What should be the role of professional societies and certifying entities in promulgating the concepts of evidence-based medicine and CQI among its professional cadres? Based on an assessment of data published in goal of professional societies and certifying entities should be to ultimately move the QCI agenda through education and improvement. Professional societies and certifying entities should proclaim the concepts of evidence based medicine and CQI through the creation of opportunities and incentives that act as motivators for professional improvement.
Within pediatric sub-specialties, this can be accomplished in large by making technological improvements (both in the areas of medical research and development and patient records), developing additional quality assurance procedures while establishing enjoyable methodology to promote improvement, and making any necessary changes in management to improve efficiency with growth. Because of the many variant subspecialties and the many involved locations, developing an improved protocol for patient records and communication among facilities/organizations should also be a certifying entity responsibility.
Also, supporting the data from the case study, ongoing fund-raising should remain a professional society/certifying entity responsibility to aid in the funding of the implementation of CQI programs in each of the many sub-specialties. Page 496, Question 2 How would one go about developing the business case for CQI in this setting? The first step in developing a business case for CQI in this setting would be the establishment that a positive impact on function and sustainability will occur within a reasonable time frame.
I would then clarify the quality improvement tools to be utilized and establish a plan for the organization of cross-functioning teams. Likely one of the main focuses of a CQI plan in the genre of multiple pediatric subspecialties is the establishment of quality communication between specialties (the transfer of patient records and the process of record management should remain under continued improvement). I would then organize existing quality improvement plans to provide a CQI guideline for all staff and establish a team to decide on ‘enjoyable’ CQI methods.
I would establish a budget and a plan that included a rubric for the estimated costs of low quality health care within pediatric specialties and set up an early training program to implement quality improvement incentives. I would launch a plan to involve directly involve pediatric physicians in the CQI process and, finally, I would promote the recognition that health care establishments (especially given the involvement of such a wide base of subspecialties) require a more broad definition of quality. Page 496, Question 5
The approach in this case would seem to benefit from some attention to the concepts of Microsystems in Chapter 15. Suggest how those concepts might be worked into the ongoing efforts of these professional organizations. Because communication and organization between the many pediatric subspecialties proves a challenge, implementing microsystem concepts may help to protect patient information, improve the patient/physician or practice relationship, and make the transition from one health care facility to another more smooth.
Enabling the “talking-listening-tuning” concept of chapter 15 may promote a more successful working relationship between specialties. By bridging the gap between the acting specialty groups, and enabling a more cohesive microsystem, better care can be given patients who must be treated within both specialties. In short, and as quoted from chapter 15 “partnership synergy” will help the diverse specialties recognize the powers their cohesive group can have in terms of patient care and quality improvement.
Establishing a more dynamic relationship between Microsystems may also, in this case, help to reveal areas where further improvement is needed. Basically, the cultivation of a “team” effort will prove more effective for reaching the ultimate goal (in this case improving the ability of a large group of pediatric gastrointestinal specialists to collectively maximize IBD care) than will a collection of individual actions.