attachment_1Managing Health Care Quality
Kimberly A Jeter
Dr. Beharry
HSA 501 (Management in Health Care)
November 28, 2016
Imagine that you are a hospital administrator at the Sunlight Hospital in California. The main complaint among the patients is the quality of care. Your job is to understand the state of the hospital, create value, increase efficiency, and turn the facility into a local hospital of choice. Whenever you are making visits in various wards to meet the employees and the patients, you hear how the patients love the hospital, but they would like to see certain improvements in care. The employees seem to be very busy executing their duties and not interacting much with the patients. The hospital board has asked you to compile a report of your findings and suggested strategy for achieving the hospital’s current goals.
As the hospital administrator for Sunlight Hospital in California, there is much talk among the patients about the quality of care as it relates to the hospital. Although the hospital is well-loved by the patients, they all would like to see some improvements to Sunlight Hospital that could help to make it the hospital that everyone in the area requests to come to when they are in need of services. It is my job to look at where we can add improvements to the hospital so that it can be where we would like for it to be so that it will be the hospital of choice for all.
There are many different areas that any hospital can evaluate when deciding what matters most to its patients. In this instance, Sunlight Hospital is going to look at the five measurements of quality of care that we think are the most important to our patients based on feedback that we have gotten from patients in the past. The first one that we are going to take a look at is readmission rates. Readmission rates are imperative to patients because they want to go to a hospital that gets them better the first time around and doesn’t have a high readmission rate. They wish to know that when they leave the hospital, they have been successfully helped, and the problem is taken care of so that they do not have to continue to get help for the same acute health problem.
The next measurement to take a look at is mortality rates, which is going to evaluate the number of individuals who come into the hospital and die after receiving care from this facility. The mortality rate is going to be extremely important to the patients because they want to know that when they to Sunlight Hospital, the likelihood that they are going to recover from their ailment is greater than the risk that they are going to die. They want to know that we can treat them and have a low rate of mortality here at the hospital, which I think is something that should be evaluated.
Other Measures used to assess and compare the quality of health care organizations and are classified as either a structure, process, or outcome measure. Known as the Donabedian model, this classification system was named after the physician and researcher who formulated it. Structural measures give consumers a sense of a health care provider’s capacity, systems, and processes to provide high-quality care. For example:
- Whether the health care organization uses electronic medical records or medication order entry systems.
- The number or proportion of board-certified physicians.
- The ratio of providers to patients.
Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition. These measures typically reflect generally accepted recommendations for clinical practice. For example:
- The percentage of people receiving preventive services (such as mammograms or immunizations).
- The percentage of people with diabetes who had their blood sugar tested and controlled.
Process measures can inform consumers about medical care they may expect to receive for a given condition or disease, and can contribute toward improving health outcomes. The majority of health care quality measures used for public reporting are process measures.
Outcome measures reflect the impact of the health care service or intervention on the health status of patients. For example:
- The percentage of patients who died as a result of surgery (surgical mortality rates).
- The rate of surgical complications or hospital-acquired infections.
Outcome measures may seem to represent the “gold standard” in measuring quality, but an outcome is the result of numerous factors, many beyond providers’ control. Risk-adjustment methods – mathematical models that correct for differing characteristics within a population, such as patient health status – can help account for these factors. However, the science of risk adjustment is still evolving. Experts acknowledge that better risk-adjustment methods are needed to minimize the reporting of misleading or even inaccurate information about health care quality.
Hospitals will rely heavily on data mining and analytics to guide care. The healthcare community is pushing to make big data actionable, including through the use of predictive medicine. “You need to be able to handle the patient in a seamless way. If you’re going to do that, you have to have clinical information systems that are very effective,” said Michael Blaszyk, CFO of Dignity Health, Becker’s reported. In Atlanta, doctors at Emory University Hospital are using health IT to combine data collected by multiple machines used in critical care into a single report that provides a comprehensive picture of the patient’s condition, Fierce Health IT previously reported.
With patients shouldering more of cost burden of care, it is essential for hospitals to make their pricing available for customers, said Toby Cosgrove, M.D., president and CEO of the Cleveland Clinic, according to the article.
- Provide risk-based contracts:
Hospitals must provide efficient, coordinated care that focus on the patient in order to take on risk. “If you’re going to take risk, you have to have a seamless integrated system that is all around the patient,” Blaszyk said.
With a growing demand for comprehensive healthcare and a physician population that isn’t growing as fast as America needs, Henderson said hospitals must give non-physician caregivers the ability to work at the top of their license. Hospitals that embrace teamwork also could help prevent medical errors, encourage reciprocal communication and reduces errors, Fierce Healthcare previously reported.
Hospitals are often called upon to improve the quality of its various health care activities in order to better serve patients and immediate communities. A quality improvement plan thus helps in the selection of high priority areas and the utilization of evidence-based practices in conducting the improvement. There are several quality measures that can be used to gauge how a hospital delivers healthcare to its patients. In most cases, each quality measure targets a specific aspect of a hospital’s healthcare system.
In view of the healthcare improvement needs of Sunlight Hospital, this paper seeks to classify and justify five measurements of quality of care in a hospital, specify the four main features in a health care organization that can be used in the design of a quality improvement plan, and suggest the salient reasons quality of care would add value and create a competitive advantage to sunlight hospital. Assignment 2: Managing Health Care Quality
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