Measuring Quality Healthcare
Measuring quality healthcare is critical as it helps show the performance and how various aspects of healthcare services can be improved. It entails the process of evaluating healthcare plans concerning set quality standards. Dy et al., (2015) argued that the measures can take multiple forms and can include hospitals systems, healthcare settings, imaging services, and overall hospital systems. Besides helping how various aspects of the healthcare system can be improved, healthcare quality measurement is critical towards improving the value of healthcare. Research indicates that there are instances in which patients receive inadequate and improper healthcare services, overuse and underuse of various aspects of healthcare services, and uncoordinated service delivery. These can no doubt, lead to numerous devastating effect on patients. According to Singh and Sittig (2015) q uality measuring can thus be used to prevent underuse, overuse, and misuse of healthcare provisions. It can also help in the identification of factors that can help drive healthcare improvement. At the same time, it can help in setting the appropriate standards of quality care within the healthcare facilities. Other benefits include aiding in making informed decisions, addressing healthcare service disparities, and providing accountable healthcare services.
There are four essential types of quality measures; patient experience, outcome experience, process and structural measurement. The paper will look into structural and process measures.
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Structural Measures
Under structural measures, consumers are provided with an essential awareness of the healthcare provider’s processes, systems, and capacity towards offering standard quality care. For example, the number of certified physicians within the facility, the ratio of physicians to patients, and strategies by which the healthcare provider applies the use of medication orders, medical records, and information technology ( Josephson et al., 2017) . The central focus of structure measures is to assess the trait of policies on healthcare delivery, procedures, personnel, and setting. For example, the action can seek to measure the healthcare facility has a critical physician within the facility at all times.
Process Measures
These show the healthcare provider’s engagement towards improving, maintaining good health for both healthy and sick people within its healthcare setting. They are a reflection of the recommended recommendations for healthcare practice. For example, Singh and Sittig (2015) posited that the number of people diagnosed with diabetes or those requiring preventive services, for example, immunization. According to Dy et al., (2015) these measures can help consumers understand what they expect to get in concerning their health conditions and how they can contribute towards making the outcome better about set standards. In essence, process measures are designed to evaluate if and how services are in line with clinical care. For example, how does a physician ensure that a patient is granted recommended diagnosis?
Process measures do play an essential role in informing consumers what they expect to get for their disease or condition and how can it improve their health results. Most public reporting uses process measures. For best results, it is vital to know what to measure. For example, it is critical to choose measures that are critical and relevant to patients, means that address identified gaps within the healthcare facility, standards that are aligned with specific healthcare practice ( Singh & Sittig 2015) . At the same time, it is vital to align the measures against regional or national initiatives that may include Core Quality Measures Collaborative, Merit-based Incentive Payment System or payers. The standards also need to align to specific determinable objectives in addition to remaining relevant to the medical practice and the people targeted.
Towards Best Results
Additionally, for best results, it is critical to understand the primary and relevant components of the measurement quality. For example, Moore et al., (2015) argued that it is necessary to know that a measure must have several parts that include the Measure ID; for example, the Electronic Clinical Quality Measures has a particular version number and ID. For instance, the measure ID for a health complication such as screening breast cancer is NQF #2372, MIPS Quality ID #112, and CMS Ecqm #125v5 ( Singh & Sittig 2015) . At the same time, the measure must have a measurement period, value sets, exceptions, and exclusions in addition to denominator and numerator. The denominator represents a fraction applied in calculating a rate. The numerator represents the upper component of a fraction utilized in working out the rate.
Benchmarking entails the comparison of one’s performance and process to the most appropriate practice and performance within the healthcare sector (Dy et al., 2015). Benchmarks are often set within the payers or data registries, and they are essential towards motivating improvement.
Various aspects make a measure critical within the healthcare industry. For example, to what level is the measure important, feasible, scientifically measurable, or achievable? It is vital to evaluate a measure in line with its usability and measures alignment to achieve the above objectives. For instance, according to Josephson et al., (2017) competing or similar measures need to be harmonized or compared with the most appropriate measures duplicated or removed. It is thus critical to align standards with the Core Quality Measures Collaborative set by AAFP.
Towards Improving Organizational Effectiveness
The above two methods of quality measurement aim at improving healthcare service delivery, improve patient, positive outcome, and monitor how the results align with the general objective of healthcare delivery. Quality measurements are critical towards aligning the best practices with issue and efficiency. For example, process measurement can serve as a vital source of vital information towards improving physician’s engagement with the consumers. According to Moore et al., (2015) the measures are vital in enhancing the willingness of healthcare providers in aligning their services with the best clinical practice. The measurement will provide the most reliable information towards setting target requirements in addition to helping formulate the best practices and policies within the workplace.
Physicians, nurses, and the overall working personnel with the healthcare facility will have the most appropriate benchmark to set their goals and patient outcome. Singh and Sittig (2015) stipulated that t he practices will, at the same time, help the healthcare management and set an applicable standard that all physicians and nurses will meet to improve service delivery and outcome ( Josephson et al., 2017) . Since it is only possible to manage what can be measured, the measurement applied will form the basis of anchoring management practices for the best outcome. The results from the measurement will no doubt play a critical role in setting the standard and goals to be achieved with the single aim of improving patient care and outcome. It is thus crucial to ensure that the type of measurement applied and used is relevant to the general management objective of the healthcare facility.
References
Dy, S. M., Kiley, K. B., Ast, K., Lupu, D., Norton, S. A., McMillan, S. C., ... & Casarett, D. J. (2015). Measuring what matters: top-ranked quality indicators for hospice and palliative care from the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association. Journal of pain and symptom management , 49 (4), 773-781. https://www.jpsmjournal.com/article/S0885-3924(15)00073-1/fulltext
Josephson, E., Gergen, J., Coe, M., Ski, S., Madhavan, S., & Bauhoff, S. (2017). How do performance-based financing programmes measure quality of care? A descriptive analysis of 68 quality checklists from 28 low-and middle-income countries. Health policy and planning , 32 (8), 1120-1126. https://academic.oup.com/heapol/article/32/8/1120/3855112
Moore, L., Lavoie, A., Bourgeois, G., & Lapointe, J. (2015). Donabedian’s structure-process-outcome quality of care model: Validation in an integrated trauma system. Journal of Trauma and Acute Care Surgery , 78 (6), 1168-1175. https://journals.lww.com/jtrauma/Abstract/2015/06000/Donabedian_s_structure_process_outcome_quality_of.16.aspx
Singh, H., & Sittig, D. F. (2015). Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework. BMJ Qual Saf , 24 (2), 103-110. https://qualitysafety.bmj.com/content/qhc/24/2/103.full.pdf
