Managing Health Care Quality

Introduction

Quality health care delivery is important to improve the patient care experience, population health, and nurse outcomes. It also impacts a facility’s bottom line under the safety-driven, value-based reimbursement system. The quality of the healthcare service at Sunlight Hospital has a direct impact on patient satisfaction from the point of admission to discharge and necessary follow-up visits. For this reason, understanding the five quality of care measurements in this facility is essential to achieving better outcomes. Additionally, designing a successful quality improvement strategy based on specific features in health care organizations can contribute to patient safety, reduced readmissions, and lower mortality. Identifying these features will enable the suggestion of salient reasons why improving the quality of health care adds value by creating a competitive advantage against other hospitals.

Quality of Care Measurements

The quality of care measurements helps quantify the clinical processes and patient experiences. In this case, the inputs are transferred into outcomes of health systems. Donadedian defined a classical framework to measure the quality of care that formed a distinction between three classifications: organizational structure, clinical processes, and resulting outcomes. However, in recent years, the concept has been developed further to include quality of care domains that include efficiency, effectiveness, equity, safety, timely, and patient-oriented (Mercuri, 2019). The clinical efficiency measure aims at reducing the wastage of resources such as medical supplies, personnel energy, or ideas. In contrast, the effectiveness of quality of care is measured via the services provided based on scientific knowledge (Mercuri, 2019). These services should be aimed at patients who can benefit from them as opposed to the public.

By following these concepts, efficiency at Sunlight Hospital can be measured by comparing inputs, such as nursing hours, to outputs – hospital admissions and discharges. The third domain, equity, requires health care providers to deliver services without discrimination against unique characteristics such as gender, race, location, or status based on finances (Breyer et al., 2019). Its measurement at Sunlight Hospital will involve utilization rates and access by different groups with diverse needs determined from a community health assessment. The quality of care should be consistent across the board.

Safety is the fourth quality metric that Sunlight Hospital can use. Avoiding causing harm to patients by providing appropriate care forms the basis for safety in measuring quality. The medical error rate and 30-day readmissions will be a useful quality metric at Sunlight Hospital. Additionally, patient-centered care that reflects individual needs and values can improve inpatient experience as measured through patient satisfaction surveys. In patient-centered care, health providers are encouraged to ensure patient involvement in key clinical decisions.

When choosing a hospital for emergency or inpatient care, patients can use four quality metrics (clinical efficiency, effectiveness, safety, and patient-centered care) to the domain to improve outcomes. In my opinion, the quality rating of a facility based on publicly reported measures influences the patient selection of a hospital because of the associated reputational effects. Patient choice of emergency or inpatient care depends on the efficiency and effectiveness of clinical services, safety, and patient-centeredness.

Features in Health Care Organizations

Implementing large-scale changes at Sunlight Hospital can be challenging; hence, a microsystems approach is required. According to Breyer et al. (2019), the features in a healthcare organization essential to designing a successful quality improvement (QI) project include adaptive leadership and culture, analytics, evidence-based practices, and financial alignment. Teams within a hospital could be dedicated to QI but their efforts may not be successful without top leadership support and commitment. Data-driven decisions and an adaptive culture are needed at the administration level to prioritize QI initiatives. A second feature essential to sustained QI is analytics, which allows a comparison of a change to baseline data to determine improvement milestones achieved (Breyer et al., 2019). A quality improvement cycle, PDSA (plan, do study, and act), is a standard approach to measure and sustain the outcomes of QI efforts.

Evidence-based best practices in a healthcare organization are the foundation of quality improvement. Assessing and integrating research evidence on safety, efficiency, effectiveness, and patient-centered care into clinical processes, including nursing interventions, can impact outcomes. Further, adopting automation in evaluating best practices in healthcare is useful in building QI-oriented culture in a facility. The organization must also allocate resources to implementing QI initiatives. Training, performance measurements, and staff motivations are all linked to successful QI efforts (Breyer et al., 2019). The goal is to build the organization’s capacity to adapt and lead quality improvement programs throughout the facility. Another critical organizational feature is financial alignment with quality improvement goals. A hospital must align its payment models with metrics used to evaluate QI efforts. It must link its processes and structures to the value-based purchasing incentives.

The four features identified are significant success factors in designing and implementing a QI project. Successful adoption of quality improvement at Sunlight Hospital will require adaptive leadership to prioritize and sustain QI efforts by promoting a culture of learning in the facility to address specific problems. An analytics system will help capture data for use to measure improvements at each phase of a QI project, while evidence-based best practices will ensure the provision of consistent, high-quality care aligned with national standards. The financial alignment will enable Sunlight Hospital to provide budgets to units or departments according to its quality priorities. Misalignment will lead to resource wastage, variation in clinical services, and inefficiencies (Breyer et al., 2019). Therefore, successfully sustaining QI efforts requires a deeper understanding of the critical prerequisites for designing such programs.

Quality of Care Value Addition

Competitive advantage is a business strategy for creating a unique customer value in the industry. Quality, safety, and patient-centered care ensure higher value to patients. Value-based incentives will increase for Sunlight Hospital by improving its quality metrics. As a result, it will become a facility of choice in California because of better process outcomes and reputation. Another reason is quality results in cost leadership; offering the lowest price due to efficiency gains is a competitive advantage (Drew & Pandit, 2020). QI efforts at Sunlight Hospital will reduce wastage and ensure minimal costs, allowing the facility to offer care at the lowest price.

Conclusion

Health care delivery aims to improve both the patient experience and clinical outcomes. Measuring the quality of health care using metrics such as efficiency, effectiveness, safety, and patient-centeredness is a priority area under the value-based payment system. It also ensures consistent QI efforts to provide quality, affordable care that meets patient needs and expectations. Successful continuous quality improvement requires key organizational features or prerequisites, including adaptive leadership, evidence-based best practices, and financial alignments. Using nationally recognized metrics, Sunlight Hospital can measure, improve, and maintain the quality of care consistently across all organizational levels as a competitive strategy.

References

Breyer, J. Z., Giacomazzi, Kuhmmer, R. J., Lima, K. M., Hammes, L. S., Ribeiro, R. A., Kops, N. N., Falavigna, M., & Wendland, E. M. (2019). Hospital quality indicators: A systematic review. International Journal of Health Care Quality Assurance, 32(2), 474-487.

Drew, J. R. & Pandit, M. (2020). Why healthcare leadership should embrace quality improvement? The BioMedical Journal, 368, 1-4.

Mercuri, M. (2019). The “problem(s)” with quality improvement in health care. Journal of Evaluation in Clinical Practice, 25(3), 335-337.

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