It is the desire of the medical community to provide patients with the best possible quality of care. Members of this community have dedicated immense effort toward the achievement of this desire. For example, the community has been able to significantly reduce child and mother mortality through the implementation of various safeguards. Despite the commitment that healthcare professionals have demonstrated, much still remains to be done. Among the issues that are derailing progress is the failure to adopt comprehensive assessments of quality of care. If patients in the US and other parts of the world are to witness improvements in the quality of care that they receive, the medical community will need to re-evaluate how it assesses quality.
Dimensions of Quality of Care
In previous years, it was left to practitioners to determine for themselves if the care that they offered was in line with quality standards. The self-assessments that they performed were important as they offered insights into the need for improvement. Today, other additional dimensions have been adopted as part of quality of care assessment. Patient experiences and perspectives are among these dimensions (Beattie et al., 2015). Since they are the recipients of care, patients are best placed to determine quality. By obtaining feedback from patients, practitioners and healthcare institutions are able to establish if the care that they provide meet the expectations and the needs of patients. The importance of patient experiences and perspectives is that they facilitate quality improvement. If it is determined that patients are not satisfied with the care provided, measures can be instituted to improve service delivery. Apart from the views of patients, harm prevention and patient safety are other metrics for assessing care quality (Cohen, 2012). Hospitals have a mandate to take all necessary steps to ensure that the environment is free of hazards and enhances patient wellbeing. By fulfilling this mandate, the hospitals enable patients to experience the highest levels of care. Harm prevention and patient safety are important because they secure patient wellbeing while safeguarding the image of healthcare providers. If a healthcare institution is found to be unsafe and riddled with health hazards, its image is likely to suffer and may become the subject of punitive government and regulator action. Therefore, healthcare providers should spare no effort as they strive to create safe environments.
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Patient experiences and the steps that medical institutions take to enhance safety and prevent harm are not the only measures of quality of care. Effective learning is yet another metric that can be used to assess how well hospitals are fulfilling their mandates (Wright, 2009). Medical institutions need to engage in continuous learning. To achieve this, they should encourage their practitioners to embrace life-long learning. It is through learning that the institutions are able to adopt latest insights, technologies and interventions into the delivery of quality care. Another metric for evaluating quality of care is clinical performance (Cohen, 2012). Essentially, this metric is concerned with such issues as the cost-effectiveness of treatment, outcomes of treatment and the general delivery of care. Clinical performance measurement is vital as it enables medical service providers to determine if the care that they offer meets set standards and is in line with their objectives and strategies. As noted earlier, doctors are no longer relied on to offer personal assessments of the quality of care. Instead, a comprehensive approach that combines various performance measurement metrics has been adopted. This approach is far more reliable and offers an accurate depiction of the state of the healthcare system.
Health Care System and Resource Allocation Addressing Quality of Care
The utilitarian model has been adopted to enhance the quality of care offered to patient populations. Basically, through this model, healthcare providers endeavor to provide care that delivers the greatest amount of benefit while keeping costs low. The priorities that the American healthcare system pursues and resource allocation have facilitated the achievement of quality of care in the United States. Improving access for disadvantaged communities, achieving the goals of the Healthy People initiative and reducing the cost of care are the key priorities that the US is pursuing (“2016 National Healthcare”, 2018). Minority communities in the US have historically lacked adequate access to quality and affordable care. Consequently, they have suffered poor health outcomes. By working towards enhancing equality and parity in the delivery of care, the US has clearly demonstrated its dedication to improving the quality of care. The country has also implemented various measures with the hope of ensuring that all its citizens enjoy high quality medical services. For example, through expanded insurance coverage and the adoption of such frameworks as the Affordable Care Organizations (ACOs) model, the country is striving towards enhanced care quality (Burke, 2011). There is no doubt that if it sustains these efforts, the US will achieve its healthcare priorities and goals.
Apart from the priorities that it pursues, the US is also seeking to deliver quality and low-cost care through efficient resource allocation. Rationing is an element of resource allocation that defines healthcare in the US today (Daniels, 2016). Given its limited budget, the US is able to allocate funding for all healthcare issues. It is therefore compelled to fund operations and programs that are vital. This is the essence of efficient and wise resource allocation. As it allocates resources, the US focuses more on the needs of vulnerable populations. For example, the poor and racial minorities receive a bulk of the funding set aside for healthcare. While rationing has enabled the US government to maximize benefit while minimizing cost, it has raised ethical questions. One may wonder what authority the government has to prioritize certain patient populations while neglecting others.
Implicit and Explicit Criteria
There are two main approaches for evaluating the quality of care that practitioners offer: implicit and explicit. On the one hand, the implicit criterion involves assessing care quality on the basis of some global set of standards (Kerr et al., 2007). Basically, this criterion requires individual practitioners to use their own judgment and experiences to determine if the quality of care that they provide is at par with standards and expectations. On the other hand, explicit criteria involve the use of some standard guidelines to assess care quality (Kerr et al., 2007). Instead of relying on personal perspectives and impressions, practitioners who adopt this criterion work with set guidelines and standards. The difference between implicit and explicit criteria extends beyond how they are used to perform assessments. Reliability is another issue that distinguishes the two approaches. It has been shown that since it involves the use of standard guidelines, the explicit criterion is far more reliable and its results are accurate (Kerr et al., 2007). While there are differences in the level of reliability of implicit and explicit criteria, they are both useful for evaluating the quality of care.
In conclusion, the measures that the medical community has implemented to improve quality of care is evidence that the community is dedicated to safeguarding the wellbeing of patients. The state of affairs today stands in stark contrast to the situation in previous years. In the past, physicians served as the assessors of their own performance and the overall quality of care. Today, various approaches and tools are used to determine if the quality of care meets standards and expectations. Some of the measures that constitute these approaches include patient safety and perspectives. Thanks to these metrics, it has become possible to gain a better understanding of the state of healthcare in the US. There is need for the American medical fraternity to commit to constantly improving the quality of services that they offer.
References
2016 National healthcare quality and disparities report. (2018). Agency for Healthcare Research and Quality. Retrieved August 11, 2018 from
https://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/overview.html
Beattie, M., Murphy, D. J., Atherton, I., & Lauder, W. (2015). Instruments to measure Patient experience of healthcare quality in hospitals: a systematic review. Systematic Reviews, 4, 97. DOI: https://doi.org/10.1186/s13643-015-0089-0
Burke, T. (2011). Accountable care organizations. Public Health Reports, 126 (6), 875-8.
Cohen, D. L. (2012). Quality in healthcare: a five-dimensional view. Patient Safety and Quality Healthcare. Retrieved August 11, 2018 from https://www.psqh.com/analysis/quality-in-healthcare-a-five-dimensional-view/
Daniels, N. (2016). Resource allocation and priority setting. In Barrett, H. D., Ortmann, W. L.,& Dawson, A. Public health ethics: cases spanning the globe. New York: Springer.
Kerr, A. E., Hofer, T. P., Hayward, R. A., Adams, J. L., Hogan, M. M., McGlynn, E. A., & Asch, S. M. (2007). Quality by any other name? A comparison of three profiling systems For assessing health care quality. DOI: 10.1111/j.1475-6773.2007.00730.x
Wright, J. (2009). Measuring the quality of hospital care. BMJ, 338. DOI:https://doi.org/10.1136/bmj.b569
