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A health care assignment on quality improvement approaches for residential care home service in Woodland Court

Question

Task: Using an appropriate reflective model, critically reflect in the health care assignment on your experience of applying quality improvement approaches and tools to an identified area in health and social care.

Answer

Introduction
Health is a very crucial aspect of human life and it impacts the people and the economy significantly. In this health care assignment, a reflective model will be applied to reflect upon the experience of applying the improvement tools and approaches to the residential care homes. The improvement plan that will be formulated is expected to affect the stakeholders of the residential care homes. There are various improvement tools which could be applied for generating the improvement proposal. The reflection section of this health care assignmentwould include a personal development plan related to the use of the available tools. The research will be strictly based on literature searches, where previous works in this field that have been conducted by scholars will be reviewed. Healthcare is a vast area for research, therefore, this study will focus specifically on residential care homes. The residential care homes for adults are care facilities where the residing elderly individuals get long term care (Hajdú, 2020). They get a residential setting which is not their own home, however, it is better than hospitals or typical old age homes. The quality of service and care at the residential care homes could be improved through the application of improvement tools like process map. The residential care home referred to in this health care assignmentis Woodland Court.The CQC reports or NHS long term plan will help in assessing the quality improvement that is required. The aim of this health care assignmentis to improve the satisfaction of the residents with the stay and care they are being provided.

Application of Improvement Toolsin the health care assignment
The residential care home selected in this health care assignment, Woodland Court, located in Fareham, near Portchester,offers a home away from home to its residents who are mostly elderly people. These people seek for accommodation in the residential care home because they find it challenging to manage everything on their own at home. As per the health care assignment they are in need of constant support and help, which they get at the residential care home. As per Buckland Care (2022), the residents at Woodland Court are well supported by the care givers. The staff is devoted to offer the residents personal care. The staff provides support to the residents in their daily tasks like cooking, laundry, housekeeping, gardening, etc. The residents get more time to rest and relax. The residential care home has provision for entertainment, so that the residents can enjoy in their leisure time and feel safe and comfortable in the environment. However, there are various aspects of the care quality which needs improvement. For instance, the residents are all older people who find it difficult to manage various activities of everyday life on their own. This could include wearing clothes to using the washroom. As per the health care assignment they need to be supported and assisted by the residential care home staff. Beyond these assistance for physical limitations, another crucial aspect is their mental health (Chen, 2020). The residents need to feel satisfied with the care they are getting at the residential care homes. The improvement tool of process mapping could be effective for improving the quality of care service provided at the residential care home. According to Antonacciet al(2021), process mapping is a healthcare quality improvement tool which is significant for clinical audit. Through process mapping the journey of the patients or residents could be managed and examined. The perspective of the residents would be considered for identifying their problems. This process mapping facilitates suggesting of improvements. The residents at Woodland Court have various needs on the basis of which they are provided the care service by the staff. The process maps are the improvement tools which can be applied to the context of Woodland Court so that the satisfaction of the residents are enhanced. The process maps mentioned in the health care assignmentwould help the management of the residential care home to visualize the healthcare needs and understand how it is expected to be delivered. The complex process of care service is simplified through process maps. The process maps will facilitate determination of the step wise process of care giving (Antonacciet al, 2018). The timing, identification of the outputs and the handoffs can be easily measured, visualized and studied through process mapping. As per Wong et al(2018) in the health care assignment, the strategy suggested by NHS long term plan fosters quality improvement of the care service being provided. The NHS approach suggests that the residential care home should ensure that the safety of the residents is prioritised. Woodland Court should keep their vision right, so that their foundation is based on a safety culture and a safety system for the residents. The NHS plan will facilitate constant improvement in quality of care, provide better insight and encourage involvement. The process mapping and NHS approach will ensure that the residents’ dignity, independence and identity is maintained. The process maps will conduct a clinical audit to see how far the residential care home is providing the care as per the needs of the residents.

As opined by Mortimer et al(2018) in health care assignment, the culture of the residential care home impacts the quality improvement. The culture fosters collaboration, staff empowerment and transparency. Woodland Court is expected to engage in quality improvement if it has a supportive organisational culture. The leadership as stated by Ward et al(2018), has a crucial role to play in quality improvement. Woodland Court can improve their care towards elderly residents if their managers or leaders plan their improvement strategy keeping the needs of the residents in mind. The internal environment of the residential care home should be maintained so that the residents get 24X7 assistance, which would enhance their satisfaction.

