...Running head: COST AND QUALITY ANALYSIS Healthcare cost and quality Grand Canyon University July 24th, 2012 Ethics, Policy, and Finance in the Health Care System Sally L. Clark A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare. Differences in HealthCare Cost and Quality Working in the healthcare system, you often wonder if the nation works on quality of care or do they work more on cost of healthcare. Quality of care is an important role in achieving the best healthcare. Cost of healthcare is based on incentives that support the effectiveness while curving the spending growth (MacReady, 2012). Reform needs to be provided a baseline in evaluating healthcare delivery systems for a broader success of payments and delivery models with payment providers (2012, p.2). Sometimes higher cost effects quality of care. Some decisions need to be made that may affect the “clinical and fiscal health of the nation” (2012 p.1). Differentiating Roles and Major Activities Public and Private agencies plays an important role on how healthcare is delivered. The Commonwealth Fund...
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...Assignment Agency for Healthcare Research and Quality HCM 4002 Risk Management February 12 , 2014 Introduction “The Agency for Healthcare Research and Quality, (AHRQ) is responsible for producing guidelines for improving the quality of healthcare” [ (Agency for Healthcare Research and Quality (AHRQ), 2014) ]. Mission “AHRQ's mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work with the U.S. Department of Health and Human Services (HHS) and other partners to make sure that the evidence is understood and used” [ (Agency for Healthcare Research and Quality (AHRQ) , 2014) ]. Goals AHRQ has four primary goals. First, they aspire to “Improve healthcare quality by accelerating implementation of patient-centered outcomes research (PCOR)”. They hope to be successful in doing so by “developing PCOR methods, training PCOR researchers, and disseminating PCOR findings” [ (Agency for Healthcare Research and Quality (AHRQ) , 2014) ]. In response to the rapid changes in the delivery of healthcare and the impact of The Affordable Healthcare Act, AHRQ is currently attempting to penetrate the primary care practice environment. The Affordable Healthcare Act requires a change in the current system. One goal is to improve healthcare quality and be cost-efficient in delivering services and; in line with doing so, specialty physician practices will be minimal. On the upside of this change...
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...Running head: AHRQ Health Care Agency for Healthcare Research and Quality Research Training and Education is one of the programs the Agency for Healthcare Research and Quality (AHRQ) has. Research and education are two primary mechanisms of the discipline as they direct the way to the advancement of new technologies, the innovation of new pathological treatments, and evidence based medicine. They both affect every aspect of the healthcare field. While pathologies change and invasive procedures are needed less and less, it’s important that research and education maintain pace to keep up with these changes and diseases and continue to grow. Therefore, it is essential these types of programs receive funding. Applications are accepted by the Training and Education program from persons interested in research and training for improving the quality of healthcare services. Students and researchers that are either interested in pursuing a career in the healthcare field or currently in the field can apply for these funds. Grants and stipends are awarded to researchers under defined time constraints. They have that time to establish their ideas for eliminating waste in hospitals, reduce the number of hospital related infections for example; CLABSI and MRSA, create environments free of medical error and overly expensive care, develop the functionality of the prescription drug market, and to increase funding of programs such as Medicare/Medicaid reimbursement. (AHRQ...
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... October 17, 2011 QI Plan Part I- Consumerism Healthcare organizations have a responsibility to its consumers and various stakeholders to ensure only the highest quality care is delivered. Quality measures such as performance measurement and quality improvement processes play a critical role in helping organizations achieve quality outcomes. This paper will contrast performance measurement and quality improvement processes. In addition, this paper will discuss a healthcare organization, Gulf Coast Medical Center, its mission and QI goals, and the role of the consumer and stakeholders in the QI process. Performance Measurement vs. Quality Improvement Processes Performance measures are an important element of the overall quality management of an organization. “Performance measures quantitatively tell us something important about our products, services, and the processes that produce them” (Oak Ridge Institute for Science and Education, n.d.). In the healthcare industry, performance measures are a tool used to help understand, manage, and improve what healthcare organizations do. Performance measures are composed of units of measure; a number to tell how much, a unit to give the number a meaning of what, each tying in to the overall target number. In contrast, quality improvement (QI) focuses on bridging the gap between current levels of quality and expected levels of quality. “QI uses quality management tools and principles to understand and address systems...
