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Quality Measures Implementation, Standards, and Barriers in the Healthcare Services
Introduction
Quality measures for improving health care services provided
The situation concerning the health care services provided by the staff members of the Health Science Center described in the case study suggests that quality improvement measures should be implemented about the needs and expectations of the organization and its staff as well as patients that may suffer from gaps ineffectiveness of measures implementation. It is necessary to monitor and assess the effectiveness of measures implemented due to recurrence of problems and the possibility of providing other measures in order to make sure that the situation is stable. In this respect, the improvements should be implemented in accordance with the existing standards with regard to the possibility of barriers occurring after implementation. Effective measures should be analyzed as well as ineffective to enable professionals that operate in this area to make adequate decisions in the future.
Implementation, standards, and barriers
The implementation of quality improvement measures should be effectively monitored in order to make the system more appropriate for normal operation opposed to the current situation when people have to pay more for the services of lower quality. In this respect, specific standards are established by agencies that deal with health care issues to ensure that all requirements are met. Certain barriers that may interfere with the implementation of the quality improvement measures should be identified and eliminated, when possible.
Measures to Monitor and Revise Quality Program Implementation
Criteria to evaluate the measures
As suggested by McGlynn (2003), Quality of care can be measured (p. I-46). In this respect, every health care organization should implement changes adequate in terms of the quality improvement initiatives on the national level in the United States of America. Besides, Four sets of criteria are commonly used to evaluate potential quality measures: they must be important, scientifically acceptable, usable, and feasible (McGlynn, 2003, p. I-40). All these criteria are aimed at making the improvement patient-oriented and cost- and time-sufficient. In other words, the criteria used to evaluate the improvement should respond to one of the national goals so that the quality improvement measures are designed to meet the needs and expectations of health care professionals and patients on the national level. Some health care organizations choose cost-efficiency as one of the key measures that should be implemented while the quality of health care services includes more than one aspect.
Indicators of quality improvements
The indicators of quality improvement should be related to the potential patients, their problems, and the methods used to cope with those problems. For instance, in the study by McGlynn et al. (2003), a specific approach was used. So, such issues as acute and chronic conditions that represented the leading causes of illness, death, and utilization of health care in each age group, as well as preventive care related to these causes were selected (McGlynn et al., 2003, pp. 2636-2637). Besides, such indicators as stuffing can be used to monitor the quality improvement measures implementation (Dlugacz, 2006, p. 33). In other words, some indicators can be considered generalized in terms of their applicability in other situations while others are very specific and should be applied to defined situations only.
Appropriate measures for present circumstances
The present circumstances include a health care organization that operates as the Health Science Center. The number of staff members and increased competition in the situation when anyone can become unemployed due to the conflicting environment in different health care institutions do not leave any space for adequate decision; the current situation brought the health care organization described in the case study to the necessity of assessing the situation, identifying the gaps and inadequacies in order to implement quality improvement measures claimed to be effective in similar situations with regard to the parties concerned. The present circumstances require such measures as leadership team cooperation, development of vision and strategy as parts of the overall improvement plan, sharing results as a method for involving the staff in the improvement process, and other measures that have been taken in the study described (Ransom et al., 2008, pp. 363-373).
Regulatory and Accreditation Standards
Strategies to meet the standards
The following organizations are those that operate in the area of health care issues and are able to establish specific standards as well as suggest certain indicators for quality improvement measuring and monitoring: the National Committee on Quality Assurance, the Center for Medicare and Medicaid Services, Formerly the Healthcare Financing Administration, or Institute for Healthcare Improvement (Rubin, Pronovost, and Diette, 2001, p. 490). As a rule, the standards presuppose to be striven for by organizations that operate in the same area. The standards established for health care service providers should be followed in order to achieve the highest results in the area and meet all needs of all parties concerned. In other words, specific standards such as those related to cultural and linguistic appropriateness of services provided by health care organizations may be typical for health care organizations only or be aimed at overall implementation by organizations that claim to be international level-oriented and other issues.
Strategies used by the health care organization described in the case study included such areas of main focus as leadership accountability, budget priorities, excellence in all activities, and goals identified and pointed at the strategic maps (Ransom et al., 2008, p. 365). In this respect, the strategic maps contained the key goals to be achieved while all initiatives had to be performed in accordance with the goals set with regard to leadership, budget, and excellence credo. It is necessary to take into account a number of other factors so that the strategies established and followed were aimed at achieving a common goal.