According to Wong and Headrick (2021) in health care assignment, in Deming’s theory of total quality management there are fourteen criteria which Woodland Court has to fulfil as a residential care home. They first need to create purpose constancy. Further, the new philosophies should be adopted. They should rely less on the mass inspections, avoid rewarding their organisations for its achievements on paper, aim at continuous service improvement, etc. According to the health care assignment the staff should be trained to bring the cutting edge in job. The leaders should implement the methods which are cutting-edge approaches. The fear should be abolished from the organisation and its staff. The residential care home needs to deconstruct the barriers across departments, remove standards, avoid quantity based work goals, etc. The staff’s pride of talent should be supported and their proper education and training should be encouraged. Finally, the management should support all the thirteen points.

Improvement Plan
The improvement plan which has been applied in one of the Residential care home that is Woodland Court is presented below in the health care assignment:

Action

Priority

Stakeholders and their perspective 

Outcome

Resources

Responsible officer

Timescale

To dynamicallystimulate direct payment with other user groups (Buckland Care, 2022)

High

Government: To serve proper training on ways to utilize the equipment in the care homes

To maximize users independence and to fulfil their particular needs

Officer time

Project manager,

Fieldwork teams in health care assignment,

Social workers, community

 

6 months

Make sure that the care plans recognize the religious and cultural requirement of service users

High

Social and domestic care providers:Improvement team as per the health care assignmentmust visit the care homes on a regular basis and follow clinical protocols

To assure requirement are met and services are built to fulfil particular needs

Officer time

Training manage, Smart purchasing manager, audit team, development and operational managers

4 weeks

To take forward joint commissioning plan for mental services of older people

High

General practitioner: Advanced care planning must be served to help older people in mental health services

To attain an incorporate plan to long-term commissioning that will reshape provision and aid market stabilization to fulfil needs

Within resources presently available

Manager for older person services

6 weeks

That the matching needs consultation and audit be determined within the broader consultation of the learning disability joint commissioning plan

High

Users: Seek a multidisciplinary team like care home workers, dementia specialists, pharmacists, geriatricians, therapists and so on to fulfil their needs

A benchmark for the level of support which the local authority can afford be approved in the health care assignment

Officer time

Interim joint commissioning manager

8 months

That the learning disability joint commissioning plan for change action plan is implemented fully

High

Care home manager in the health care assignment:To provide care home support visits to enhance involvement and serve QI expertise

To make sure an incorporate plan to long-term commencing that will reshape services and aid market stabilization to fulfil needs (Lloyd et al., 2019)

Within resources presently available

Interim joint commissioning manager

2 months

A social services procedure along with policy for young individual with disabilities from children’s to adult services is established

Medium

Government: To shift phasing out residential care during the improvement plan. Collaborative teams as per the health care assignmentmust adapt and work upon transporting care

To assure that appropriate support and data is served to young individuals with disabilities

Officer time

Head of families and children services

5 months

To stipulate the utilization of performance monitoring form to address quality issues mentioned in the health care assignment

High

Social and domestic care providers: The improvement team must involve with the collaborative participants and utilize their feedback to adopt tools (Kezirianet al., 2018)

To make sure quality issues can be examined via consulting procedure and promptly resolved

Officer time

Quality group, complaints manager, development and operational managers

2 months

Quality monitoring tool for services facilitated

High

Nurse: Emphasize upon enhancing handovers among staffs to aid positive safety culture

To make sure that users are confident regarding the standard of services served

Officer time

Project officer, purchasing team

6 weeks 

Reflection using a Reflective Model
Gibbs reflective model will be usedin this health care assignmentto reflect upon the application of the improvement tools and approaches (Azizet al., 2020). Gibbs Reflective Cycle is determined to be a self-reflection and management tool whichassist individuals to think systematically and clearly regarding different experiences I have gathered knowledge from the health care assignmentthat one of the major strengths of the model is that it is easy to analyse and utilize and serves a more accurate and balanced judgment. While the weakness is that it might result into superficial reflection with less possibility for professional or personal growth. As per Dewey’s theory, reflection is regarded as a careful, persistent and active consideration of any knowledge or belief in the light of the field that support it (Buljac-Samardzicet al., 2020). Based on this theory in the health care assignment, I come to know that within healthcare service reflection enables an individual to identify their strengths and weakness and utilize this to instruct on-going learning.

Gibbs Reflective Model
Description

While working in Woodland court a residential care home located at South England as a care home manager I have been given the responsibility to develop an improvement plan for the betterment of the organization and the users. Throughout the improvement plan mentioned in the health care assignment, I conducted meeting with the organizational members and gathered their opinion regarding the plan.

