7 Common Challenges in Healthcare Quality Improvement & How to Overcome Them

12/9/2024 - By Jennifer Ziolkowski, MBA, CLSSYB & Kelly Smith, PhD, CPHQ, CLSSBB

Quality improvement is an essential process for post-acute healthcare organizations. It allows them to enhance resident outcomes, increase operational efficiency, and maintain financial stability. But it’s not as easy as simply deciding to improve. In fact, implementing quality improvement initiatives—and keeping the momentum going—often comes with significant challenges.

In this article, we'll explore seven common obstacles post-acute healthcare organizations face in their quality improvement efforts and provide strategies to overcome them.

Challenge 1: Poor Communication

In post-acute healthcare settings, miscommunication can have serious consequences. This is also true for healthcare quality improvement, where the success or failure of your efforts can have a direct impact on the quality of care residents receive.

In the context of an improvement project, miscommunication can lead to misalignment between departments, resulting in wasted effort, reduced staff engagement, and potential patient safety issues. This can significantly slow down or even derail your quality improvement project.

To enhance communication:

Implement standardized methods of communication to ensure clarity and transparency
Reinforce communication across multiple channels
Conduct periodic meetings with interdisciplinary team to ensure clarity of goals, action plan, and to report progress
Utilize visual management boards to track and communicate quality metrics in real-time
Develop clear protocols for addressing concerns and feedback solicitation
Maintain documentation related to process changes to ensure clarity

Regular, transparent communication helps build trust and keeps everyone aligned on goals and progress. Consider appointing communication champions within different departments to help distribute information effectively.

Challenge 2: Inadequate or Insufficient Training

Everyone in a leadership position in a post-acute healthcare organization knows how important proper training is. Without solid training, staff may struggle to implement new processes effectively. This can increase the risk of errors, reduce efficiency as staff struggle with new procedures, and potentially decrease job satisfaction, leading to increased turnover. All of this can ultimately impact care quality and organizational performance.

To improve training:

Develop role-specific training programs and competency assessments that address the unique needs of different healthcare professionals
Implement on-demand training modules accessible through the organization's intranet to overcome identified knowledge gaps and/or in the event of turnover
Offer incentives for participation in quality improvement initiatives

Investing in staff development not only improves the success of quality initiatives but also boosts employee satisfaction and retention.

Challenge 3: Difficulty Collecting & Analyzing the Right Data

Post-acute healthcare organizations often struggle with data management, particularly in integrating data from various sources and translating it into actionable insights. This can make it hard to accurately measure progress or identify areas for improvement. As a result, you might make decisions based on incomplete or inaccurate information and missed opportunities for targeted interventions.

To improve data management:

Train staff on proper practices to ensure data availability, reliability, and validity
Establish a comprehensive plan and systematic processes to collect, analyze, and report of performance data from various sources (e.g., EHR, billing system, family/resident feedback)
Develop dashboards that display key quality indicators in an easily digestible format
Consider partnering with data analytics experts or investing in advanced analytics tools which can help you derive meaningful insights from your organization’s data

Implementing these changes to data collection and analysis can lead to more targeted and effective improvement strategies.

Challenge 4: Limited Resources (Time, Money, Staff)

Resource constraints in post-acute healthcare can impede quality improvement efforts, particularly in an era of rising costs and staffing shortages.

When you’re trying to make quality improvements, these limitations can also delay implementation, increase stress on existing staff, and potentially lead to burnout. As a result, you end up focusing on day-to-day operations at the expense of long-term quality enhancement.

To maximize available resources:

Focus on improvements that align with value-based care initiatives and/ or strategic goals
Implement lean methodologies to identify and eliminate waste in processes (e.g., clinical, operations, administrative)
Explore grant funding opportunities for quality improvement projects
Leverage technology to its fullest potential to enhance efficiency

To set yourself up for success with limited resources, align your quality improvement efforts with organizational strategic goals. This can help you demonstrate the return on investment for these initiatives, and potentially secure ongoing support and resources from leadership.

Challenge 5: Unrealistic Goal Setting

Setting overly ambitious or vague goals can lead to frustration and disengagement, especially in healthcare settings where staff are already under significant pressure.

Unrealistic goals can demotivate staff when they aren't met. They can also inadvertently incentivize corner-cutting or encourage teams to compromise quality to meet unrealistic targets. This can make it difficult to demonstrate and measure progress accurately.

To set effective goals:

Seek knowledge and information through research or use of a consultant to make informed decision about feasibility
Use the SMART framework (Specific, Measurable, Achievable, Relevant, Time-bound)
Align quality improvement goals with national benchmarks and regulatory requirements
Break large goals into smaller, relevant milestones
Regularly review and adjust goals based on performance outcomes and staff feedback

Remember that quality improvement is an ongoing process. Celebrating small wins along the way can help maintain motivation and momentum towards larger, long-term goals.

Challenge 6: Resistance to Change

One of the most prevalent challenges in post-acute healthcare quality improvement is change resistance. In other words, staff may be hesitant to adopt new methods, fearing disruption to care or increased workload.

This resistance can significantly slow down or even derail improvement efforts. It often leads to delayed implementation of significant process improvements, missed opportunities for efficiency gains and cost savings, and increased risk of staff burnout due to persistent inefficient processes.

To overcome this challenge:

Clearly communicate how changes will benefit outcomes and staff workflows
Involve frontline staff in the decision-making process to increase buy-in
Provide comprehensive training that addresses specific concerns
Highlight early successes in resident care or operational efficiency to build momentum

Effective change management requires strong leadership and a culture that embraces continuous improvement. By addressing concerns proactively and demonstrating the positive impacts of change, organizations can gradually shift attitudes and behaviors, paving the way for successful quality improvement initiatives.

Challenge 7: Sustaining Change Over Time

Initiating change can be difficult, but ensuring this change is sustained over the long term presents its own set of challenges. Often, even if organizations see initial improvements, they struggle to keep the momentum going.

This can result in wasted resources on initiatives that don't stick, cynicism among staff about future improvement efforts, and inconsistent resident care due to fluctuating adherence to new processes.

To address this:

Integrate changes into standard operating procedures
Recognize and reward sustained improvement efforts
Implement periodic audits
Continuously reinforce the importance of new processes

Creating a culture of continuous improvement is key to sustaining change. This involves ongoing education, regular communication about progress, and aligning incentives with long-term goals.

Create a Stronger Quality Improvement Plan with Saltmarsh

Quality improvement in post-acute healthcare is not just about process efficiency—it's about providing higher levels of care and improving outcomes for every stakeholder. By addressing these common obstacles head-on, post-acute healthcare organizations can create more realistic and achievable quality improvement plans, and ultimately provide better care for their patients.

At Saltmarsh, we understand the unique challenges healthcare organizations face in implementing and sustaining quality improvement initiatives. Our healthcare consultants can provide tailored guidance to help you achieve lasting improvements in your healthcare processes. Contact Saltmarsh today to learn how we can help you meet the evolving demands of value-based care.