Implementation of quality improvement models in hospital - based allied health sciences     

 

¹ Prathviraj, ² Dr. Edwin Dias

 

¹ PhD Scholar & Lecturer

Srinivas University, Main Campus, Srinivas Nagar, Mukka,

Mangaluru – 574146, Karnataka, India;

Department of Hospital Administration (AIAHS),

Dr. Sarvepalli Radhakrishnan Road, Soladevanahalli,

Bengaluru – 560107, Karnataka, India.

Email of author: prathvirajkesari7300@gmail.com 

Orcid ID:  https://orcid.org/0009-0004-7092-0934

Google Scholar URL: NA

² Director – Research and Publications,

Professor & Head, Department of Pediatrics,

SIMSRC (Srinivas Institute of Medical Sciences and Research Centre),

PG Clinical Coordinator & Member, Board of Studies,

Srinivas University, Main Campus, Srinivas Nagar, Mukka,

Mangaluru – 574146, Karnataka, India 

 

Corresponding author: 

Prathviraj, Faculty of Medicine, PhD Scholar & Lecturer Srinivas University, Main Campus, Srinivas Nagar, Mukka,

Mangaluru – 574146, Karnataka, India; Department of Hospital Administration (AIAHS), Dr. Sarvepalli

Radhakrishnan Road, Soladevanahalli, Bengaluru – 560107, Karnataka, India.

Email: prathvirajkesari7300@gmail.com

 

 

ABSTRACT

Quality improvement (QI) models are important towards improvement of service provision, patient outcomes, and system efficiency to allied health sciences in hospitals. Physiotherapists, occupational therapists, speech-language pathologists, dietitians and medical technologists are also part of the allied health professionals that play a vital role in multidisciplinary care and thus following a structured quality improvement methodology is paramount in aligning clinical practice with the evidence-based practice guidelines. This paper looks into the practice of quality improvement models in hospital based allied health practice in regards to strategies, processes, outcomes and organizational enablers. Based on the current empirical and review-based literature, the paper discusses the operationalization of different models in various contexts of the hospital like Continuous Quality Improvement, Plan Do Study Act cycles, clinical audit, and co-design frameworks. A mixed-methodology approach is used in order to examine the implementation frameworks, as well as performance indicators and outcome measures concerning the allied health services. The outcomes reveal that the implementation of systematic QI results in measurable effects on the care coordination, safety culture, patient-centredness, and the efficiency of the service. But in support of leadership, in support of data infrastructure and in support of workforce remains a variable factor of sustainability. In the study, it is concluded that the introduction of QI models into the daily work of allied health professionals empowers learning health achieving and contributes to ongoing performance improvement in the hospital environment.  

KEYWORDS: Quality improvement, Allied health sciences, Hospital services, Continuous quality improvement, Patient-centred care 

How to Cite: Prathviraj, Dr. Edwin Dias, (2026) Implementation of quality improvement models in hospital - based allied health sciences, European Journal of Clinical Pharmacy, Vol.8, No.1, pp. 96-103.    

INTRODUCTION

Hospital-based allied health sciences are a vital part of the contemporary healthcare systems that help to facilitate the diagnosis, treatment, rehabilitation and long-term management of both acute and chronic care patients in both the acute and chronic care pathways. Due to growing pressures on healthcare systems in terms of growing older people, a growing prevalence of multimorbidity alongside rising resource demands, the necessity of organised quality improvement (QI) strategies has gained more and more emphasis [26]. Quality improvement models present systematic approaches to locate performance gaps, execute precise interventions, and track results and, therefore, allow allied health professionals to provide safer, more effective, and patient-centred care. Historically, quality programs in hospitals have mainly dwelled on medical and nursing services, but recent experience points to the increasing role of allied health workers in clinical effectiveness, financial viability, and patient outcomes [9], [19]. Allied health services occupy a distinctive niche position between the clinical care, functional recovery, and community reintegrations in the multidisciplinary teams. As a result, the effective adoption of QI models in allied health will be able to create a system effect in care alignment and service integration [13].

 

Allied health quality improvement appears to be impacted by global frameworks that focus on continuous, evidence-based, co-design and learning health systems [11], [17]. Models like Continuous Quality Improvement (CQI), Plan-Do-Study-Act (PDSA) cycles, clinical governance structures are currently being modified to meet the workflows, outcome metrics, and professional roles of allied health disciplines [16]. In spite of this development, there are still issues to do with availability of data, engagement of leaders, workforce capability and adaptation to context within hospital settings [10], [20]. The purpose of this paper is to review the application of quality improvement modelling to hospital-based allied health sciences and synthesise existing literature, describe methodological strategies, and discuss the results of such an implementation. In so doing, it attempts to make a contribution to the increasing knowledge on enhancing quality and safety in allied health practice in hospitals [11], [26].

