The Value of a Quality Assurance Department Incrisis hospital has been concerned
ID: 127487 • Letter: T
Question
The Value of a Quality Assurance Department
Incrisis hospital has been concerned with the increased number of calls from patients regarding their quality of care from a variety of departments, including its emergency room, and its surgery, oncology, and X-ray/lab departments.
Incrisis is a 100-bed acute facility and was established in 2006. The human resource department hired you as a consultant to review the quality of care issue and make a recommendation on creating a quality assurance department.
Develop a 10- to 15-slide PowerPoint presentation to provide to the board of directors.
The presentation should cover the following topics:
The link between cost and quality in healthcare. Cite at least two studies conducted in the past five years supporting your response.
The role health insurance plays in cost, quality, and healthcare consumer expectations.
The various customers (e.g., patients, families, providers, insurance companies) and the healthcare quality from their perspective.
At least three current business initiatives driving healthcare quality.
The role that national policy plays on the quality of healthcare.
A clear explanation of why the quality assurance department should be created.
Submit the PowerPoint presentation to the Submissions Area by the due date assigned.
Maximum Points
28
24
32
24
24
24
44
200
Assignment 2 Grading CriteriaMaximum Points
Discussed the link between cost and quality in healthcare and cited two studies.28
Described the role health insurance plays in cost, quality, and healthcare consumer expectations.24
Identified the customers and defined healthcare quality from their perspective.32
Identified three business initiatives driving healthcare quality.24
Articulated the impact of national policy on the quality of healthcare.24
Demonstrated an understanding of the principles and practices of healthcare quality by making a recommendation to create a quality assurance department.24
Style (4 points): Tone, audience, and word choiceOrganization (12 points): Introduction, transitions, and conclusion
Usage and Mechanics (12 points): Grammar, spelling, and sentence structure
APA Elements (16 points): In-text citations and references, paraphrasing, and appropriate use of quotations and other elements of style
44
Total:200
Explanation / Answer
Slide 1 What is Quality Care?
The quality of care is “the extent to which health care services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, health care must be safe, effective, timely, efficient, equitable and people-centred.” (WHO)
Slide 2 Basic Elements of Quality Care
Safe. Delivering health care that minimizes risks and harm to service users, including avoiding preventable injuries and reducing medical errors.
Effective. Providing services based on scientific knowledge and evidence-based guidelines.
Timely. Reducing delays in providing and receiving health care.
Efficient. Delivering health care in a manner that maximizes resource use and avoids waste.
Equitable. Delivering health care that does not differ in quality according to personal characteristics such as gender, race, ethnicity, geographical location or socioeconomic status.
People-centred. Providing care that takes into account the preferences and aspirations of individual service users and the culture of their community.
Slide 3
Quality comprises three Components
1.Structure
-Stable material characteristics (infrastructure, tools, technology)
-Resources of the organization
-Financing of care
Slide 4
2.Process(transformation of inputs from the health care system into health outcomes)
Slide 5
3. Outcomes
health status
Deaths
morbidity
Disability adjusted years
Patient satisfaction or responsiveness to the health care system
Slide 6
Benefits of Cost:
Individual:
Higher quality prenatal and post natal care decreases mortality and improves subsequent school performance
Social:
Slide 7
Studies Supporting Cost and quality:
1.Steven T. Fleming The Relationship Between Quality and Cost: Pure and Simple? InquiryVol. 28, No. 1 (Spring 1991), pp. 29-38
This study focuses between quality and the cost of hospital care. Findings of the Study revealed that cost regressions that include outcome indicators of hospital quality:Risk adjusted mortality and readmission indices.Hospital level data are aggregated from a modified 1985 medicare provider Analysis file and the commission of professional and hospital activities.Results show several quality measures to be statistically significant determines of cost. With each measure the cost quality relationship is nonlinear but not monotonically increasing throughout the entire range of quality.
Slide 8
2.Deborah Peikes, PhD; Arnold Chen, MD, MSc; Jennifer Schore, MS, MSW; et alRandall Brown, PhD Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare Beneficiaries-15 Randomized Trials,JAMA. 2009;301(6):603-618. doi:10.1001/jama.2009.126
Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care, patient adherence, and communication.The Objective was to determine whether care coordination programs reduced hospitalizations and Medicare expenditures and improved quality of care for chronically ill Medicare beneficiaries.
Hospitalizations, costs, and some quality-of-care outcomes were measured with claims data for 18 309 patients (n = 178 to 2657 per program) from patients' enrollment through June 2006. A patient survey 7 to 12 months after enrollment provided additional quality-of-care measures. Nurses provided patient education and monitoring (mostly via telephone) to improve adherence and ability to communicate with physicians. Patients were contacted twice per month on average; frequency varied widely.Viable care coordination programs without a strong transitional care component are unlikely to yield net Medicare savings. Programs with substantial in-person contact that target moderate to severe patients can be cost-neutral and improve some aspects of care.
Slide 9
Triangle of Iron
The health care systems operate in a dynamic and complex relationship: Cost, Quality, and Access. The Triangle is Iron because it is generally difficult to have a low-cost, high quality, wide access health care system. It is generally assumed that if quality increases, then costs must increase as well.
Slide 10
Perspectives:
Client: Services And activities that meet the needs of clients in achieving their expectations and outcome
Insurance provider Perspective: “Services and activities which meet the needs of clients, need to be- Medically safe ,Professionally ethical, Accessible, & acceptable to all..
Provider Perspective: “Services and activities that meet the needs of clients and program goals need to be- • Safe, • Satisfying, • Affordable, • Accessible and • Delivered in a technically competent manner within the socio-cultural context of the country.
Slide 11
current business initiatives driving healthcare quality.
-Policy formulation, health legislation, regulation and control
- Resource mobilization and allocation, coordination and intersectoral linkages
- Public health related interventions
- Management support of level three hospitals including National, Referral, and Special Hospitals
- Supervision and Monitoring of special and Referral Hospitals owned by NGOs
- Provision of feedback to other levels
- Training of key professional health cadres and monitoring quality of training
- Monitoring and evaluation of health services countrywide
- Supervision and inspection of provision of health services
- Health research
- Mobilizes resources - Interprets policies into actions
- Provides technical support to the districts
- Coordinates, supports supervision, monitoring and inspection of all health facilities and activities in the district
- Mobilises resources and management
- Ensures communities are responsible in taking care of their own health and also the safety of medicine and equipment in their health facilities.
Slide 14
Need for quality assurance department
satisfying Internal & External customers’ requirements.
· Increase Productivity.
· Quality health outcome( Speedy recovery, Reduced Mortality,Life Expectancy)
Cost effective care
Correct Identification of human resource.
· Increase in Revenue.
· Increase in Clients.
Make a branded organisation
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