The use of models like cultural competency, as designed by Campinha-Bacote, enable healthcare provider to continue striving towards attainment of the desired qualities necessary for working effectively in the context of individuals, clients, family as well as the entire community (Brathwaite 2003). Some of the quality improvement issues identified included lack of technology to engage patients as well as to transform healthcare into a more effective, efficient and patient centered. Also, many health institutions do not have adequate information technology tools to aid in documentations as well as monitoring quality improvements. In addition leadership support provided to nurses needed to be reviewed. There is also inadequate use of scorecards to highlight key strategies and tactics towards improvement of quality service delivery to the patients (Kaplan 1992).

There are various issues that can be used to measure the quality of healthcare services being offered to patients. For instance nurses need to be engaged in the entire nursing process so as to boost his or her morale and trust in the system. Relevant information should be provided to the patient through proper communication. In case there is a communication breakdown between nurses and patients of among nurses, a lot of time will be required to gather relevant information about the patient. Spending much to acquire information about a patient reduces the effective time for providing health care services to patients.