Feelings
During the application of this plan I felt satisfied as the organizational members supported me a lot. They assisted me in developing this improvement plan. Initially, I felt uneasy regarding the implementation of whether it will turn into a successful plan or would fail. However, with the support and coordination of the team members the plan turned out to be highly successful.

Evaluation
Throughout the process, I have evaluated the importance of developing this improvement plan within Woodland court. I have analysed the fact in the health care assignmentthat the plan will prove to be helpful in enhancing the lives of users. It will also enhance the experience of developers or owners in managing senior living projects.

Conclusion
From my experience, it can be concluded in thishealth care assignmentthat the development of the improvement plan will be helpful in identifying and communicating the needs of the users and implementing ways to fulfil them.

Action

Activity

Strategy

Outcome

Staff practice

Tailoring activities to support resident needs

Enhancing staff confidence and knowledge in assisting  residents with advanced dementia (Ballard et al., 2018)

Resident wellbeing and activity levels

Training will be centered on the wellbeing wheel tool

Increasing the multi-tasking ability of the staff members

 

Gibbs-reflective-model

Figure: Gibbs reflective model
(Source: Azizet al., 2020)

Reflection on Experience
While developing the improvement plan in the health care assignmentI have analysed the fact that the plan will help in minimizing medication errors and serve quality and safe care to the users. Moreover, at the time of developing the improvement plan I come to know that it will assist in developing a support network among the care homes. Furthermore, I have experiencedin thehealth care assignmentthatthe team members presented and shared their ideas regarding the improvement journey which in turn helped in completing the project effectively and on time.

Personal Development Plan (PDP)
PDP is regarded is regarded as a guideline for the present life along with future success (Häggman-Laitilaet al., 2019). The PDP will be created to address the skills gap which is identified at the time of applying the improvement tool. The PDP is given below in the health care assignmentalong with short, mid and long-term goals:

Short-Term Goals
To mobilize community action
Mid-Term Goals
To reach out to hard-to-reach and high-risk people.
Long-Term Goals

To enhance my skills and serve accessible and quality residential home care service.

SMART objectives

Skills gap

Strategy

Resources

Timeline

Outcome

Specific:To servestructured plan to build and design a work plan

To enhance interpersonal skills

Developing good rapport and listen to the perspective of the users mentioned in the health care assignment. There is also a need to coordinate for the best outcome and depict empathy (Dugstadet al., 2019)

Practicing active listening

5 weeks

It will lead towards user satisfaction with the services provided. Other benefits are minimization in psychological impact

Measurable: To build the stage for measuring performance and recognizing opportunities for improvements

To improve my communication skill

Asking open-ended questions to the users and becoming aware regarding the attitude of the older people. I will focus towards engaging families and friends in the health care assignment

Communicating practically with others

3 months

I have acknowledged that it will result into enhanced interaction with the user

Achievable: To methodically examine progress towards a target

To enhance my leadership skills

To search for non-work related leadership opportunities and seek out learning prospects. Practicing communication skills by communicating with others within the organization regularly as per the health care assignment

Online courses

2 weeks

It will lead towards coaching, managing and setting objectives

Realistic: To communicate progress to other healthcare providers

To enhance relationship-building skills

I will build effective communication and emotional intelligence skills. I will also ask for feedback from others regarding my performance in the health care assignment

Books and joining training courses

6 weeks

It will assist in anticipating patient needs efficiently and facilitate proactive care

Time-bound: To determine the time-scale for achieving the set goals

To improve time management and organization skills

I will emphasize upon establishing goals and taking benefits of technology. I will look upon my long-term schedule and capitalize the resources around me in the health care assignment

Setting SMART goals

4 months 

It will result into providing efficient residential care services to the user on time (Pearson et al., 2019)

 

The PDP presented above in the health care assignmentdemonstrated the SMART objectives which will help in providing quality and safe care to users who seek residential care services. Through this PDP I have acknowledged that my major skills gaps are communication, time management, organization, leadership and interpersonal skills. However, the strategies to address these skills gaps are also presented which will help me providing services to the users which involve independent and comfortable lifestyle, opportunities along with activities to socialize. The plan mentioned in thehealth care assignmenthelped me in analysing my strengths along with weaknesses and looking forward towards implementing certain strategies to achieve the short, medium and long-term objectives. It helped me in enhancing my skills and engaging with relevant stakeholders related with the improvement plan.

