Healthcare Quality Improvement

Topic: Nursing
Words: 657 Pages: 2


In healthcare facilities, a vast number of professionals may have difficulty following the rules, communicating with each other, and carrying out their responsibilities due to different reasons. In most cases, it may lead to decreased performance of the hospital and reduced patient satisfaction, as well as higher levels of medical errors or other issues. In the case study, there are specific problems that the district hospital faces, and it is essential to analyze the situation.

Problem-Solving Methodology

Before creating a plan and addressing an issue, it is necessary to understand its essence and define a problem statement. Overall, in this case, Mr. Lester, the hospital’s chief executive officer, faces several concerns that lead to poor performance of the ED department and decreased patient satisfaction (Longest & Darr, 2014). The problem statement would be the following: In what ways can the district hospital manage the distribution of responsibility and control between the ED registered nurses and physicians, improve associations with the EMTs, and strengthen the ED physicians’ commitment to the hospital? The alternative solution would be as follows: to train the members of the emergency department, encourage them to educate the EMTs, introduce some necessary changes to the ED, and implement input and output control measures.

Educating the Members of the ED Physician Staff

It is evident that the inpatient census directly depends on the total number of ED admissions. The more patients are admitted to the emergency department, the more of them are hospitalized. Educating the ED staff is crucial for enhancing their commitment and improving overall performance, but the first step is to convince employees of the need for training. According to Chaghari et al. (2017), “empowering education can facilitate occupational tasks and achieving greater mastery of professional skills among the nurses” (p. 26). After the staff is convinced of the necessity of training and expresses their desire to take part in it, in-service education would be effective. The training would consist of reminding the ED nurses and physicians of their responsibilities, teaching them how to treat patients ethically and in a way that meets clients’ expectations, and improving working relationships between the RNs and physicians.

Principles of CQI

The first principle of CQI is output quality: assessing whether the patient’s expectations and needs are met or exceeded. In the case under study, patient expectations are rarely met since it is stated that patients are not satisfied with the services they receive. Therefore, significant changes are needed to be introduced to the ED department. For example, a planning or coordinating body for the emergency department would be effective (Longest & Darr, 2014). It would sanction the creation of quality improvement teams to analyze the situation, process information, and recommend improvements and proper strategies.

The Role of the EMTs

EMTs play an essential role in the district hospitals’ performance and the number of admissions because they can partly decide which hospital they transport patients to. However, the relationships between the EMTs and ED staff are not positive and should be improved. Financial rewards should be offered to the ED workers for training the EMTs, and in this case, they will be encouraged to help their colleagues. There are no negative aspects of this educational activity. A potential conflict of interest may be in the ED staff’s concerns that the EMTs can encroach on their responsibilities, but it actually cannot happen because both teams have different duties.

Control Measures

Recommended control measures for Lester may be divided into three categories: output, input, and process control. The former would include Lester’s provision of patient satisfaction surveys and management of emergency department discharges and admissions. Input control would basically be focused on the relationships between the ED registered nurses, physicians, and EMTs. Lester would have to observe whether the moral qualities and the general levels of empathy, support, and mutual trust are maintained (CMS, 2021). Finally, the process control would involve staffing concerns, including hiring the ED physician director.


Chaghari, M., Saffari, M., Ebadi, A., & Ameryoun, A. (2017). Empowering education: A new model for in-service training of nursing staff. Journal of Advances in Medical Education & Professionalism, 5(1), 26–32.

CMS. (2021). Quality measurement and quality improvement. Web.

Longest, B., & Darr, K. (2014). Managing health service organizations and systems (6th ed.). Health Professions Press.

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