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...Quality Improvement Email Glorybel Rodriguez HCS/588 Measuring Performance Standards November 24, 2014 Dr. Debbie Simmons Quality Improvement Email Health care organizations aim to provide both quality and safe patient care. These two fundamental and critical concepts in health care require continuous effort. “Organizations must make an intentional effort to measure, assess, and improve performance” (Spath, 2014, pp.266). Quality improvement (QI) is essential for the continued success of an organization as it reveals specific guidelines and methods to provide consistent and dependable quality services. This paper will discuss QI while focusing on quality management’s role and importance in health care, stakeholder’s different views of quality, QI roles, and what areas in health care require monitoring. Additionally, involved accrediting and regulatory organizations in QI and helpful resources and organizations that affect QI will be discussed. Quality Management According to Kelly (2011), quality management refers to how managers operating in various types of health services organizations and settings understand, explain, and continuously improve their organizations to allow them to deliver quality and safe patient care, promote quality patient and organizational outcomes, and improve health in their communities” (pp. 9). Therefore, the purpose of quality management is to enhance the effectiveness, efficiency, and safety of health care processes to achieve quality...
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...Introduction: The U.S. spends more per capita, and the highest percentage of GDP, on healthcare than any other Organisation for Economic Co-operation and Development (OECD) country as reported in the March 2009, “Trends in Healthcare Costs and Spending” by Kaiser Family Foundation. Given the unusual relationships in healthcare between consumers, payers, and providers, the ethical implications involved in healthcare decisions, it is nearly impossible to define the “right” amount to be spend in healthcare. As our nation is debating what the appropriate amount to be spend on healthcare is, this project aims on understanding the drivers for this high cost and possible ways to control them. One of the important drivers for this high healthcare cost that we identified and will discuss in this paper is unnecessary care. Although there are number of factors contributing to unnecessary care, this paper focuses on four key issues mainly sterilization, hospital acquired infections, medical errors and hospital readmissions. Sterilization: Background of the issue Hospitals are hygienic paradoxes. It is where patients are cured from diseases and acquire a new one. Hospital hygiene is difficult to achieve. According to the World Health Organization estimates, “more than 1.4 million people worldwide are affected by infections acquired in hospitals” (Cleanhospitals.net). Why are there so many unclean hospitals and what body of people holds them accountable for medical negligence...
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...knowledgeis to prevent patient mortality rate by following the national clinical guideline. Therefore the purpose of this paper is to discuss information from the the clinical practice guideline for preventing and reducing the risk of surgical site infection. Practice Setting Problem The Practice seting problem chosen for this assignment is reducing the risk of surgical site infection by using clinical practice guideline. Surgical site infections (SSI)is an infection patient acquired from hospital after surgery, It has a significant representation of healthcare associated infections. According to Center for Dieases Control and Prevention (CDC) SSI is defines as “ an infection that occurs after surgery in the part of the body where the surgery took place.” (Spruce, 2014). The author, Spruce (2014) addressed the mortality rate of surgical site infection and further noted that SSI is the second most prevalent healthcare associated infection that are estimated to be 40% to 60% preventable. Spruce reported that $28.4 lillion to $45 billion is about the cost of hospital associated infections annually. “Preventing SSIs is a national priority (Spruce, 2014). Significant amount of informations and literature guidelines are available to help reduce the risk of surgical site infections. Important of the Clinical Problem and its Significant to Nursing Practice The important of preventing and reducing...
