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The Five pillars of Quality: Knowledge, Skill, Transparency, Supervision, and Accountability

An in-depth look into the ambiguous Healthcare System


Originally Published by Illumination Curated on Medium


Photo by Adrian Swancar on Unsplash

Knowledge is the guide of every Skill

Knowledge and science are about acquired facts, information, and intelligence by an individual through experience or instruction. It is the theoretical as well as practical awareness about a subject. In literal terms, knowledge is precise to what we borrow every day to live a decent life and share our understanding with others at some point in time and locale. What we learn is knowledge gained throughout our existence. Hence it is invaluable.

There is no doubt; we live in a very competitive era where everyone in the healthcare arena wants to earn more for putting in relatively more minor of their effort. Almost everyone seeks to improve the chances of survival rate in the business by reducing competition. In other words, knowledge is not out of obtaining the skill to solve a problem. It also pertains to strategizing that knowledge into various skill sets to minimize effort and maximize return. For instance, a carpenter typically may spend carving a chair out of wood or selecting to put together different pieces of precut timbers to build one. The artistry of carving from a single piece of wood may be more astonishing under the circumstances, yet the alternate way may be less burdensome and a more efficient method.

A Soul with the right Skill never flunks Transparency

Transparency is excellent, drives out wasteful practices, and promotes collaboration and shared learning. Yet, some scholars say too much of it is destined to trigger falsifications of fact and counterproductive inhibitions. The latter phenomenon seems logical when the team’s person lacks a particular skill on that inhibition behavior. Simply, someone was not transparent or possessed enough skill during the hiring process. So, it may be a complex issue yet, solely due to a lack of transparency at some point in time and place. Not being transparent may, indeed, help overcome particular obstacles but surely not for the better.

From the rhetorical perspective, a transparent person is always synonymous with authenticity. Because people don’t want to be lied to, but they also wish to experience knowledge. Nonetheless, the temptation by the agent of service is always overwhelming to obscure one or the people’s expectations when lacking such skill. That is an involvement that tends to fulfill a necessity in their lives, irrespective of its reality. To the irony, prominent complex parts are figuring out what people want and where the line is between the expectation and the ability of the agent of skill. Then the big question arises; do people want to be transparent?!

Despite our past mindset, today, we are confident that transparency isn’t risky. That all doesn’t necessarily invite unwanted consequences such as litigation or job loss. Yet, one hundred percent transparency is even impeded by fear from both individual and organizational perspectives. There is the fear of competition, judgment, fear of harm to reputation, and yes, fear of litigation. But fear should never be the agent of prohibiting doing the right thing; however, doing the right thing in the capable hands never flunks transparency.

Proper conversation and communication with patients require both full and frank transparency. And that is not merely of the doctor-patient relationship but also applies to every person or organization involved with patient care. That transparency must be from the patient’s point of view, not the other way around. In other words, the healthcare system must ensure that the transparent information shared with patients, be it through individual interplays or publicly, make sense for them. That is why we should design sets of agencies that give patients what they need to engage in this discourse. And once the dialogue has occurred, we need to follow up on patients’ ideas and testimonials. But, no matter how much we agree on this, still, there is a strong sense of fear of transparency.

Supervision needs precise Transparency

We supervise to ensure quality service and minimize risks. But the fear of transparency often comes from the way specific bestowed data are handled. It’s important to monitor data for a better plan of action as well as error prevention. It is even more vital to create reports and monitor information critical to an accurate assessment of performance. But still, using data only in this way can reach from implying vain to genuinely counterproductive. Therefore, it is also crucial to urge researchers to use collected data for improvement and not merely judgment.

This transparency is expected to prevent irrational, inconsistent, and thus ineffective ordinance by inviting broad public participation and mandating a deliberate public debate over the content of proposed precepts. One apparent goal of this transparency is to provide clarity and predictability to the given supervision. It aids in making explicit how healthcare agencies and government are considering exercising their authority power.

The wisdom behind the creation of precision transparency is that balance brings out more considered and effective regulations and builds respect for and adherence to the decisions, which is essential for accountability.

