Improving Health Care Quality Indicators

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

What is HEDIS? This abbreviation stands for the Healthcare Effectiveness Data and Information Set. This information set has morphed in its usefulness since 1991, where it was first termed the “HMO Employer Data and Information Set” (AHRQ, 2010). Since its inception, this information has been used by a majority of the country’s health care plans to evaluate performance. Today, the data sets allow for evaluation and more fluid comparison of certain areas of care and service. Furthermore, HEDIS comprises eighty-one measures that spans over five domains of care. Due to this amount of information gathered, stakeholders are given the opportunity to compare different plans in similar terms. In addition, the healthcare plans have the availability to view their own rankings to make necessary adjustments. The data sets are also examined to assess which plan is best for employers and employees based on specific needs. This data is also utilized when seeking accreditation and is now a powerful reimbursement tool. The HEDIS results are accessible for stakeholders via Quality Compass, which is a web-based tool that allows one to view and compare benchmark information (HEDIS, 2015).

Keywords: The Joint Commission, Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, The American Nurses Association, Hospital Inpatient Quality Reporting,

McLaughlin, C.P., & Kaluzny, A.D. (2006). Continuous Quality Improvement in Health Care, Third Edition, Jones & Bartlett Publishers, Sudbury, MA.

Quality Improvement Organizations (QIOs), work in partnership with the Centers for Medicare and Medicaid Services (CMS) to advocate for safe, efficient, and quality healthcare for Americans. Working at the community level, QIOs collaborate with providers and interact with beneficiaries to improve patient outcomes. Additionally, QIOs support new models of care and promote healthcare goals endorsed by the National Quality Strategy, and CMS Quality Strategy. CMS has strategically placed QIOs in several regions nationwide, and Mississippi is served by Information and Quality Healthcare (IQH). IQH founded in 1971 as a non-profit organization has strived to improve the quality of care received in Mississippi. IQH participates in a tobacco cessation helpline, behavioral health services, and diabetes education for Medicare beneficiaries.

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

All of the quality indicators are important for hospital quality but the in-patient quality indicators for mortality rates are essential for better care. Research has shown that mortality indicators varying across different hospitals and suggests there could be deficiencies in quality of care that is causing this wide range. Therefore the mortality rates as quality indicators are important to provide better quality of care across our

Outcome measurements are used to evaluate the health status of patients following the care he/she has received in a given hospital. The measurements look at both the intended and unintended effects such care might have had on the health status of patients and general function. They also help evaluate the level to which a hospital is achieving its goals as they relate to the care being provided to a patients. Outcome measurements usually include traditional measures such as mortality, morbidity, and issues that are related to quality of life. They incorporate patient satisfaction reports related to the healthcare services they have received. These measures are important to patients looking for a hospital as he/she may seek the opinion of persons who have previously received medical care in a given hospital (Jha &Epstein, 2010).

Once data is collected it can be used by numerous health care providers and decision makers to monitor the health and needs of individuals and populations, as well as contribute to the analysis of the health system. Users including hospitals, health care practitioners, government, professional associations, researchers, media, students, and the general public. Having the correct and up-to-date coded data is critical, not only for the delivery of high-quality clinical care, but also for continuing health care, maintaining health care at an optimum level, for clinical and health service research, and planning and management of

Quite informative, your post, I found it interesting that the quality improvement initiative dates back to the 19th century, and with whom it all began. Today the standards as you stated, are being set and monitored by the Joint Commission and the Centers for Medicare and Medicaid in all settings, including durable medical equipment. Patient awareness plays an integral part in the quality of care as well. After an inpatient stay, most facilities have their patients complete a 10-page survey surrounding their care. That gives a first-hand account of the areas that mean the most to the person receiving care. Excellent work!

The healthcare system is very important in maintaining the health status of various individuals. The quality of health care provided to patients, is relevant in determining the outcome of the patient’s health care.

Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.

The first quality initiative that could increase patient satisfaction and potentially reduce healthcare cost is the national data warehouse. According to Brennan, Cafarella, Kocot, McKethan, Morrison, Nguyen, Shepard & Williams II (2009), “this type of quality analysis needs to be valuable to both payers and consumers. For payers, quality analysis helps them potentially understand payment mechanisms, quality providers, regional differences and medical management techniques. For consumers, there is a better understanding of practice and potentially cost differences of providers. So, the primary purpose for creating a national data warehouse will be to develop key quality measures that all parties can agree on.” The second quality initiative that could increase patient satisfaction and potentially reduce healthcare cost is creating one common contract between all health plans and providers (Brennan et al., 2009). According to Brennan et al., (2009), “to accomplish this, a national group comprised of government personnel and knowledgeable provider contractors from the health plans will set national guidelines. Regional contracting groups will be entirely made up of current health plan contractors and will do the local contracting under

The institute of Medicine (IOM) defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Lohr, 1990). This means that when measuring quality of health care services performance it has to focus on improving the health status of an individual and or the population. Effectively measuring quality to an individual’s satisfaction will be challenging because the perception of what is quality to one person can be different to the other. Further, health care provides will have to use scientific methods that are consistent with current professional knowledge to effectively measure quality of performance.