The first chapter in “Health quality and the patient” provides an overview of the concept of healthcare quality. According to the authors, despite significant improvements made in the recent decade, the quality of healthcare in the U.S. is below the expected level (Joshi & Berwick, 2014). The chapter contains a brief overview of the development of the concept in recent years as well as an in-depth analysis of the most important reports on the matter.
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The first is the IOM’s 1998 report, which provided a comprehensive overview of the issue of healthcare quality observed on a country-wide scale and regardless of the size of the community and introduced three categories of the defects – underuse, overuse, and misuse (Joshi & Berwick, 2014). The second is the 2000 follow-up report by IOM, which is among the most widely recognized documents on the topic due to the massive severity and prevalence of the issue. The third is a unified and systematized report published by IOM in 2001.
This document’s primary value stems primarily from the blueprint of a framework for a redesigned healthcare system oriented towards quality improvement. The framework was based on six dimensions of quality – safety, effectiveness, efficiency, timeliness, patient focus, and equitability (Joshi & Berwick, 2014). The fourth document is a report on the healthcare quality introduced by AHRQ in 2003 and containing information on the progress made in the field of healthcare.
The latest version of the report is based on the dimensions of care proposed by IOM. The fifth document is the report on the initiatives necessary for the improvement of quality on a national level, released by NPP in 2008. The chapter also contains several case studies exemplifying the process of healthcare quality at the organizational level. All cases are supported by comprehensive data in the form of graphs and tables. Overall, the chapter provides a solid introduction to the issue of quality of care in the U.S. and the key milestones of its development.
Chapter five focuses on the issue of data collection, reliability of different sources of data, and specificities of obtaining data for various areas of health care. The issue is exemplified through a case of Spectrum Health’s clinical reporting system that disaggregates data on clinical quality, the financial viability of the operations, levels of employee and patient satisfaction, and functional status (Byrnes, 2014). Data processing is conducted with the help of several algorithms intended to minimize confounding variables and adjust for case severity. According to the authors, a balanced perspective that makes use of all four categories is necessary to reach a reliable conclusion.
The chapter also provides an overview of the most common issues in the data collection process. These issues include the time and resources required for data collection, inadequate choice of the scope of the inquiry resulting in redundant data and additional expenses, and difficulties between a collection of inpatient and outpatient data. Next, the authors discuss different sources of data and explain the advantages and drawbacks of each approach.
The sources include retrospective review of medical records, prospective data collection, access to administrative databases, patient surveys, health plan databases focused on population health management, and condition-specific patient registers (Byrnes, 2014). Due to differences in the obtained data, a unique combination of sources is usually selected for each study. To sum up the provided information, the authors exemplify the data collection process by the case of CR system use. Overall, the chapter provides a sufficiently detailed explanation of the data collection process as well as descriptions of the most common collection processes along with their strengths and weaknesses.
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Byrnes, J. J. (2014). Data collection. In M. S. Joshi, E. R. Ransom, D. B. Nash, & S. B. Ransom (Eds.), The healthcare quality book: Vision, strategy, and tools (3rd ed.) (pp. 111-133). Chicago, IL: Health Administration Press.
Joshi, M. S., & Berwick, D. (2014). Health quality and the patient. In M. S. Joshi, E. R. Ransom, D. B. Nash, & S. B. Ransom (Eds.), The healthcare quality book: Vision, strategy, and tools (3rd ed.) (pp. 3-29). Chicago, IL: Health Administration Press.