Improving Healthcare Quality
The purpose of this paper is to identify aspects of quality improvement in healthcare. This research is conducted by examining and reviewing various literature regarding the definition and makeup of quality healthcare, need for improvements in healthcare, various quality measures or indicators and weighing the cost of improving healthcare quality.
Defining Healthcare Quality
Before any discussion can take place regarding improving healthcare quality, an examination of the definition of healthcare quality must be conducted. There are legitimately varying perceptions of what is consider to be the critical dimensions of quality healthcare. These views on quality largely results from the perspective one adopts as a patient, healthcare provider, health care manager, purchaser, payer, or public health official. The same health care experience may be assessed differently depending upon the person’s role. For example: ➢ The patient may view his or her experience with the health care system both by its outcome and personal feelings, such as whether the physician listened well, communicated clearly, and was compassionate as well as skilled in delivering healthcare services. ➢ A healthcare provider may view quality in a technical sense, such as whether an accurate diagnosis is made, whether a surgical procedure is performed proficiently and whether the patient’s health has improved. From this view, quality is the difference between what is technically sound and possible, and the actual practice and delivery of healthcare services. ➢ The health care manager, payer, or purchaser (employer health plan, or government program) may want to know if the healthcare services provided are cost effective. ➢ Public health officials may want to know if resources are being utilized appropriately to optimize population health and provided equitably within the population. Quality as defined in Clair G. Meisenheimer’s book, Improving Quality: A Guide to Effective Programs, is “. . . the totality of features and characteristics of a health care process that bear on its ability to satisfy stated or implied needs; a process or outcome that consistently conforms to requirements, meets expectations, and maximizes value or utility for the customer. For the customer: getting what you were expecting and more; for the supplier: getting it right the first time, every time.” The Institute of Medicine of the National Academies (IOM), a not-for-profit, non-governmental organization whose purpose is to provide national advice on issues relating to biomedical science, medicine, and health, and to serve as adviser to the nation to improve health, defines healthcare quality as the “degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” (Retrieved July 11, 2009 from http://www.iom.edu). Further expounding the definitions provided, the IOM developed six dimensions of quality healthcare: 1. Timeliness – refers to the length of time it takes to provide care to patients. For example, how long it takes a patient to receive a treatment or follow-up care once a breast mass is detected. Delays should be shortened to increase the efficacy of treatments and to ease the patient’s fears. 2. Safety – refers to the ability or need to avoid injuries that result from the provided care that is intended to help the patient. Injuries such as those resulting from administering the wrong drug or wrong dosage, incorrect diagnoses, etc. 3. Effectiveness – the extent to which healthcare service is provided based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit, that is avoiding over-and underuse of resources. 4. Equity – the extent to which quality care is provided without regards to a patient’s gender,...
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