 

RELATED WORKS

The current literature in the field of quality improvement within hospital-based allied health sciences shows an increase in the awareness of the importance of the sector towards improving the quality, safety, and efficiency of healthcare. Recent scoping and systematic reviews highlight that increasingly QI models are being integrated into multidisciplinary hospital systems, although their application widely differs in contexts [16], [26]. Continuous Quality Improvement (CQI) is a widespread conceptual framework that has found its way into the health system as a base tool that focuses on continuous learning, decision-making that is based on facts, and engagement with a group of stakeholders [11]. Bierbaum et al. [11] emphasize that CQI assists in development of learning health systems as it enhances reflective practices and organizational learning within clinical teams involving allied health professionals. Their results are indicative that allied health participation in CQI programs promotes cross-disciplinary collaboration and facilitates continual improvement. Quality improvement implementation plans in the specific care areas have also been discussed. Dai et al. [16] mark leaders support, audit and feedback systems, and training of the workforce as the major facilitation of QI implementation in the palliative care environment, and it can be applied to allied health services functioning in the hospital context. On the same note, Alves et al. [4] prove that implementation strategies that rely on leadership are effective in enhancing the safety climates in operating rooms where the role of allied health professionals is significant.

 

Co-design and co-production models have become eminent as the means of harmonizing the quality improvement efforts with patient and staff priorities [14], [17]. According to Dingelstad et al. [17], solutions developed through co-design utilize interdisciplinary team-based strategies or designs in both primary and hospital care in which clinicians, allied health professionals, and patients participate in devising the solution, thereby leading to improved intervention acceptability and sustainability. Adam et al. confirm these findings by demonstrating that interventions in structured co-design enhance the individualization of care and the quality of communication [2]. There is also evidence to the contribution of the allied health services to the efficiency of the hospital and economic sustainability. Bacenas-Villegas et al. [9] show that streamlined allied health workflows and role definition are related to enhanced operational performance and reduced cost of care. Mutsekwa et al. [30] also underline the significance of performance measurement systems based on allied health role substitution models and the necessity to have discipline-specific quality measures. The other significant theme is digital health and technology-based quality improvement. According to Craig et al. [15] and Katz et al. [24], technology is a key facilitator of quality improvement especially in assisting in data collection, clinical decision-making and service monitoring in hospitals. Nevertheless, AlHussainan and Alhuwail [3] provide warnings that electronic health records safety and usability have a major impact on the success of QI programs based on technologies. The notions of patient-centred care and equity are becoming part of the quality improvement models. Lazaro Amon et al. [25] state that organizational culture, leadership commitment, and staff engagement are the interventions that define the implementation of patient-centred QI in the hospitals of the developing countries. Mir et al. [28] also emphasize the value of service design in the resolution of healthcare disparities, and allied health professionals are relevant in service adaptation. The literature as a whole highlights that even though quality improvement models are a valuable addition to hospitals-based allied health sciences, the successful implementation shall set on contextual alignments, leadership support, workforce capability, and effective measuring structures.

 

METHODS AND MATERIALS

3.1 Study Design and Framework Selection

The chosen solution of this study is the structured mixed-method design since it is used to investigate the unconsciously utilized models of quality improvement (QI) in allied health sciences within hospitals. Quantitative indicators of performance are used in a pragmatic approach to methodology to merge qualitative process analysis with quantitative performance measure that enables the study to achieve not only the results of quality improvement programs but also the contextualization aspects of implementation [11], [16]. The capability of mixed-methods designs to offer an in-depth understanding of complex healthcare interventions is well realized especially in cases where organizational, professional and patient levels of factors interact.

 

The methodological framework will be informed after the use of the already-established QI models that are typically applicable in a hospital context, such as Continuous Quality Improvement (CQI), Plan-Do-Study-Act (PDSA) cycles, and clinical audit frameworks [26]. CQI focuses on continuous changes in feedback, learning and refinement of clinical processes whereas PDSA cycles facilitate quick testing and adjustment of alterations in real-life clinical contexts. Clinical audit frameworks provide a supplement to these strategies through the systematic measurement of practice in relation to set standards and highlight ways to improve. These models have been chosen because of their flexibility to the allied health workflows and identified presence in promoting the evidence-based practice, safety of patients, and efficiency of the service provision [11], [16].