Conclusion
It can be concluded in the health care assignmentthat residential care homes like Woodland Court can improve their quality of service by implementing improvement tools. The process mapping and approach of NHS long term plan could facilitate better quality enhancement. The Deming’s theory is an approach which fosters quality management. The culture and leadership play an important role in improvement of quality. The leaders need to strategically prepare and implement the improvement plan. The reflective model of Gibbs in the health care assignmenthas been used for reflecting upon the experience. Furthermore, the personal development plan would ensure that the gaps of skill and research are filled and the various goals are achieved.

References
Antonacci, G., Lennox, L., Barlow, J., Evans, L. and Reed, J., 2021. Process mapping in healthcare: a systematic review in health care assignment. BMC health services research, 21(1), pp.1-15.
Antonacci, G., Reed, J.E., Lennox, L. and Barlow, J., 2018. The use of process mapping in healthcare quality improvement projects. Health services management research, 31(2), pp.74-84.
Aziz, A., Mahboob, U. and Saleem, T., 2020. Benefits of reflective writing in health care through the vivid lens of house officers. MedEdPublish, 9(60), p.60.
Ballard, C., Corbett, A., Orrell, M., Williams, G., Moniz-Cook, E., Romeo, R., Woods, B., Garrod, L., Testad, I., Woodward-Carlton, B. and Wenborn, J., 2018. Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes: A cluster-randomised controlled trial. PLoS medicine, 15(2), p.e1002500.

Buckland Care. 2022. About the Home. Available at https://bucklandcare.co.uk/the-care-homes/woodland-court/gclid=Cj0KCQjw8amWBhCYARIsADqZJoWqg4kE6oyCoQmV0lNS9kAAvC_4iMWOC6UgB-8afOAZ-KAi5EcGmcUaAkPDEALw_wcB [Accessed on 11 July 2022] Buljac-Samardzic, M., Doekhie, K.D. and van Wijngaarden, J.D., 2020. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Human resources for health, 18(1), pp.1-42.

Chen, S., 2020. Caring for Mom: Establishing Statutory Rights for Elder Care Facilities. American Journal of Law & Medicine, 46(1), pp.111-132. Dugstad, J., Eide, T., Nilsen, E.R. and Eide, H., 2019. Towards successful digital transformation through co-creation: a longitudinal study of a four-year implementation of digital monitoring technology in residential care for persons with dementia. BMC health services research, 19(1), pp.1-17.

Häggman-Laitila, A., Salokekkilä, P. and Karki, S., 2019, October. Young people’s preparedness for adult life and coping after foster care: A systematic review of perceptions and experiences in the transition period. In Child & Youth Care Forum (Vol. 48, No. 5, pp. 633-661). Springer US.
Hajdú, J., 2020. Dignity of elderly persons and digitalised social care. The Right to Human Dignity, 569.
Kezirian, A.C., McGregor, M.J., Stead, U., Sakaluk, T., Spring, B., Turgeon, S., Slater, J. and Murphy, J.M., 2018. Advance care planning in the nursing home setting: a practice improvement evaluation. Journal of social work in end-of-life & palliative care, 14(4), pp.328-345.
Lloyd, T., Conti, S., Santos, F. and Steventon, A., 2019. Effect on secondary care of providing enhanced support to residential and nursing home residents: a subgroup analysis of a retrospective matched cohort study. BMJ quality & safety, 28(7), pp.534-546.
Mortimer, F., Isherwood, J., Wilkinson, A. and Vaux, E., 2018. Sustainability in quality improvement in health care assignment: redefining value. Future healthcare journal, 5(2), p.88.

Pearson, C.F., Quinn, C.C., Loganathan, S., Datta, A.R., Mace, B.B. and Grabowski, D.C., 2019. The forgotten middle: Many middle-income seniors will have insufficient resources for housing and health care. Health Affairs, pp.10-1377.
Ward, M.E., De Brún, A., Beirne, D., Conway, C., Cunningham, U., English, A., Fitzsimons, J., Furlong, E., Kane, Y., Kelly, A. and McDonnell, S., 2018. Using co-design to develop a collective leadership intervention for healthcare teams to improve safety culture. International journal of environmental research and public health, 15(6), p.1182.
Wong, B.M. and Headrick, L.A., 2021. Application of continuous quality improvement to medical education. Medical Education, 55(1), pp.72-81.
Wong, D.J.N., Harris, S.K., Moonesinghe, S.R., Moonesinghe, S.R., Wong, D.J., Harris, S.K., Bedford, J., Boney, O., Chazapis, M., Drake, S. and Farmer, L., 2018. Cancelled operations in health care assignment: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British journal of anaesthesia, 121(4), pp.730-738.

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