The provision of quality healthcare whose value matches the health and safety needs of patients remains the biggest challenge for most health care organizations and centers. With dynamics in the healthcare sector and the introduction of healthcare legislation such as the Obama Care Act that emphasize on the provision of quality and equitable healthcare to consumers of healthcare services, most healthcare organizations have had to device strategies and come up with initiatives for ensuring quality in healthcare delivery to patients. Višnjić, Veličković and Jović (2012) define quality healthcare as one that meets and satisfies that health and safety needs and expectations of patients or customers (p.54). As a Quality Assurance Officer in a modern healthcare organization, it is important to develop and implement acceptable and conventional healthcare quality techniques and methods in order to remain relevant and competitive particularly in the private sector where quality and efficiency are paramount for survival.
Moreover, healthcare quality is directly related to healthcare costs as poor quality healthcare services increases healthcare costs for both patients an d the organization while high quality healthcare helps maximize efficiency and reduce financial costs. Quality improvement (QI) techniques and activities should therefore be a top priority for such officers responsible for quality in healthcare organizations. According to the Institute of Medicine, the main aims and goals of a quality Medicare or healthcare system in any state facility or organization are to ensure and promote patient safety, effectiveness and efficiency in service delivery, ensure time timeliness, equity in healthcare access and to ensure that healthcare system is patient-centered or responsive. Further, quality improvement in a healthcare organization entails reducing organizational costs while at the same time enhancing patient experiences and clinical outcomes
Quality Initiatives for My Organization
Contracting Quality Improvement Organizations
Entering into partnerships with firms that provide quality assessment and improvement services to healthcare and other service organizations is a great way and starting point for an organization with serious quality issues. The benefit of contracting such organizations and consultants is that they are normally made up of professionals who understand quality improvement issues better than the healthcare organization, hence likely to evaluate and recommend ways of ensuring quality.
Establishing Health Care Quality Improvement Committees
With such committees in place, a healthcare organization is better placed to manage quality issues as and when they arise within the organization. Such committees should be responsible for continuous healthcare quality assessments and recommendation on the best way forward.
Use of Evidence-Based Quality Performance and Practitioner Accountability
According to Glickman, Baggett, Krubert, Peterson and Schulman (2007), an evidence-based quality improvement and performance measurement system in a healthcare setting involves the adoption of healthcare quality policies and programs that measure quality in terms of the established medical practices. Further, by holding the medical practitioners such as doctors, pharmacists and nurses accountable for ensuring healthcare efficiency and quality, an organization is able to manage quality through individual job performance assessments. Glickman et al. (2007) argue that for such an initiative to be successful, the top senior and executive hospital management must be actively involved in setting such policies and ensuring accountability.
Other equally important initiatives for ensuring quality of care in modern healthcare organizations include the application of information management technology concept to run the various aspects of healthcare service provision in the organizations and also emphasis on healthcare quality and safety education or training workshops for nurses and doctors in these facilities. According to Dolansky and Moore (2013), the latter initiative involves the integration of healthcare safety and quality competencies into education of nurses through the systems thinking model whereby they can be able to translate the same knowledge to their nursing practice.
Reduction of Health Care Costs
Even as healthcare organizations strive to manage and reduce the costs of providing affordable healthcare services to patients, they need to do so without necessarily compromising on the quality of care for patients. According to an article that appeared in the Harvard Business Review by Kaplan and Porter (2011), healthcare costs in countries like the US are currently rising even above the GDP and hence there is need to come up with effective strategies that will not only improve quality of care, but also manage costs of healthcare and prevent it from spiraling beyond reach of patients’ reach. The authors have blamed this trend on third party payers such as governments and insurance firms that pay emphasis on reimbursing medical procedures rather than healthcare outcomes accomplished. One of the ways of reducing care costs but still ensures quality according to Kaplan and Porter (2011) is to measure costs accurately and make comparison with the healthcare outcomes. Moreover, matching clinical skills and competence to the healthcare cost measurement process is another great way of ensuring care quality while at the same time preventing costs from escalating. Also important is the development of innovative approaches to reimbursement by healthcare organizations that do not adversely affect their ability to sustain themselves financially.
Further afield, according to McClellan and Rivlin (2014), the best ways of reducing care costs but maintain quality are by “rewarding measurable value” rather than the “volume of services” offered in an organization (p. 2), enhancing competiveness of healthcare organizations to ensure ability of consumers to go for cost-effective healthcare service providers and change in healthcare organizational culture to one that encourages healthy living behaviors by their patients. Further, Stanton (2002)states that healthcare organizations can reduce costs by developing flexible spending accounts, changing employer contributing plan or methods to a single contributor, substitution of ambulatory care for hospital visits by health management organizations, merging hospitals or facilities owned by one or competing healthcare organization sand sharing the costs of insurance (p.2).