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...Dimensions of Quality in Healthcare Presented by: Connie Kirkpatrick, PhD, MS, RN Franciscan Health System Tacoma, Washington Quality Basics Series Taught by quality experts for staff in Quality Improvement Organizations, Quality Basics focuses on the fundamentals of quality in areas such as the history of quality improvement, methods and models, performance measurement and other key topics. 1 Quality Basics Dimensions of Quality in Healthcare Connie Kirkpatrick, PhD, MS, RN Director, Quality & Clinical Support Franciscan Health System, Tacoma, Washington Question from a seminar participant: “I can see that it must work in practice. But does it work in theory?” 2 Dimensions of Quality Learning Objectives Define Quality Define Quality Improvement Describe six key “Dimensions of Quality” Describe seven key “Pillars of Quality” Quality Institute of Medicine: “Quality of Care” is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Institute for Healthcare Improvement (IHI): Quality is turning into outcomes management, and involves minimizing unnecessary variation so that outcomes become more predictable and certain. 3 Quality Basic Principles: All work is a process The process is the main source of quality defects (versus human error) Understanding variability in processes is the key to improving quality Quality Improvement ...
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...Quality Improvement Report Quality Improvement Report Health care quality improvement focuses on promoting the best possible outcomes for patients. Historically, quality was determined by individual providers and lacked standardization. “How care is provided should reflect appropriate use of the most current knowledge about scientific, clinical, technical, interpersonal, manual, cognitive, and organization and management elements of health care” (Ransom, Joshi, Nash, & Ransom, 2008, p. 3). This paper will discuss the foundational frameworks of quality improvement, the various stakeholders involved, quality management needed in the industry, and accrediting and regulatory agencies involved in quality improvement. The Foundational Frameworks of Quality Improvement The foundational frameworks of quality improvement can be traced back to the “influential contributors and thought leaders of quality improvement systems and theories intent on improving process and producing sustainable quality results at highly productive levels” (Ransom, Joshi, Nash, & Ransom, 2008, p. 63). Walter Shewhart is one inspirational leader who addressed reliability of a process by focusing on limiting variation through statistical analysis (Ransom, Joshi, Nash, & Ransom, 2008). He is also credited with acknowledging the importance of establishing a common language for what is being measured, which is known as operational definitions (Ransom, Joshi, Nash, & Ransom, 2008). “Shewhart...
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...both the hospital and the client in decreasing length of stay; from decreasing stress to the client to decreasing additional work on staff, requiring fewer resources and making more efficient the treatment plan for the patient. Demands for provider’s time lead to distraction and mistakes, further complicating matters. My first goal is to improve my communication skills with my peers and colleagues on a daily basis. This goal will increase the clarity of our vision and common goals of the unit. Nurses must communicate effectively in order to provide appropriate medical care. Effective communication skills in nursing has benefits for both nurses and patients; creating a higher level of patient satisfaction and decrease medical mistakes. Improving my communication skills will give me the ability to facilitate the best possible care for the patient; as well as develop a more clear and concise plan of care that will optimize the staffs work load and the patients hospital experience. The article Shaping Effective Communication Skills and Therapeutic Relationships at Work by Susan Grover elaborates on the significance...
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...from when considering their options for their healthcare organization to participate in. One consideration is whether to participate with a regionally or nationally accredited organization. Committee looking at their options are not only concerned about the healthcare organization. The patients they serve are also very important, as their expectations of the accreditations that are held by the organization they receive care in must be considered. The cost of the accreditation organization’s services, and what each bring to the table in terms of their processes and communication they deliver is vital. As of last year there are four accreditation options that are nationally recognized organizations that healthcare organizations can choose from if they are concerned with proving and demonstrating their compliance with the Medicare conditions of participation, they are: the Center for Improvement in Healthcare Quality, the Joint Commission, the Healthcare Facilities Accreditation Program, and Det Norske Veritas Healthcare Inc.,’s program (Thompson, 2013). Healthcare organizations must consider their needs when determining which nationally accredited organizations to enter into agreements with. Thompson (2013) states, “The Joint Commission dominates the field. In 2010–11, the report states, 90% of hospitals with so-called deemed status obtained it from the Joint Commission. The rest of the hospitals split almost evenly between the Healthcare Facilities Accreditation Program of the American...
