Discussion
The Australian Commission on Safety and Quality in Health Care developed NSQHS which is National Safety and Quality Health Service Standards which provides a consistent statement of national nature to provide quality care to patients at a level which they expect healthcare organisations to do. The main aim of this governing body is to protect the general public from any kind of harm and improve the level of provision of healthcare at all costs (Australian Commission on Safety and Quality in Healthcare 2022). There are eight standards of this framework which are the clinical governance framework, the standard of partnering with consumers, the standard of preventing and controlling infections, the standard of medication safety, the standard of comprehensive care, communication of the safety standards, standards of blood management and standards of recognising as well as responding to acute cases of deterioration (Murphy 2020). In this report, there will be a discussion on the issue related to compliance with the standards of NSQHS by one of the renowned healthcare organisations of Australia while comparing it with the actual standards. Information regarding the current performance of the organisation will be discussed while deciding on recommendations to improve the same in the future.
The Royal Melbourne Hospital in Melbourne, Australia is one of the renowned health service organisations in Australia. However, there has not been enough maintenance of the standards of the hospital with respect to “preventing and controlling infection standards” during the outbreak of the pandemic in the year 2020. Between the 1st of July and the 31st of August in 2020, around 262 staff was infected with Covid-19, of which 205 were female and 57 were males. It included doctors, nurses, support staff and allied health practitioners. Some students and administrative staff were also infected (Buising et al. 2020). At the peak time of the outbreak of the pandemic when the hospital needed more and more staff to support the incoming gush of patients, such a vast number of staff getting infected was indicative that the hospital was not in compliance with the NSHQS standards.
The needs and requirements of stakeholders basically represent the views of the people at the entrepreneurial operations and the business level which includes that of users, customers, acquirers as well as other stakeholders when they relate to the problem to find a solution that can render the services required by the stakeholders within a particular environment (Reeves et al. 2020).
Stakeholder Needs and PEST Influences
The stakeholders of the hospitals are: Nurses, doctors, patients, management, nursing and medical students and other health practitioners.
Patients: They are the most important stakeholders of the hospital since the hospital generates revenue when patients are admitted and they get treated and consequently pay the bill to the hospital for the service. If such a massive amount nurses and other healthcare staff are infected, then it would be difficult for the workforce to provide effective and safe care to the patients. Thus, patients as stakeholders are in need of hardworking, dedicated and healthy staff.
Nurses: They are the second most important stakeholders of the hospital as it is the dedicated duty of the nurses that lead to the treatment of patients who in turn pay the hospital and help it earn revenue (Nyein and Gregory 2020). The nurses should be provided with an ample amount of equipment to protect them while coming in contact with Covid-infected patients. Such equipment provides PPE kits, hand wash, hand sanitizers, hand gloves and N-95 masks, which would help them keep themselves prevented from acquiring the infection.
Doctors: They are the stakeholders who provide treatment to the incoming patients and make them well. Thus, hospital management is highly dependent on the flawless service provided by doctors to keep the patients well-treated (Wu et al. 2019). When patients are not given proper treated, they will provide negative reviews in society and this in turn would defame the reputation of hospitals highly. Thus, the needs of doctors as stakeholders are enough measures of personal protection and hand hygiene equipment from the hospital authorities along with adequate support from the nurse fraternity and other allied health professionals so that they can continue their services without any kind of hindrances.
Management: The management is responsible for providing an adequate supply of instruments and equipment for maintaining personal protection and hygiene so that staff can protect themselves from acquiring Covid-19 infection. Also, it is important that they provide enough room for the staff so that they work in peace and coordination with effective teamwork so that the hospital can keep on functioning at its normal pace. For this, the management is in dire need of funds to supply these required materials along with well-maintained relations with logistics suppliers.
Since Australia has well-maintained relations with the USA, Canada, China, Russia and the UK and is a member of some of the top platforms of the world such as the WTO, it shall be very easy for the healthcare sector of the country to acquire funds from different nations. Holding a very stable political environment, the production of PPE kits and hand hygiene substances can be very easy by attracting investors from different parts of the world (Messineo et al. 2022). Since there is little or no corruption, meeting the needs of stakeholders shall be very easy for Royal Melbourne Hospital. As the per capita income of the country is comparatively high around 50,850 AUS Dollars, people can easily afford the price charged for the purchase of equipment by the hospital. However, due to increased unemployment during the crisis of Covid-19, the country’s annual revenue fell in 2020 and thus the power of buying and availing healthcare services dropped for the people of Australia. This led to lesser production of PPE kits and other materials needed for protection against Covid-19. As a result, the hospital authorities are being able to meet NSQHS standards or the needs of stakeholders.
Gap(s) Measurement
At the Royal Melbourne Hospital, the construction of buildings was done in a manner having air conditioning plants with an inappropriate system of air current exchange which was not in compliance with the standards of the NSQHS standard of preventing and controlling infections. In some of the wards, patients were found to be shouting or coughing in a vigorous manner, thereby increasing the infection of staff leading to the closure of wards and beds treating Covid patients due to the deficiency of enough well-trained staff. It was due to a large number of patients suspected or confirmed Covid-19 getting confined in spaces with improper air circulation, that the nurses and other healthcare professionals acquired the disease and when they further moved around the hospital, they spread the disease (Buising et al. 2020). It was required to immediately isolate patients when they were suspected of having acquired Covid-19 but due to a lack of workforce and infrastructure, such a step was not possible to be undertaken.