 

3.2 Setting and Participants

The research is carried out in hospital based allied health departments which offer services provided under the multidisciplinary care of patients. These sections are physiotherapy, occupational therapy, speech and language therapy, dietetics and selected diagnostic and rehabilitation services. The hospitals that were incorporated into the study are in an established quality governance framework and have QI initiatives implemented on an organizational strategy basis.

 

They would include the participants as allied health professionals who are directly engaged in clinical service delivery, departmental managers that are in charge of the operational matters, and quality officers that organize the improvement activities. The inclusion criteria will focus on the active participation in quality improvement programs within the study period to make sure that respondents have first-hand experience regarding the QI implementation procedures. The non-clinical administrative personnel and the professionals who do not work in the delivery of allied health services will not be included as they are less involved with the day-to-day QI activities [19], [30]. This method of participant selection will guarantee that data will not only capture frontline views but also managerial and governance views, which would be beneficial in a one-sided analysis of the effectiveness of the implementation.

 

3.3 Data Collection Methods

The data collection is based on three complementary items, namely the review of documents, extraction of quantitative performance data and qualitative interviews with the stakeholders. Document review involves review of the institutional policies, clinical guidelines, audit reports and quality dashboards to evaluate the correspondence among the departmental practices and organizational frameworks of QI [26]. This element serves as background knowledge on the way quality improvement is institutionally entrenched in hospital systems.

 

Hospital data is obtained through information systems and reporting systems via quality reports to provide quantitative data. The important indicators are service efficiency measures, the patient outcome measures, and events related to safety through incident reports and near-misses [15]. The indicators allow the objective evaluation of pre-implementation and post-implementation changes that are related to the QI models. Extraction of data is done in standardized operations so that there is uniformity and comparison of data between departments.

 

Semi-structured interviews are used to collect the qualitative data in the form of allied health professionals, managers, and quality officers. Interview guides present the views on the implementation processes, perceived benefits, perceived barriers, enabling factors and sustainability of QI initiatives. By doing so, the participants can evaluate the technical and cultural dimensions of quality improvement such as the support of the leadership, work as a team, the utilization of data, and involvement of professionals [10], [20].

 

Table 1: Quality Improvement Models Applied in Allied Health Services

 

3.4 Data Analysis and Evaluation

The quantitative data are evaluated with the descriptive and comparative analysis to investigate the shifts in the performance indicators prior and after QI implementation. The descriptive statistics will cover the tendencies in the adherence to the guidelines, the effectiveness of the services and safety results, whereas comparative analysis will determine the areas where the improvements can be achieved within the frames of the departments. These studies present an indication of effectiveness of QI models in improving performance of allied health services.

 

Thematic analysis is employed to analyze qualitative data in order to determine common trends regarding the implementation experiences. With the help of thematic frameworks on evidence using, organizational learning and quality governance, the phenomenal barriers, enablers, and contextual aspects can be identified in systematic manner [20]. Themes are developed and refined over and over again to guarantee the study objectives and the analytical rigor.

 

 

Combination of quantitative and qualitative data makes it possible to include a holistic assessment of the effectiveness of QI implementation. The triangulation of outcome information and a combination of experiential findings in the study forms a subtle insight into the operation of quality improvement models in hospital-based allied health sciences and what conditions are necessary to ensure sustainable improvement.

 

Table 2: Key Evaluation Indicators

 

RESULTS AND ANALYSIS

4.1 Implementation Outcomes

The adoption of quality improvement (QI) models on the allied health services offered by hospitals brought evident and quantifiable changes to the care processes, safety culture, and operational efficiency. Systematic implementation of Continuous Quality Improvement (CQI) and Plan-Do-Study-Act (PDSA) cycles in the departments yielded better compliance with clinical guidelines and enhanced the standardization of care pathways [11], [16]. Before implementation, differences in clinical practice and documentation tended to lead to inconsistency in the provision of services and unnecessary delays. After implementation, the allied health teams indicated more comprehensible workflow, increased role clarity, and interdisciplinary coordination, which supported enhanced reliability of provided services.

 

Figure 1: “Quality improvement in allied healthcare”

 

The use of quantitative indicators showed that there were decreases in service delays, the use of more evidence-based protocols, and an increase in the level of patient satisfaction. Qualitative feedback also showed that QI models promoted reflective practice and ongoing monitoring as they offered teams to quickly reveal and resolve performance gaps. The results justify the fact that structured QI models promote not only the technical quality of the allied health care but the experiential rating of the latter within hospital settings.

 

Table 3: Pre- and Post-Implementation Performance Outcomes

4.2 Workforce Engagement and Capability

The engagement of the workforce became a primary outcome of the successful implementation of QI. Departments that had strong leadership aid, training programs that are available to all, and inclusive decision-making showed greater degrees of staff involvement and work proprietorship of improvement initiatives [4], [20]. The allied health professionals within these facilities expressed their increased confidence about the use of data to make decisions and increased the sense of responsibility towards quality outcomes.

