Thehealthcare system is one of the most important aspects to thehumankind. For that reason, the quality of medical care should be atthe required standard. Though adequate delivery of care is valued,achieving the same is quite complex. This is because improvingperformance in the sector entails multiple interventions that must besequenced and coordinated to fit the particular context [ CITATION Cai14 l 1033 ].Evidently, the American healthcare system requires improvement.However, due to the intricacy involved in implementing thestrategies, it has been slow. Applying evidence-based interventionshas faced numerous challenges particularly consternation and debates.It is, therefore, vital to construct practical frameworks to governsystematic improvements. The framework is founded on health systemredesign, organizational behavior, and systems engineering. Thisstructure is also applicable to less-organized delivery institutions.The framework regarded as UW Health system targeted theenterprise-wide, large-scale enhancement initiatives. The main goalof the system is to organize enhancement efforts, facilitate projectand communication evaluation, and system redesigning. As entailed inthe framework, establishing the causes of failures is important toenhance quality care[ CITATION Sal14 l 1033 ].
TheUW Health is an academic center for the UW-Madison. It is the stateand nationwide leader in biomedical research, education, communityservice, and patient care. The public academic medical structureconsists of three organizations i.e. a physician team practice, atertiary hospital as well as its related clinics, and a medical andcommunity health school.
Needfor the enhanced framework and its description
Theintricacy of the tripartite organizational framework directlyaffected the capability to plan and implement enhancements at theenterprise level. With each department using different methodologiesof improvement, it became quite complex. In that regard, slowprogression was influenced by the lack of standard strategies tocomprehend and implement enhancements. Due to these variations, UWhealth realized that primary care and clinic operations specialtiesneeded an enhanced framework. It would give improvement interventionsthat would reduce the differences between medical practitioners inthe same clinic [ CITATION Sal14 l 1033 ].
Aftercomprehending the factors leading to inconstant performances, the UWHealth established a homogenous structure for improvement. Theframework first defined the levels in the health structure beforereviewing the literature to ascertain the critical domains requiringchange. The outcomes obtained from industrial and systems engineeringas well as organizational behavior offered awareness into the maingroups needing change. This framework specified the structures andprocesses necessary to achieve success. The cultural, structural,technical, and strategic dimensions ought to be aligned to attainlarge-scale change. The relationship between the employees is alsovital. By combining all these aspects, a framework that is practicaland simple to remember was developed [ CITATION Sal14 l 1033 ].
Accordingto the WCHQ, the performance of colorectal cancer was graded 11 outof 20. The cancer screening was done using multiple methods. UWresponded by initiating a multiyear program to enhance theperformance associated with colorectal cancer screening. The teamcomprised of physicians, operational leaders, insurance companiesrepresentatives, and information technology staff. An industrialengineer provided expertise on project management and improvement.The governing principles and visions were steered by a committee thatmet regularly. The committee determined high-level approaches andtogether with the planning group they implemented improved designsand interventions. The enhancements were done over several years.Improvements were done on CT colonography, EHR, and staff education.Capacity testing was also heightened before the demand for screening.Patient education was also offered to improve the entire system [ CITATION Sal14 l 1033 ].
Theinterventions were implemented at the environmental, clinic andmicrosystem as well as organizational levels. The physicians andclinic care groups were monetarily incentivized to enhance thecolorectal cancer screenings. Transparency was also improved. EHRperformance was also heightened, and education on the ailment weregiven. Organizational systems were also initiated to overseeprogress. The teams met regularly to plan on how to enhance thesystem further. To incorporate the community, UW Health leaderscombined with the local players to enhance performance. The localinsurers initiated pay-for-performance initiatives that gave bonusesto physicians and clinics to improve the quality of care. Communityevents to enhance colorectal cancer screening awareness were alsoinstituted [ CITATION Sal14 l 1033 ].
Thisframework is simple and can be implemented in a large-scale settingto enhance the quality of care. Since the other systems are slow toimplement due to the intricacy involved, this framework provides aleeway for health care improvement. This framework alleviates thechallenges associated with varying strategies instead of a commonone. As evidenced by the case study, this framework is implementableacross the different health care institutions.
Morris, C. (2014). Measuring Health Care Quality: An Overview of Quality Measures. 1-16.
Sally Kraft, P. C. (2014). A Simple Framework for Complex System Improvement.