...influencing healthcare service quality Ali Mohammad Mosadeghrad* Abstract Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. Keywords: Healthcare Organisations, Quality, Pluralistic Evaluation, Iran Copyright: © 2014 by Kerman University of Medical Sciences Citation: Mosadeghrad AM. Factors influencing healthcare service...
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...The impact of legislature and regulations on quality of healthcare services The impact of legislature and regulations on quality of healthcare services The health plan exchange program required from the Patient Protection and affordable care Act (PPACA) became in effect as of 2014. This very important piece under the Affordable Care Act (ACA) regulates, that all states would be required to form health insurance exchanges. A marketplace in which people and businesses would be able to purchase healthcare coverage. In California this is what is known as Covered California. In creating these exchanges the state would also need to address different issues to ensure that these exchanges meet the needs of the public. Some of those regulatory issues would include how much the government would need to be involved in the management of these exchanges, structure and governance of the exchanges, requirements for insurance to also offer an option of exchanges and the structure of the exchanges themselves (Hoffman, 2012, p. 881). A few very important steps that may make a huge impact in healthcare regarding these government requires exchanges can be the future reportable results for 13 clinical quality measures set forth in order to compare the different exchanges. Some benefits to the new health plans exchange system is individuals can no longer be denied coverage due to a pre-existing condition or premiums cannot increase due to health conditions. With the new health plan...
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...achieving and maintaining accreditation…………………..…5 The role of the URAC as an Accreditation Body………………………………………………....5 How the URAC accredits healthcare institutions….........................................................................6 Quality assessment and control solutions in accreditation ……………………………………......8 Implementation of quality improvement and accreditation solutions…………………………......9 Justification…………………………………….…………………………………………………10 Summary and conclusion……………………….…...……………………………………………10 References ………………………………………………………………………………………..11 Achieving and Maintaining Accreditation in Managed Care Managed healthcare organizations and professionals encounter numerous challenges on a yearly basis in the course of offering services, whereas the state, stakeholders, and clients (patients) expect to be reassured that bodies that render managed healthcare services are well equipped to meet their demands. Accreditation is, therefore, a detailed evaluation process through which an independent professional body or authority assesses another organization’s systems, structures, and procedures to certify that it satisfies the set industry criteria and standards (Bialek, Duffy & Moran, 2009). The evaluation and accreditation processes that are conducted by bodies such as URAC help in maintaining the quality of care in organizations. Physicians and nurses receive professional certification and...
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...Healthcare is a sensitive area in which the quality of service needs to be of the highest level, without which the consequences would be dire. With this factor, there arises the need for measures to ensure that the highest level of service is being accorded to the patients. Thus arises the need to have means by which to evaluate and establish the quality of service being accorded to patients so that there can be determination of which dimensions need to be improved. Quality measures, therefore, are tools by which quantification of the processes and outcomes in healthcare, patient perceptions as well as structures or systems of organization is undertaken (Centers for Medicare & Medicaid Services, 2016). The Centers for Medicare & Medicaid Services, on their website explain that those parameters are chosen as they are related the goals defined for healthcare quality. Quality measures are classified into four general categories namely structural, process, outcome and patient experience (Morris & Bailey, 2014). Structural measures seek to acquaint consumers with the healthcare provider’s systems, processes and overall capacity to dispense high quality care. Process measures on the other hand give an indication of the steps the provider takes to maintain or improve health for the healthy and the unwell respectively (Agency for Healthcare Research and Quality, 2015). The agency also defines outcome measures as the type of measure that give a reflection of impact that healthcare services...
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...should be able to have access to healthcare at an affordable price with quality service which are three aspects that are the most important in healthcare access, quality, and cost. Healthcare access is simply being able to have it when you need it although many don’t have it due to cost or because they don’t have the knowledge to access it. Access to healthcare effects the consumer’s quality of life which can lead to fatally. Cost which is being able to afford the healthcare is one of the biggest issues according to www.cdc.gov.com the percent...
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...Risk and Quality Management Jamaica Benton HCS/451 August 13, 2012 Matt Dennis Risk and Quality Management According to Valley Healthcare System (2012), “Valley Healthcare System formerly known as Community Health Center of South Columbus opened its doors August 1994. This name change is reflective of the growth in Valley Healthcare and the services that they provide to the community. Valley healthcare began as a small service within the Baker Village community of the South Columbus area” (p.1). Today, Valley Healthcare provide medical, dental, out-reach services, and pharmacy services to residents from the Chattahoochee Valley region and beyond. Valley Healthcare goal is to provide comprehensive primary healthcare, selected specialties and referral services to the population of the Chattahoochee Valley area regardless of circumstances. The ECRI Institute (2010) website, “The Patient Quality and Risk Management Program supports Valley Healthcare System philosophy that patient quality and risk management is everyone’s responsibility. Teamwork and participation among management, providers, volunteers, and staff are essential for an efficient and effective patient quality and risk management program” (p.3.). * Patient safety * Patient quality * Risk management is a policy that is enforced by Valley Healthcare to ensure that all patients are protected and free from hazardous conditions; medical errors; disclosure of privacy; infections and etc. All staff are...
