In general terms, quality might be described as a characteristic of excellence or superiority. Additionally, it may be viewed as a dynamic attribute of a service or a product that can be enhanced to meet or exceed customer expectations (Spath, 2018). In the context of healthcare services, quality is associated with proper treatment options provided by medical facilities, favorable health outcomes, high quality of care, and best practices used by doctors and personnel.
The definitions of quality are consistent with the work of Joseph M. Juran, a quality management expert who became prominent after publishing his Quality Control Handbook in 1951 (QP Staff, 2010). Juran concentrated his attention on the human aspect of quality instead of focusing on statistics and emphasized planning, control, and improvement as integral components of quality management. Juran’s theory assumes that quality can be achieved through standardized procedures, perfection, and effective leadership strategies.
During my nursing practice at the Med-Surg unit, I encountered a patient who developed venous thromboembolism (VTE) as a result of insufficient prophylaxis. The patient underwent hip joint replacement and was at high risk of VTE. However, he was non-compliant and refused to apply compression devices and receive low-molecular-weight heparin (LMWH) or aspirin due to the lack of knowledge about the procedures and pharmacological options.
Nurse managers need to regularly review procedures and policies to improve timeliness and compliance (Yoder-Wise, 2019). Matharu et al. (2020) claim that VTE is a common cause of long-term morbidity and preventable mortality, and the research supports the efficiency of anticoagulants for post-operative VTE prevention. Thus, the patient could have benefitted from education on VTE prophylaxis, as it would eliminate the need for wasteful actions (costly and long-term interventions) and improve rehabilitation experience.
The definition of quality discussed above and Juran’s theory of quality management provide guidance on the VTE patient’s experience in several ways. Firstly, the planning stage should have included timely VTE risk assessment based on best practices to determine the patient’s need for preventive measures and develop a prevention plan. Secondly, the control element could have realized through mechanical or pharmaceutical prophylaxis according to the current VTE prevention guidelines to ensure a favorable patient outcome. Finally, the improvement stage required to introduce the changes in existing strategies and develop a standardized prevention protocol to decrease VTE rates and patient non-compliance with prophylaxis.
Matharu, G. S., Kunutsor, S. K., Judge, A., Blom, A. W., & Whitehouse, M. R. (2020). Clinical effectiveness and safety of aspirin for venous thromboembolism prophylaxis after total hip and knee replacement: A systematic review and meta-analysis of randomized clinical trials. JAMA Internal Medicine, 180(3), 376–384. Web.
QP Staff. (2010). Guru guide: Six thought leaders who changed the quality world forever. Quality Progress, 43(11), 14–21.
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.
Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). Mosby.