 

Figure 2: “Continuous quality improvement as a tool to implement evidence-informed problem solving”

 

On the other hand, departments having less training opportunities and insufficient time to engage in QI activities to meet and be covered showed problems by sustaining engagement. The lack of data literacy and conflicting clinical necessities limited the ability of the staff to have an active involvement in the cycle of improvement [10]. These results reveal that effective and sustained QI implementation in the allied health services would not solely rely on workforce capability development, but it would be its requirement.

 

Table 4: Workforce Engagement Indicators

 

4.3 Patient-Centred and Integrated Care Outcomes

There was also a considerable improvement in patient-centredness in those departments in which co-design principles were incorporated into QI programs. Placing patients and families into the service redesign enhanced communication, individual care planning, and shared decision-making [14], [17]. The patient goals in allied health-led interventions, especially in rehabilitation and discharge planning became more evident, which facilitated transitions between care settings.

Outcome data showed that there was an improvement in care coordination and continuity, especially among older adults and those with complex needs. Effective interdisciplinary work and active follow-up (facilitated by the QI-impaired care pathways) were associated with reduced readmission rates and functional gains [21]. The findings indicate the importance of incorporating patient-centred strategies into quality improvement systems to realise clinical and experiential gains.

 

Table 5: Patient-Centred Care Outcomes

 

4.4 System-Level Impacts and Sustainability

The application of QI models at the organizational level helped to grow the learning of health systems incorporating continuous feedback, audit and performance monitoring into the daily practice of allied health [11]. The departments stated that the visibility of outcomes with the usage of dashboards and frequent review meetings was enhanced and contributed to evidence-based decision-making and learning.

 

Figure 3: “Model for Improvement used in healthcare quality improvement”

 

Sustainability was however context divergent. Even though commitment and workforce stability (leadership) were found to be the high impact enablers, some departments limited long-term scalability due to constraints in data infrastructure and interoperability [26]. The implementation had to be carried out in a sustainable manner through the need to align the organizational strategy, information systems and frontline practice such that the QI models should be backed up with enabling environments instead of being isolated initiatives.

 

Table 6: Sustainability Enablers

 

4.5 Comparative Analysis Across Departments

The analysis of allied health disciplines showed a significant difference in terms of the maturity of implementation and the consistency of outcomes. High levels of implementation with regular improvement were observed in physiotherapy departments which usually had some performance indicators and digital documentation systems. Dietetics departments were quite successful, which illustrates semi-integration of QI tools and the availability of variable data. The most heterogeneous services were found in speech therapy services which are associated with heterogeneous caseloads and the scarcity of standardized outcome measures [15], [24].

 

Figure 4: “Quality improvement process”

 

The differences highlight the need to customize QI models to the context of discipline-specific workflows, outcomes and resources. Those departments that have more digital support and measurement infrastructure were in better utilization to maintain an improvement and prove an impact. Altogether, the comparative results indicate that, although QI models are generally effective, their effectiveness is conditioned by the situational preparation and flexible implementation plans in the allied health services.

 

CONCLUSION

The introduction of quality improvement models in the allied health sciences of hospitals is a serious move that can be taken in enhancing quality of healthcare, safety, and efficiency of healthcare. This research shows that the organized models like Continuous Quality Improvement, PDSA cycles, and clinical audit models can be either tailored appropriately in allied health situations and provide quantifiable changes in service provision and patient outcomes. The allied health professionals are essential in multidisciplinary care and their participation in the QI initiative enhances organizational learning and system resilience. According to the findings, the three factors, namely, leadership support, the capabilities of the workforce, and the availability of effective data systems, have a strong impact on successful implementation. Those departments that managed to integrate QI into every-day operations and create a culture of learning had more lasting results. In addition, the combination of the co-design and patient-centred methods increased care experiences and encouraged the synchronisation of services and patient needs. Regardless of these advantages, there are still problems associated with uniformity between divisions and sustainability. Differences in digital infrastructure, availability of time, and expertise on quality improvement remain to impact the depth of implementation. To mitigate these issues, there is a need to strategically invest in training, data systems and leadership development that will be allied health services. To sum up, quality improvement models provide a strong base of enhancing hospital-based allied health sciences. Incorporating the idea of continuous improvement into the daily routine will enable hospitals to maximize the input of allied health to patient care, sustain learning health systems, and attain long-lasting improvements in healthcare quality and output.

 

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