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...Eric Yee 12/06/2014 MHR 452 Dr. Farmer Quality Versus Quantity in Health Care System There is health care reform happening today. According to Journal of Healthcare Finance, “Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care” (Scamperle 2014). As the demand for health services, controversies of the direction of the healthcare system stirred. Should healthcare providers focus efforts towards quality or quantity care of patients? There is an emerging trend of efforts leaning towards a quality of healthcare direction as opposed to high volume service. This issue sparked my attention because of initially hearing testimony of mal-practice within healthcare facilities. Friends told me of the staff tending to their own needs before the patients’ needs. Other mal-practice includes negligence and ignoring hospital policies that can make the entire hospital liable for damages. Overall, negligent behaviors lead me to critically analyze the source of healthcare system operations. Briefly describing this issue, healthcare providers used a payment plan called Fee-for-Service which reimburses healthcare providers rewards per patient attended. As precautions for low paying reimbursement transactions from insurance providers, healthcare providers such as doctors write extra medical operations, tests, medicines for patients to purchase. Some doctors order more than one visit to have a cushion of funds to avoid a potential...
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...Running head: ACCESS TO QUALITY HEALTHCARE PAPER ASSIGNMENT Access to Quality Healthcare Paper Rudolphe Lubin University of Phoenix Lori Lewellen MBAJOGZL57 April 27, 2009 Quality Healthcare Introduction It will be evident to realize that financial, educational, and socio – demographic implications can bring serious impact on access to quality healthcare in the organization. Labor shortage will stay an important component that can affect as well the access to quality care. Socio – demographic changes linked with chronic illnesses can have an effect on the aging population, which may reduce the quality of life, increase costs for healthcare and rise resource allocation. In point of fact, both labor shortage and socio – demographic changes are exactingly dominant in the admittance to quality care in the United States. Besides, the demand for registered nurses and changes in science is already exceeding supply in U.S. nation, including more implications associated with other ethical dilemmas. Healthcare Labor Shortage People have to realize that progresses in medical technology, increasing expenses and market forces provide to the financial decline of many rural healthcare organizations. In reality, small rural healthcare suppliers, particularly hospitals, cannot meet the costs of the equipment and practitioners needed to treat the range of modern syndrome and injury...
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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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...approach. Discusses how system cost reductions impact the quality and efficiency of health care. Discusses how pay-for-performance affects health care providers and their customers. Discusses the effects pay-for-performance will have on the future of health care Pay-for-Performance is 1,400 to 1,750 words in length Even though the effects of pay-for-performance will influence the future of health care in patient care, reimbursement to the healthcare providers will require close monitoring. The physician receives reimbursement for providing quality care and for making quality innovations. Pay-for-performance offers financial incentives to close the gap in healthcare the patients receive and the healthcare the patients could receive. The effect of pay-for-performance for the healthcare providers depends on his or her quality and efficiency of services he or she provides to the patient. The consumer groups, government, and patients are actively applying pressure on healthcare organizations to lower the costs, improve patient safety and care, and to enhance services (Shi & Singh, 2012). Definition To define the pay-for-performance in the healthcare payment system is rewarding the providers who achieve, improve, and exceed his or her performance on quality and lower the cost. Also known as incentive pay or merit pay remains a motivation for healthcare providers to receive compensation for providing higher quality of work for less expense for the insurance companies and...
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...KWAME UNIVERSITY OF SCIENCE AND TECHNOLOGY (KNUST) SCHOOL OF BUSINESS ASSESSING THE EFFECTS OF NATIONAL HEALTH INSURANCE AUTHORITY (NHIA) COST CONTAINMENT MEASURES ON THE QUALITY OF HEALTHCARE DELIVERY: A CASE STUDY OF ATWIMA NWABIAGYA DISTRICT MUTUAL HEALTH INSURANCE SCHEME By RUFAI ADJEI July, 2013 KWAME UNIVERSITY OF SCIENCE AND TECHNOLOGY (KNUST) SCHOOL OF BUSINESS ASSESSING THE EFFECTS OF NATIONAL HEALTH INSURANCE AUTHORITY (NHIA) COST CONTAINMENT MEASURES ON THE QUALITY OF HEALTHCARE DELIVERY: A CASE STUDY OF ATWIMA NWABIAGYA DISTRICT MUTUAL HEALTH INSURANCE SCHEME A Dissertation Presented to the School of Business, Department of ………….in Partial Fulfillment of the Requirements for the MBA Degree in ………………… By RUFAI ADJEI July 2013 DECLARATION a) “I declare that I have wholly undertaken the study reported herein under supervision”. …………...................................................... RUFAI ADJEI (STUDENT) b) “I declare that I have supervised the student in undertaking the study reported herein and I confirm that the student has my permission to present it for assessment”. ……………............................................ MR. MUNTAKA ………………………. (SUPERVISOR)...
