Quality measures are crucial in hospitals as they help gauge the patient care provided. These measures include quality indicators, process indicators, and clinical indicators. The results of the measures are determined by scientific evidence that reflects practice parameters, guidelines, and level of care. These measures process medical information into percentage or rates from patient records, hence allowing facilities to assess their health care service (Mira et al., 2014). In the past, health organizations health was defined as the standard and complete state of physical, social and mental well-being. As of today, the health care process focuses on the health need, satisfaction of the care process and the minimization of the patients’ burden, for instance, Medicare cost. This paper deals with the evaluation of the medical care process at the various hospitals, and the impact rating programs have on hospitals service delivery (Austin et al., 2015).
The Brooklyn Hospital Center has undergone significant developments since the 18th century, and become fully modernized after World War II. In 2013, the center advanced its acute care services, primary and outpatient services, and mainly put into focus an initiative of chronic disease prevention. The hospital has partnered with many organizations including, the community-based Organizations, Federally Qualified Health Centers and Community Advisory Board (CAB). CAB measures and identifies health needs, guidance concerning the scope and quality care towards the residents. In addition, the hospital uses hospital surveys concerning patients’ culture; it is electronically enabled to receive and track lab results, tests and referrals. To end with, it provides emergency services, and it uses both inpatient and outpatient services.
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Surveys conducted by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) rates the patients’ past stay experience. Brooklyn Centre has sole rating together with Kings County Hospital Center while as for the other competitor, University Hospital of Brooklyn has a double rating and a single rating. The communication between the doctors and patients impacted the rating in University Hospital center since it is above average. Generally, the three hospitals have produced poor ratings due to the low average performance in the patient experience.
The measure of Timely and Effective care is also quite disappointing as the hospitals have a one-star rating. The measure shows how quickly hospitals provide care; it is based on research done in the context of the patient’s result in certain conditions. The ratings in the hospitals portray a below average performance compared to the New York average and also the national average.
Next is complications and death measure of which the same hospital has a relatively poor performance, it gauges the admitted patients who get medical complications in the health care process, for instance, serious injuries or even a worse scenario of death. Some patients are likely to be re-admitted due to poor health care practices that can result in complications. The Brooklyn Hospital Centre out ways its competitors as it has no significant issues in infection cases, 30-day death rates or surgical complications, but the other two have substantial problems in surgical complications.
Unplanned hospital visits result in unexpected usage of money, disruption of patients’ lives and lead to a higher increase in risks like healthcare-associated problems. This measure reporting on unplanned visits is divided into three types, namely, rate of readmissions, rates of hospital visits and hospital return days. It is clear that the three hospitals have high numbers of readmission cases after discharge have been made to patients, worse than the national rate.
Next is the medical imaging usage measure, also a low rating, as from the hospitals outpatient departments. These measures clearly show the information behind a hospital’s use of medical imaging tests, for example, CT scans, MRIs and mammograms. It is precisely for outpatients based on risk prevention, stress and cost avoidance, identification of problems in screening procedures, and upholding of patient safety in practices that involve radiations or other related. In the overall performance, Brooklyn Hospital is better compared to the University Hospital; for instance, the University Hospital has many unnecessary follow-ups for MRI or mammograms. Kings county hospital has many information gaps making it unreliable.
Lastly is the payment and value of health care. Here, the measure is done using the Medicare Spending per Beneficiary; it confirms whether Medicare spent by a treated patient for an episode of care in a particular hospital is more, equivalent or less compared to all inpatient hospitals nationally. The payment includes a three day before a hospital stay, the actual hospital stay of the patient and the 30 days after the discharge period. The payments can be from the patients themselves, health insurers or from Medicare. The hip/knee replacement cost is higher than the national average in Brooklyn Hospital Center, the ratings for University Hospital are optimal, and the payment for heart attack is less in Kings County Hospital.
The public call of accountability in health care quality in various health organizations has contributed to the development of websites that post the ratings of the mentioned data sets to the public, however, the disadvantages that arise (Huesch et al., 2014). These quality measures might be misleading, being based on things such as readmissions may not be convincing enough. In a point of view, system appears as inaccurate as the result of a particular hospital can annually change significantly. For instance, Brooklyn Hospital can reduce its knee replacement cost within planned duration. In addition, the consequences of the ratings in individual hospitals can cause unnecessary or inappropriate care, and provision of false information to patients as they would aim to please patients in getting better satisfaction scores or good ratings (Detsky et al., 2013).
The advantages of the 5-star system exceed the shortcomings of it. The system ensures the tooling up of events in preventing the Never Events; these are the serious, preventable medical mistakes that should not happen at all. These include infections after treatment and retention of foreign objects after surgery. Making reports of such related cases, such as the Kings County hospital will result in the increase of hospital accountability which in turn increases the hospital’s pressure in eliminating the occurrences (Cantrell, 2016).
The system also promotes a culture of safety; readmission of patients causes them to develop emotional distress. With psychological assessments of the patients and ratings of unplanned hospital visits in the mentioned hospitals, the hospitals are obligated to promote the culture of safety (Cascio, 2016). Furthermore, the system fosters disclosure about the risks involved in trials. It can either be done by examining the toxicity profiles of involved drugs during a trial, then determine whether the drugs to be used can exceed the daily life standard (Kennedy et al., 2014). It consequents to risk minimization or assessing the increment of risks, that can either arise from therapies or medical imaging tests. With the ratings, one can choose a hospital with the least, or zero incidences of patient safety complains to seek imaging service or other related. Brooklyn hospital center is the best pick among the three (Joffe, 2014).
Rating programs offer people crucial information to use when choosing hospitals that meet their needs. But still, people defer physicians’ recommendations, or else they chose certain hospitals that surgeons have privileges. The big deal becomes the questioning of the impact; the ratings have on the quality improvement if it is that way (Bardach et al., 2013). Transparency should be embraced, to give patients more information and encourage health providers to change their behavior. Implementation of rating programs should be advocated for, as it favors social care providers and the general practices (Kumpunen et al., 2014).
References
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Cascio, C. (2016). Spotlight on safety. The role of patient spirituality in a culture of safety. ONS Connect.
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Detsky, J., & Shaul, R. Z. (2013). Incentives to increase patient satisfaction: Are we doing more harm than good?. CMAJ , 185 (14), 1199-1200.
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Kennedy, G. D., Tevis, S. E., & Kent, K. C. (2014). Is there a relationship between patient satisfaction and favorable outcomes?. Annals of surgery , 260 (4), 592.
Kumpunen, S., Trigg, L., & Rodrigues, R. (2014). Public reporting in health and long-term care to facilitate provider choice.
Mira, J. J., Lorenzo, S., & Navarro, I. (2014). Hospital reputation and perceptions of patient safety. Medical Principle.
Huesch, M. D., Currid-Halkett, E., & Doctor, J. N. (2014). Public hospital quality report awareness: evidence from National and Californian Internet searches and social media mentions, 2012. BMJ open , 4 (3), e004417.