The NSQHS standard of prevention and control of infections considers infections to be preventable. This control standard is mainly aimed at minimising the risk of transmission of the disease by identifying and isolating the patients as soon as they are detected with any kind of infection that is associated with spread. The standard also aims at providing effective management of disease to the patient with the use of strategies that evidence-based (Islam et al. 2020). All prevention and control programs need to reflect on the local risks and context. The tasks which are to be implemented by the organisation must reflect the complexity of the services along with the risks that are association with the delivery services of the company.
To bring about improvements in the process of preventing and controlling infection transmission, the following meso and micro analysis can be conducted:
Meso analysis: Meso analysis is important to understand how communities react and interact with information as well as how they are giving value to information (Serpa and Ferreira 2019). When such a large number of staff got infected due to covid-19 infection, the service backbone of the hospital suffered massively which is quite obvious. For this, the hospital authorities should not have closed down wards due to a lack of doctors and nurses. Instead, they could have hired staff to work on a part-time basis at times when there was not much strength of staff working. This is a kind of support along with a compassionate attitude from the management of Royal Melbourne Hospital towards the patients who were panicking due to the outbreak of such a dreadful infection as Corona virus and were seeking help from the hospital anticipating seeking speedy recovery of their near ones. Also, there should be proper ventilation in indoor spaces to avoid the accumulation of viruses.
Micro analysis: This perspective shall encompass the day-to-day activities which the hospital could have performed for ensuring the safety of patients as well as staff from the infection of Covid-19 (Lavelle et al. 2020). As preventive measures, the hospital can provide PPE kits to each and every staff every day before they join duty. They must have kept spare kits in case of any kind of discrepancy. Hand sanitizers and disinfectant sprays must be kept at the side table of each patient so that nurses and doctors can use them to sanitize themselves before interacting or getting direct contact with any patient, mandatorily the ones in the Covid ward. The wards must be sanitized properly every day to destroy the harmful virus. All the measures must be considered in compliance with NSQHS standards.
Hospitals are required to maintain complete cleanliness for the minimisation of the growth of microorganisms which can infect and harm patients along with the visitors and the staff of the hospital (Lee 2019). To accomplish this, more and more PPE kits, hand gloves, masks and hair caps should be kept available in hospitals. The authorities of the hospital must procure enough funds for the supply of these instruments. When improvements are brought about by the hospital by complying with the regulations of NSQHS, the risk of patients acquiring infections will be reduced (Hay et al. 2020). This will increase the publicity of Royal Melbourne Hospital among the public of Australia and in turn would contribute to growth as well as revenue generation in Australia. With improvement in safety and hygiene conditions of the hospital and preventing rapidly outspread of infections, patients are bound to trust the organisation completely.
Quality improvement in healthcare is aimed at enhancing the efficiency and safety of the stakeholders and hence redesigning a healthcare infrastructure will need indulgence in the tools and methods that are applied for bringing about improvement (Oesterreich et al. 2020). In the advanced technological world, implementing digital record-keeping inventory can be utilised which will turn out to be a systematic approach that shall improve the standards and quality of healthcare (World Health Organization 2018). The activities which bring about changes in the organisation are cyclic and must be subjected to continuous improvement so that the organisation can perform functionally. With the help of continuous upgradation, organisations can come out of traditional concepts which will make utilisation of technology and tools for performing conveniently while generating results that are better (Farrington, Antony and O’Gorman 2018). With the help of improved efficiency of the management of the hospital as well as clinical processes, there are transition spaces left for the staff as well as the doctors for providing responsive as well as respectful as well as value-based strategies of treatment to the patient.
Firstly, approaches for reducing the burden on measurement are required. Priorities must be given to data capture systems that will collect data from various health organisations without putting much extra effort along with abstraction of data which will not require any review of manual charts (Matthew et al. 2020). For this, a key role shall be played by the government and the organisations of quality reporting who can push the market to adopt these strategies.
Secondly, the lag in reporting quality data will need to implement strategies that can better capture as well as report on the quality through the provision of clinical care (Matthew et al. 2020). The measures taken must be less reliant which having a time lag should focus on some measures and can be generated from the electronic records of health.
Conclusion
It can be concluded that maintaining the quality of healthcare means maintaining the degree of health services that various health organisations serve individuals and populations for increasing the likelihood and nature of the health outcomes which are desired. It also indicates providing care to patients according to their needs and demands in a very safe and effective manner. Through discussion of stakeholder needs and the influences of political and social factors, the need of Royal Melbourne Hospital to comply with NSQHS standards can be understood. Analysis of the gap in complying with the same will give improvement suggestions which would render opportunities to improve and accordingly recommendations have been suggested that would bring about the growth of the organisation.
Reference List
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