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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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... ROLL: 19 SEMESTER: 6 COURSE: BACHELOR IN BUSINESS ADMINISTRATION TOPIC: PRIVATISATION IN THE INDIAN HEALTHCARE SECTOR CONTENTS 1. INTRODUCTION 1.1. PRIVATIZATION 1.2 INDIAN HEALTHCARE INDUSTRY 1.2.1 DRIVERS FOR GROWTH OF HEALTHCARE 1.3 PUBLIC HEALTHCARE IN INDIA 1.4 PRIVATE SECTOR IN THE INDIAN HEALTHCARE DELIVERY SYSTEM 1.4.1 GOVERNMENT POLICIES TO SUPPORT THE GROWTH OF PRIVATE SECTOR 1.4.2 FDI IN THE INDIAN HEALTHCARE 1.4.2.1 STATUS AND PROSPECTS FOR FOREIGN INVESTMENTS IN HOSPITALS IN INDIA 1.4.2.2 CONSTRAINTS TO FOREIGN INVESTMENTS IN HOSPITALS IN INDIA 1.4.2.3 FOREIGN PRESENCE IN HOSPITALS IN INDIA 1.4.2.4 SUMMARY OF PROS AND CONS FOR FINANCING SOURCES OF HOSPITALS OBJECTIVES 2. LITERATURE REVIEW 3. ANALYSIS OF THE IMPACT OF PRIVATIZATION IN THE HEALTHCARE SECTOR 3.1 QUALITY AND PRIVATE HEALTHCARE SERVICES 3.2 IMPACT OF FOREIGN INVESTMENTS IN HOSPITALS IN INDIA 3.3 CONSUMER PERCEPTION OF PRIVATE SECTOR 3.4 EMERGING TRENDS IN HOSPITALS IN INDIA: CHALLENGES AND INTERVENTIONS 4. CONCLUSION 5. ACKNOWLEDGEMENT 6. BIBLIOGRAPHY ...
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...ASSIGNMENT: Using theory on healthcare quality. Critically evaluate approaches that you, as a healthcare manager, could use to improve the quality of care provided by your organization. Introduction The concept of "quality" has been contemplated throughout history and continues to be a topic of intense interest today. Quality of service is rendered extremely important in any industry and it has been a subject of study and research in many fields. (Reeves and Bednar, 1994) This essay will look at definitions of quality in healthcare; examine the theories of quality in healthcare and approaches taken toward evaluating and improving quality of health services in Uganda’s public health sector with the main focus on the implementation of Millennium Development Goals. The discussion will focus on patient satisfaction as an aspect of quality and how it influences quality of care provided from a District healthcare manager’s perspective, analyse factors that influence patient satisfaction, how the MDGs aim to improve the quality of care provided to patients by exposing the gaps between healthcare management perceptions of service quality and how the service is actually being delivered to the consumers. Social constructionism in healthcare In social constructionism it is important to look at social settings and human way of life when focusing on healthcare in different cultures and societies. Class and social stratification can have profound implications for the way we experience...
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...Quality in Health Care Shanna Marie Fulwood HCA 305 Tessa Guisinger September 17, 2012 Healthcare has become a major issue within recent years. “In spite of its long history and common years the US healthcare system has a complex puzzle to many Americans” (Sultz and Young, 2010, pg XVII). Obama has tried recently to provide access to every individuals they can have some kind of medical care. His new healthcare bill says that everyone has to have medical insurance. This was done because so many Americans are without health care coverage. Now that is mandated we have healthcare coverage what our options? One of the major concerns that we face and always have faced is the quality of care we received. Anyone deserves quality out of the healthcare system. Fortunately there are ways to measure healthcare quality. These tools are mostly used by the professionals. Some questions that will be answered here are how does the quality of healthcare in the United States compared to the quality of care and other industrialized nations; how can an acceptable quality of healthcare be assured for all; will providing data in areas such as patient outcomes, compliance with national standards for preventive and chronic care, and comparative cost to the public be an acceptable measure of healthcare delivery outcomes; the physicians believe that only physicians could and should judge the quality of medical care, they found participation in such hospital peer review activities and most disagreeable...
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