Defining the Quality of Healthcare Services

The concept of quality in healthcare is a central component of the services rendered by healthcare personnel. The Institute of Medicine (IOM) refers to quality healthcare services as those that are safe, timely, efficient, effective, equitable, and patient-centered (Tzelepis et al., 2015). To encourage the delivery of quality healthcare services, organizations such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) routinely assess and award certification to hospitals that meet desired quality standards. One of the most utilized quality models is the Donabedian model of quality as applied to healthcare services (Moore et al., 2015). This model states that quality improvement initiatives in healthcare institutions must address three aspects to be effective. These are the structure of the organization, its procedures, and outcomes.  Defining the Quality of Healthcare Services Essay Example

Definition of Quality from the Donabedian Perspective

As stated above, quality healthcare is healthcare that is provided at the time it is needed, does not cause harm to the patient, produces the effects that it is expected to produce, puts the interests of the patient first, and does not discriminate. In other words, the definition of quality can be summarized as the state of being efficacious, on time, and given with the interests of the patient in mind. According to the Donabedian theory of quality, it must focus on the structure of the organization, the procedures within that organization, and the patient outcomes that are expected. What this means is that a quality initiative in an organization that is structurally anti-change will always fail. The structure of an organization must be such that it enables change by facilitation (resources), motivation, and direction (management). Then the procedures of the organization must also be geared towards delivering healthcare services with the patient in mind and not just the organization’s interests. Lastly, any quality initiative is only successful if it has the outcome in mind. It must be known what kind of patient outcome is desired from the beginning, if quality healthcare is to be delivered by any organization in a planned and structured manner.  Defining the Quality of Healthcare Services Essay Example

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A Practice Problem as a Practitioner

A practice problem that is identifiable to the author as a practitioner is the practice of ordering very many laboratory and other investigations instead of focusing on specific tests. These investigations end up costing the patient a lot of money either from their pockets or insurance coverage. Invoking the Donabedian model, this means that the procedures within the organization are weak and do not encourage the delivery of quality healthcare. Eliminating this wasteful practice would entail having a functional electronic health record (EHR) system that has an up-to-date computerized provider order entry (CPOE) component (Alotaibi & Federico, 2017). This CPOE would be having treatment algorithms for every condition that have preinstalled tests to be ordered for every condition diagnosed. Additionally, the EHR will also be having a dashboard that tracks and monitors specific quality benchmarks (such as readmission rates) related to the services provided (Weggelaar-Jansen et al., 2018). The definition of quality presented above applies to this situation in that the practice problem shows a lack of patient-centeredness. The clinician just orders the tests without considering the benefit to the patient or their financial position.

References

Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631

Moore, L., Lavoie, A., Bourgeois, G., & Lapointe, J. (2015). Donabedian’s structure-process-outcome quality of care model. Journal of Trauma and Acute Care Surgery, 78(6), 1168–1175. Doi: https://doi.org/10.1097/TA.0000000000000663

Tzelepis, F., Sanson-Fisher, R., Zucca, A., & Fradgley, E. (2015). Measuring the quality of patient-centered care: Why patient-reported measures are critical to reliable assessment. Patient Preference and Adherence, 9, 831-835. https://doi.org/10.2147/ppa.s81975

Weggelaar-Jansen, A.M.J.W.M., Broekharst, D.S.E., & de Bruijne, M. (2018). Developing a hospital-wide quality and safety dashboard: A qualitative research study. BMJ Quality & Safety, 27(12), 1000-1007. Doi: https://doi.org/10.1136/bmjqs-2018-007784

Defining the Quality of Healthcare Services Essay Example