From limited resources to a lack of adequate staffing, tribal hospitals and clinics face numerous challenges. The resulting healthcare process barriers often lead not only to poor patient outcomes, but sometimes forced closure and loss of access to care in the greater community.
The good news: staff can improve their care delivery – and population health – by dismantling process barriers.
When Healthcare Process Barriers Hinder Quality of Care
Improvement starts with an honest assessment of facility policies and procedures. This analysis can unearth process barriers such as:
- Inadequate or ineffective policies and procedures: Well-defined policies and procedures help ensure all patients receive standardized, high-level quality of care. They also help the facility meet national standards of care. Without effective policies, care can vary from provider to provider and patient to patient. For instance, at Tribal EM, we help tribal clinics tailor their policies to the population they serve. By creating facility-specific policies that align with national standards of care, we help ensure each patient receives exceptional treatment.
- Ineffective Communication: Poor communication is synonymous with poor quality of care. Ongoing, effective communication with stakeholders – such as staff, patients and tribal leadership – is critical. To do this, we design best communication practices like daily huddles with staff members to check in about ongoing concerns or establishing a Quality Assurance and Procedure Improvement (QAPI) team to review care delivery results and discuss policy or procedure improvements.
- Training Shortfalls: Do the staff have proven competency in simple procedures like suture removal? Are they trained in proper quality checks to ensure equipment is working and provides accurate readings? Are they knowledgeable enough to assess patient environments for risk? These clinical and skill competencies are vital. That’s why we work with facilities to implement core clinical competencies, ligature risk assessments, Crisis Prevention Intervention training, sitter training, suicide risk assessments, and more.
Of course, these are just a handful of common challenges facing facilities; each hospital and tribal nation are different. Leaders should take stock of the needs, goals and challenges specific to their own clinics.
Identifying Process Improvements
Outlining healthcare process barriers is just the start. Designing a path for improvement means asking three key questions:
- Does our policy support our procedure? When polices are ignored or misunderstood, quality failures soon follow. As a result, patient safety may lapse, or door-to-doctor times may increase, eventually costing revenue. Consider a Quality Assurance Process Improvement (QAPI) program to identify gaps and align policy with process.
- Do our procedures follow national standards of care? Address procedural flaws ahead of inspections. Several options can help with this. You can seek a third-party consultant like Tribal EM; your leadership can also mandate internal QA programs. One idea is tasking your quality and facility managers with weekly or monthly checks of Joint Commission compliance measures.
- Has our staff received the right level of training for our patient population? First, ensure providers complete annual competency requirements. Is an annual “skills fair” a good solution for assuring CMS compliance? Also, does your staff need special training to address mental health areas such as substance abuse and suicide? Does the behavioral health training reflect community challenges?
Consider Outside Help
With the myriad disparities facing tribal healthcare, consider tapping an outside partner skilled in solving process gaps. A staffing and consulting company experienced in improving healthcare delivery for tribal communities can free your staff to focus on care while they refine your processes. It’s usually the fastest path to high-quality healthcare – and to a clinically skilled workforce.
