Quality and Change Management in Ireland

Over the last number of years the quality and safety of our healthcare services has increasingly become one of the main priority (Health Information and Quality Assurance-HIQA). Institute of Medicine (IOM) defines quality as ‘degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge’. Brady et al (2010) emphasis that quality is doing right thing safely and consistently to achieve patient satisfaction and best possible outcomes by skilled and responsible professionals. Quality is one of the main four principles that underline health strategy by Government of Ireland. It believes that to gain people’s trust in health system, quality should be guaranteed through standards and evidence based practice. (Department of Health and children (DOHC) 2001). However quality in health care is complex and is influenced by multifactor including the competence of professionals and the policies that shape the system. (Brady et al 2010).There is a growing public awareness regarding the importance of quality and safety, which raises concerns about the variation between actual practice and evidence based best practice (Steinberg 2003).Health care experts are constantly putting effort to improve quality of care through various measures. The National Standards for Safer Better Healthcare describe a vision for high quality, safe healthcare. It identifies quality dimensions as Patient-centeredness, safety, effectiveness, efficiency, accessibility, equity and promoting better health (HIQA). Commission on Patient Safety report inspired the nation for a change in culture to deliver high quality safe care through patient participation, effective lea...

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...he fundamental of quality. Many countries including Ireland is applying quality improvement measures to achieve safe, effective, equitable, patient centred and timely care. Planned change is essential for quality improvement. The key element for success is the way in which change is applied. Change is a complex process. It requires careful assessment, planning implementation and evaluation. Resistance is a normal response to change. Support, participation, communication and trust are key elements to reduce resistance. Continuous evaluation and correction is important. Support is essential to sustain change. Lewin’s model is used in Implementing CAM ICU .Delirium is a brain dysfunction associated with poor clinical outcomes but it is severely underestimated. Recognising delirium with CAM ICU can prompt the early treatment and consequently improve the quality of care.