Quality in Free Market Healthcare System and Single Payer Government System
A free market healthcare system is one in which healthcare services are provided and run fully by private individuals and organizations with minimal or no government intervention, say through restrictive policies on healthcare insurance policies. Here, the prices of health care services and costs of insurance schemes are set or negotiated between healthcare providers and patients; there is minimal regulation of health provision and it is the private insurers who pay for the costs of healthcare for those patients enrolled under it. That is, it is a system that is driven to a large extent by market forces of demand and supply. An example according to Lucas (2013) is the LASIK surgery system that improves quality of healthcare without necessarily increasing the costs of care. On the other hand, a single-payer government system is a universal public healthcare service provision system controlled and managed by the state which comes up with healthcare laws, policies and regulations that aim at ensuring equitable or ethical medical practice and also sets prices or costs of Medicare. In such a system, the government provides subsidies for employer-provided health insurance schemes. Examples of the single payer system of healthcare include the Medicare, Veterans administration and Medicaid under the Affordable Care Act (Schansberg, 2011). Here, it is a single payer fund established and run by the government that caters for the healthcare costs for patients under the system.
Common Law Quality Initiatives Found in the 21 Century Healthcare Organizations
Health care quality initiatives have their origin from the common law health system where certain bare minimum standards of care were expected from organizations or facilities that provided healthcare services. Such initiatives that were there in the common law system and that have found relevance in the twenty first century health care organizations include the use or implementation of information technology to keep health records and ensure efficiency, health professional education of medical practitioners on evolving standards of care, and the prevention of medical errors made by nurses and doctors. Further, there are certain core competencies and skills that the common law regards as indispensable for medical practitioners. Such skills, values and knowledge such as integrity are important for ensuring or realizing the best health outcomes in healthcare organizations. By using information technology, healthcare organizations are able to store, process and retrieve patients’ information and medical records with ease hence reducing cases of delays in the dispensation of medical services.
Significance of Health Care Quality
The importance of ensuring that certain health care quality standards are maintained within an organization cannot be gainsaid. However, healthcare quality is beneficial to both patients and individual healthcare organizations in a number of ways. To begin with, quality health care by a healthcare organization not only promotes patients’ confidence in the organization, but also ensures that at no point in time is the safety of patients compromised by the need for profits. Moreover, the provision of quality healthcare according to Lighter and Fair (2000) helps in the reduction in mortality and morbidity rates since it ensures that there are no delays in hospitals and that care delivery is efficient, responsive to the patients’ needs and is patient-centered (p.370). Thus, with such a healthcare organizational system that is founded on quality assurance, major medical complications and conditions such as kidney failure and diabetes are promptly diagnosed and treated. Additionally, when quality standards and measures are put in place in healthcare organizations, the safety of patients is guaranteed due to reduction in or total elimination of instances of medication errors. For example, when a healthcare organization relies majorly on manual methods of managing patients’ medical files, information and records, they are likely to misplace or lose crucial medical history information about a patient that would otherwise be crucial in ascertaining a medical condition and finding the best treatment. Moreover, since treatment options for most life threatening diseases can only be done through sophisticated computerized machines, lack of the same compromises quality of treatment given to patients thus undermining the credence and reputation of the healthcare organization.
Plan for Law Compliant Protection of Patient Information
It is important for a healthcare organization which rely on IT to operate patients’ records and administer care to come up with plans that ensure that confidential information about patients is kept private. For the purposes of my healthcare organization, I would recommend a health plan that provides notice of the organization‘s patient information privacy policies and practices, establishes the prerequisites for disclosure or use of patient’s medical information; clearly spells out the rights of patients at the facility and maintains relevant documents demonstrating compliance with state and federal laws and regulations on privacy. These may include the Standards for Privacy of Individually Identifiable Health Information and Laws and Regulations Governing the Disclosure of Health Information.
Dolansky, M. A., & Moore, S. (2013, September). Quality and safety education for nurses (QSEN): The key is systems thinking. OJIN: The Online Journal of Issues in Nursing, 18(3).doi: 10.3912/OJIN.Vol18No03Man01
Glickman, S. W., Baggett, K. A., Krubert, C. G., Peterson, E. D., & Schulman, K. A. (2007). Promoting quality: The health-care organization from a management perspective. International Journal for Quality in Health Care, 19(6), 341-348.
Lighter, D.E., & Fair, D.C. (2000). Principles and methods of quality management in health care. New York: Jones & Bartlett Learning
Lucas, K. (2013, November 12). What does a "free market" in health care look like" Here's an example. The Daily Signal. Retrieved February 2016, from http://dailysignal.com/2013/11/12/what-does- a-free-market-in-health-care-look-like-here's-an-example/
Kaplan, R.S., & Porter, M.E. (2011, September). The big idea: How to solve the cost crisis in health care. Harvard Business Review. Retrieved February 12, 2016, from https://hbr.org/2011/09/how-to- solve-the-cost-crisis-in-health-care
McClellan, M., & Rivlin, A. (2014). Improving health while reducing cost growth: What is possible? The Future of U.S. Health Care Spending Conference April 11, 2014 (pp. 1-25). Washinton, DC: The Brookings Institution. Retrieved 12 February, 2016, from http://www.brookings.edu/~/media/events/2014/04/11%20health%20care%20spending/improving_health_reducing_cost_growth_mcclellan_rivlin.pdf
Schansberg, D. E. (2011, Winter). Envisioning a free market in health care. Cato Journal, 31(1), 27-57.
Stanton, M. W. (2002). Reducing costs in the health care system: learning from what has been done. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved February 12, 2016, from http://archive.ahrq.gov/research/findings/factsheets/costs/costria/costsria.pdf
Višnjić, A., Veličković, V., & Jović, S. (2012). Measures for improving the quality of health care. Scientific Journal of the Faculty of Medicine in Niš, 29(2), 53-58. doi:10.2478/v10283-012-0008-4