sure that things are flowing so well in the organization.

Concepts of Risk Management in the Health Care Industry

Health care industry being one of the most crucial sectors in every country is more vulnerable to risk in their daily operations. Taking a look from business perspective, you realize that patient in this case is the central post and a symbol. Everything that happens in the healthcare sector is under the interest of a patient. These may lead to overdoing their task. From this statement, I simply mean that; every healthcare sector will always be in demand of batter drugs and health equipment to serve their customers. They are scared to losing lives in situation that a patient has been admitted but there is no enough equipment to serve their needs. In a situation where there is high frequencies of cases relating to poor delivery of services the more they are at stake of losing their clients which in this case are patients. Losing clients or rather patients bring about a negative graph of production, and when this happens profit maximizing and business maintenance becomes a problem to the industry. At the same time, developing this fear might make the employees to wake up by making sure that things happen as per the objectives and goals of the industry. But again, this might bring about overproduction which will decisively be placing healthcare at a loss.

Solving these problems, the industry should learn to share and be a position to safeguard all the information by recording all the data analyze. The recorded data should assist in researching on the drugs required against their consumption. These will help reduce overproduction and brings a clear picture of the drugs required. By doing it, they will adapt the culture of relying on statistics to solve problems and eliminate challenges in the industry.

Analyzing the information needed for decision-making processes in risk and quality management in the health care industry:

From the previous information I relayed, there is a clear picture that patient is the most influential aspect in the healthcare industry. In everyday an activity that goes on in healthcare industry, it is all about patient. What I mean is that almost all the activities that happen in healthcare industry revolve around patient. Having this in mind brings about attention and concern on making appropriate decisions that will always be in favor of client. By making these decisions we should consider beliefs, traditions and cultures that revolve around our societies. Different beliefs affect patient and they always undertake this believe before taking their treatment. While the patient has the right to choose what he wants, there should be consideration also from the other side where another person will be affected negatively about the same choose of treatment. For examples, if a patient is suffering from an airborne and he doesn’t want to be treated, then he put a risk to other person. The process followed to making decision is as followed:

(1) Recognizing the problem-recognizing problems mean that you’re acknowledging the existence of the problems. By doing these, you’ll be a position to decide which criteria you are going to use to solve the same problem in place. Secondly you should analyze the current situation. Analyzing the situation give a clear picture on the procedures or scope that are supposed to follow while solving the problem. Thirdly you should consider the consequences. Considering the consequences is accepting the results for every decision that you undertake. This give courage to take a step in every situation and by doing this you take a risk of progressing. Fourthly, develop an alternative method to solving the problem. Solving problems requires a lot of exploration of different possible alternative in the field. You cannot rely on a single alternative rather you should come up with different alternative on the same problem basing on the possibilities to solve the problem in time and saving the available resources. Fifth, take a step and act the problem. Face the problem and solve it from the information and alternative that you have on the hand. Find a solution. On finding the solution, you should evaluate results and determine whether it in line with user and customer requirement.

Risk-and quality management tools used in the health care industry

Quality and safety is one the crucial requirement in healthcare industry and any other industry that offer services directly to clients. Quality healthcare can be explained in a direction that a healthcare is in a position to provide services to a patient by meeting his requirement and without affecting the other person. There are several tools that are used as a quality improvement tools. We got clinical practice improvement tool (CPI).

Clinical Practice Improvement tool (CPI)

The tool deals with the clinical management of the patients both inpatient and outpatient. These tools or methodology is trying to find a way of resolving the current problems or complexities that are exist in the healthcare industry. Due to high demand of services by the patient’s, many hospitals encounter difficult time in finding a way forward to solving these problems in time. Every other patient admitted in hospital are from different environment and background hence their demand on services differ according to their status. Some require different criteria of treatment with their taste and preferences. In a situation where they all suffer from common diseases, there will be hard time solving their problems. This tool was developed evaluate the problem, the purpose, select the aim group, sample data, do preliminary study on the data and makes inferences. These make it one of the most successful in healthcare industry.

Advantages of the tool

It is easier to use in that it uses data collected to come up with the results. According to the world of data analyses and collection of data for research, statistics has been the major contributor of all the tools to be use. Using stats sets a base of understanding to researcher on the graphs and trends of all the habit and the probability of the same occurrence again.

Another advantage about the tool is that it uses a combine effort by researchers hence making it a best tool. The spirit of working together as one is better than working alone.

Disadvantages of the Tool

For anyone to use data there is an aspect of collecting the same data from individuals in the field. From the above information we understand that system uses data. Collecting these data comes with a lot of challenges. Some of the people interviewed in the field might not be willing give out information on the topic of concern hence hindering the whole process. After collecting data in the field, you take a step of analyzing the same data and the issue of data manipulation come in. manipulating data comes with errors for examples decimal places of patients.

Every other system in the market has its own defect. This system cannot be rated 100% effective. The issue on the hand is that, it requires highly qualified personnel not novice hence making it not a reliable system to be used by everyone.

Challenges in making risk- and quality-management decisions in the health care industry

There is an everyday challenge on delivering healthcare services. Making decision is not an easy task to undertake by individuals. There is always a notion that taking steps or making decision might end up becoming disaster or becoming another problem that will again require solutions to be solved. In this case, many health officers happen to make decision despite the weight or pressure on it. In trying to deliver the best services to the client or rather patients, health care services providers’ encounter a lot of challenges:

· Doubt; making decision is not a wake up doing thing; it requires to let go of fear and personal feelings. Sometimes you have to take assumptions that the decision made is best for the current situation. You take the step assuming that the patient has a knowhow on the decision made. These decisions made might bounce back and hence making a problem to the health providers in turn.

· Stubborn patients; everybody is entitling with different understanding on some problems. Some people take serious problem slightly with less or no concern. Health problems are a requirement that every other person does not want to be denied not even when it means death.

· Finally; every day we are faced with pressing issues that requires us to forego other needs to have another. When a patient is admitted with an emergency problem he will not be in a position to make rational decision. In this case the doctor is prompt to make decision and at times this decision does not rhyme with the patient’s.


Delivery of healthcare services requires a lot decision making with the informed and rational steps that should not interfere with both parties involved in the decision. These manual discuses all the provisions of great services in health care industry.


Davies, H. T., Nutley, S. M., & Mannion, R. (2000). Organizational culture and quality of health

care. Quality in Health Care9(2), 111-119.

Kongstvedt, P. R. (2001). The managed health care handbook. Jones & Bartlett Learning.

Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter:

what does it mean? (or it takes at least two to tango). Social science & medicine44(5), 681-692.

Horn, S. D. (2001). Clinical practice improvement. HIC 2001: Proceedings, 14.


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