Appropriate strategies for present circumstances
Strategies for circumstances described in the case study under analysis include only a few appropriate ones due to the inability of such a large organization to monitor and assess the implementation of improvement measures adequately. In other words, it is necessary to identify the strategies that are proven to be ineffective and cost-consuming and replace them with effective ones in order to meet the key goals set by the leadership team. Moreover, the appropriate strategies in the case discussed include the method of sharing results of the monitoring and assessment to encourage the staff members and make them more competitive. In addition, financial issues were brought into the discussion; Petersen et al. (2006) conducted research on the effectiveness of the financial initiatives for the quality of health care services provided to patients. In this respect, the effectiveness of cost-efficiency-oriented strategies can be questioned as well as a high status that is claimed to be one of the goals for this health care organization to be achieved.
Barriers with the Implementation/Revision of the Quality Measures
Barriers and their assessment
The quality improvement measures introduced to improve the situation within the health care organization described in the case study are partially effective due to the inappropriateness of some strategies implemented to cope with the problems experienced by the organization. Increased competition and the inability of the managerial to sustain the Health Science Center with regard to its initial roles assigned such as a teaching school and a school of healthcare professions (Ransom et al., 2008, pp. 363-364). In other words, the barriers concerning the organization mentioned above include the stability of the previous system of evaluation, leadership, and other initiatives aimed at managing this health care organization.
The identification of barriers would not take a long time because it is necessary to neutralize all aspects of the existing system that interfere with the implementation and revision of the quality improvement measures. For this purpose, it is necessary to analyze the leadership team and strategies they actually implement with regard to the changing needs and priorities of the organization. Moreover, it is possible to assess the barriers that interfere with the implementation of measures with the help of surveys that would facilitate the process of information collecting. The results of surveys would reflect the attitude of the staff members and gaps that may exist in the system of health care in this organization from the point of view of professionals that work here.
Overcoming the identified barriers
The process of overcoming the identified barriers can be more time- and cost-consuming than the original process of monitoring the organization, assessing its situation, and implementing the most appropriate quality improvement measures. In this respect, the survey conducted in order to identify the barriers can demonstrate an inability or lack of enthusiasm in staff members concerning the situation and changes implemented because changes can be perceived negatively and it is normal. However, effective management can be an adequate tool in coping with the gaps defined in the process of assessment and survey conducted. Besides, it is possible to divide the staff members into teams in order to enable them to cooperate effectively with each other instead of experiencing frustration and anxiety about the competition and inability to perform in accordance with high standards such as excellence in different activities as suggested for improvement. In other words, sharing the results of the assessment is not enough while analysis of results can be an effective and time/cost-efficient measure in coping with barriers.
Conclusion
To conclude, it is necessary to monitor the Health Science Center as it is a health care organization with specific needs and problems. To bring back the old culture, it is necessary to identify the indicators of quality measures and assess the effectiveness of those indicators. At the same time, it is necessary to take into account the results of the survey that may be used to identify the gaps that may exist with the staff members in terms of their readiness and ability to treat the changes positively. Every strategy suggested for implementation should be assessed in terms of its adequacy for the defined health organization before being implemented.
Reference List
Dlugacz,.D. (2006). Measuring health care: Using quality data for operational, financial and clinical improvement. San Francisco, CA: Jossey Bass.
McGlynn, E. A. (2003). Selecting common measures of quality and system performance. Medical Care, 41 (1), I-39-I-47.
McGlynn, E. A., Asch, S. M., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., and Kerr, E. A. (2003). The quality of health care delivered to adults in the United States. The New England Journal of Medicine, 348, 2635-2645.
Petersen, L. A., Woodard, L. D., Urech, T., Daw, C., and Sookanan, S. (2006). Does pay-for-performance improve the quality of health care? Annals of Internal Medicine, 145, 265-272.
Ransom, E. R., Joshi, M. S., Nash, D. B., and Ransom, S. B. (2008). The healthcare quality book: Vision, strategy, and tools (2nd ed.). Chicago, IL: Health Administration Press.
Rubin, H. R., Pronovost, P., and Diette, G. B. (2001). From a process of care to a measure: The development and testing of a quality indicator. International Journal for Quality in Health Care, 13 (6), 489-496.
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