Transparency is prime to the human capacity to support that rules are favorable to everyone.

Vagueness utters Audit

Auditing is the procedure by which an auditor collects and analyzes evidence about quantifiable indications related to a person or an entity to determine and report the degree of correspondence between the measurable information and established criteria. The audit is typically applied in the financial industry as a means of reducing costs and maximizing return. However, it is also a means of preserving quality in healthcare and medical service delivery.

Considering the accepted meaning, one may wonder why audits are performed. The main task circumstances comprise an audit — defined in three broad categories of decision tasks based on the degree of uncertainty about outcomes’ accuracy. If decision-makers can be entirely sure about their accuracy, the job is interpreted as “Acknowledged fact.” If decision-makers remain utterly uncertain about their decisions’ accuracy, the task is labeled a “guess.” It is also possible that some skepticism stays. The extent to which decision-makers have faith in their determinations significantly deduces ‘if ‘and ‘how’ tone will use that conclusion, then the decision task is labeled accordingly. But Most auditing undertakings are judgments because auditors can barely ever be sure that they made the correct conclusion.

What triggers the auditing process embraces a significant portion of subjective perception, and potentially the more vagueness to a scenario, the more probability for audit trigger.

On the one hand, the overwhelmingly covert nature of the healthcare system, the increasing exposition of data mining by none healthcare entities in the medical arena, has obscured the transparency to patients and medical professionals and has made auditing practice more than ever challenging. In other words, the patient information is only accessible to those who shouldn’t be needing it. That is, even though it has previously triggered an audit need many times.

From what is discussed so far, one can easily conclude that Healthcare suffers from vagueness that is resistant to efficient auditing and a corrective action plan. Latter is something that requires either full transparency or constructive trail audit.

The Audit is Costly and best minimized if Possible

For many, an audit is a necessary part of business operations. For others, however, it is not, and such businesses are increasingly declining the service. That is mere because the audit is a costly process and more so time-consuming. It is an instrument to overcome hurdles associated with lack of skills, a vague work environment, and most of all, ill intentions within the latter two.

Auditors are typically independent contractors. They charge comparatively high rates for services they render. Auditors may potentially increase fees in the middle of the project if companies slip to prevent such an effect in the agreement. A person or corporation may end up spending $4,000 to $6,000 for an audit. Besides, an audit is a lengthy process that requires employee commitment, where often they may take time off from what they are doing to attend the auditing process. There is usually time lost and uncertainty during the audit process, promoting more negative consequences on behalf of the adversary before the corrective action plan is implemented. Thus, it is improbable that unless a system is large enough to accommodate such cost, the central part of the healthcare system will have any means to perform an effective audit, more so prevent errors and skill flaws.

Healthcare is one Giant Project and needs Agile Skill

Medical practice and Healthcare, in general, is one big project with many variables and expectations. The healthcare domain is riddled with various determinants and variabilities. Therefore, having a robust management methodology in the past decade has become furthermore vital. One most prominent of those methodologies is that its values are based on their combined experience of delivering patient care skills and helping others do the same. The agile method stresses the importance of transparency and prioritization of Individuals and their interactions; over processes and tools, Working service operation; over comprehensive documentation, Clientele Collaboration; over contract negotiation and Responding to change; over following a plan. Despite all the benefits, other management methodologies such as lean management are used more often. This trend is primarily since Agile management requires transparency and collaboration. There would probably be a lesser need for auditing, better allocation of skill sets, a healthy work environment, and ethical guilt if used.

Take-Home Message

The Healthcare system is missing concrete pillars of quality. It lacks the proper distribution of skills into the right places. For instance, Healthcare illiterate politicians are making medical decisions; popularity has more priority than knowledge. Vagueness has become the success instrument as transparency is becoming a rhetorical phrase only because politics invites vagueness. Supervision and accountability have shifted synonymy to gatekeeper and control, respectively.

Broken pillars of the healthcare system are hence weight bearers of the global medical infrastructure.

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