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...Top of Form Total views: 31 (Your views: 2) Promoting Quality and Safety through Standards Core measures developed by the Joint Commission and Centers for Medicare and Medicaid have provided goals and standards for improved patient care. One element of the core measures is pneumonia. The performance measures for patients diagnosed with pneumonia were developed in a collaborative effort including the Joint Commission (TJC), the Centers for Medicare and Medicaid Services (CMS), the Infectious Disease Society of America (IDSA), the American Thoracic Society (ATS), the American College of Emergency Physicians (ACEP), and the Centers for Disease Control and Prevention (CDC) (The Joint Commission, 2014). The core measures for pneumonia stipulate the timely collection of blood cultures and administration of appropriate antibiotics (RN.com, 2013). It also focuses on the 30-day readmission rate (Agency for Healthcare Research and Quality, 2013). According to the Medicare Payment Advisory Commission in 2007, pneumonia was one of the seven conditions that account for nearly 30% of potentially preventable readmissions within 15 days of hospital discharge (Agency for Healthcare Research and Quality, 2013). Healthcare organizations report their performance as a percentage of compliance to TJC and CMS, which then effects both accreditation and reimbursement (RN.com, 2013). The increasing emphasis on quality of care, patient safety, and clinical care outcomes has resulted in impressive...
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...Position Statement Evidence-Based Practice Background Increased attention is being directed toward the development of methods that can provide valid and reliable information about what works best in healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through its...
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...Research Grand Canyon University NRS 430V Professional Dynamics August 27, 2011 Being Accountable: Utilizing Evidence-Based Research Merriam-Webster defines accountability as “an obligation or willingness to accept responsibility or to account for one’s actions” (Merriam-Webster, n.d.) What does this term mean from the global healthcare perspective? In the healthcare arena, it is a legal, moral, and ethical term used to describe healthcare providers’ obligation to themselves, their patients, and to society as a whole. The nurse is an integral part of the healthcare team that contributes to accountability realm. How does this concept translate into everyday professional nursing practice? According to the American Nurses Association, “accountability means to be answerable to oneself and others for one’s own actions. The nurse acts under a code of ethical conduct that is grounded in moral fidelity and respect for the dignity, worth and self-determination of patients.” (p. 9). The ANA developed the Code of Ethics for Nurses as a tool or guideline for the nurse to “carry out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession” (ANA, n.d.). Nurses have a responsibility for the care they provide during their nursing practice. To whom is the professional nurse responsible and accountable? Nurses are accountable to the profession, their patients, their employers, and to themselves. Using evidence based...
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...term “never events” in 2001 referring to medical mistakes that should never occur (wrong surgery site). The National Quality Forum categorizes never events into six groups: surgical, product or device, patient protection, care management, environmental, and criminal. For a never event to fit into one of the categories never events must be serious in its result (death or significant disability), unambiguous (clearly identifiable and measurable), and usually preventable("AHRQ Patient Safety Network - Never Events," 2011). As of 2006 there are currently 28 “never events” which include unintended retention of a foreign object in a patient after surgery or other procedure, intra-operative or immediately post-operative death in an ASA Class I patient and surgery performed on the wrong body part ("AHRQ Patient Safety Network - Never Events," 2011). In most states there is no mandatory reporting of never events, event though some estimates put national incident rate as high 40 per week. This includes wrong patient and wrong site. Eight hospitals and ambulatory surgical centers in the United States recognized that never events are a critical part of patient safety issues a critical patient safety ("The Joint Commission Center for Transforming Healthcare |Newsroom," 2011). The healthcare facilities joined the Joint commission center for Transforming Healthcare to address the problem. There are currently 25 states and the District of Columbia have mandatory reporting, only a...
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