Introduction
Providing for patient safety should be the long-term goal of any healthcare organization. In order to provide high-quality treatment, patient safety is essential. It is necessary to provide high-quality services to avoid and minimize patient risks, errors, and damage. To ensure that patient safety precautions are successfully implemented, it is crucial to have clear guidelines, leadership skills, and data focusing on enhancing safety, experienced medical staff, and effective patient participation in their care.
Perfect performance in a challenging, high-stress operational environment is unattainable; as a result, human error should be avoided by designing an environment that is error-proof and has well-developed structures, functions, and processes. Since it encourages responsibility-sharing among workers, a setting with an honest and open safety culture is essential. Respecting patients’ rights to safe drug administration, appropriate dosages, and the right routes of administration guarantees that patient receives high-quality medication promptly and effectively. In turn, this lowers the likelihood of many medical errors throughout therapy. The right administration of drugs is one method to ensure patients’ security and raise the standard of nursing care (Tariq et al., 2022).
The greatest way to improve the safety of patients is to create a multifaceted awareness and preventive approach. Healthcare professionals should focus on communicating with one another, collaborating as a team, and helping patients learn about their prescriptions. Rechecking the calculations to verify that the patient receives the appropriate therapeutic dosage and double-checking the dosing and frequency of all high-alert drugs are some important methods that may help avoid medication mistakes. Accordingly, errors in medicine delivery may be decreased with a safety-conscious culture.
It is necessary to gather the insights of hospital administrators on their views of obligatory mistake-reporting systems. Such ideas involve patient education on real and anticipated mistakes, forming joint committees to detect mistakes, and devising strategies to lessen the likelihood of future errors. Patient safety must be a collaborative effort between hospital administration, personnel, and patients to guarantee the overall betterment of quality healthcare and the advancement of universal health coverage. Therefore, the understanding and application of these concepts will be greatly welcomed and valuable to the overall quality enhancement of Edison Family Health.
Aspects of Quality Healthcare
Several analytical models for quality assessment have directed measure development projects in the public and commercial sectors. One of the most significant is the Institute of Medicine’s (IOM) framework, which encompasses safe, effective, patient-centered, timely, efficient, and equitable healthcare. The Medical Institute specifies the quality of care as the extent to which health services for people and groups maximize the probability of desired health goals and adhere to contemporary professional knowledge (Busse et al., 2019). In healthcare, it is also possible to characterize the extent to which clients’ demands are addressed and the extent to which outcomes are acceptable while maximizing resource use. It is essential for universal health care since it is built on expert knowledge supported by evidence.
Healthcare provision must be safe for all patients, regardless of race, culture, or ethnicity. When medical treatment aims to protect the client from harm, it is said to be of high quality. The goal of quality healthcare is to aid people, not hurt them. When healthcare systems fulfill the overall objectives of enhanced health, timeliness, financial protection, and efficiency, they are termed “high quality” (Busse et al., 2019).
The effectiveness of high-quality health care should be appreciated by people who seek them accordingly. The major reasons for inefficiency in care provision include improper medication usage, corruption, excess or overstock of equipment, and inadequate infrastructure utilization (WHO, 2018). Delivering evidence-based health services to individuals in need implies successful healthcare delivery. When care is ineffective, for instance, when clinicians do not follow evidence-based recommendations, this may indicate a lack of awareness of standards or non-compliance regardless of knowledge. When it comes to efficiency, healthcare professionals must optimize available resources and minimize wastage.
The patient-centered approach to quality care is another essential component. Respect for patients’ cultural norms and religious beliefs should be a prerequisite for providing quality treatment; patient values must be at the core of clinical decision-making. Another essential component of great treatment is timely care. Patients must not wait for extended periods to get treatment when they seek quality care. Decreases in hospital patients’ wait times are indicative of high-quality medical treatment. Another essential component of great treatment is providing equitable care. Patients have access to the same level of excellent treatment regardless of religion, color, ethnicity, or socioeconomic status.
Factors that may Influence a Consumer’s Perspective of Quality Care
Various elements influence the consumer’s perception of care. A consumer evaluates a variety of factors to determine the quality of the services. Patient satisfaction is crucial in preserving patient-provider relationships, adherence to treatment regimens, and continuous use of health services. One of the factors influencing a consumer’s perception of quality care is the customer experience. Patient-centered care is generally recognized as necessary for high-quality treatment (Bellio & Buccoliero, 2021). A patient who visits a healthcare institution must be handled with care and dignity. If clients are not treated respectfully, they may not visit the healthcare facility again. In addition, the client’s cultural beliefs should also be honored. Before administering treatment to patients, healthcare practitioners must grasp their cultural values.
The service quality is an additional factor that customers consider. In a hospital context, patients must perceive that the services are superior. Providing high-quality health care to people, families, and patients requires the expertise of physicians, nurses, and other health care professionals. First, the quality of healthcare facilities is evaluated based on the presence of fundamentals such as potable water, reliable energy, adequate sanitation, and secure waste disposal (WHO, 2018).
WHO (2018) reports that 40% of healthcare institutions in low- and middle-income nations do not have access to improved water, and approximately 20% do not have access to sanitation. These essential pillars are necessary for the delivery of excellent treatment.
Nevertheless, infrastructure does not always equal high-quality treatment. Establishing and enforcing minimum standards and stimulating ongoing development is necessary. Moreover, excellent services are delivered when a patient visits a hospital and is diagnosed, treated, and given the correct prescription.
Reputation is another significant aspect influencing customers’ perceptions of quality. The hospital’s reputation is crucial to providing treatment in a healthcare context. Consumers will visit a healthcare facility if they have received favorable feedback from other customers. In this context, reputation alludes to patient readmissions that diminish the significance of a healthcare center. A high hospital rehospitalization rate indicates that the institution does not deliver excellent treatment when patients are released without the risk of developing issues after a visit. Consequently, the hospital’s reputation influences the impression of quality provided.
Characteristics that may be Important to Purchasers and Providers in Care Delivery
Clinical Preventive Services
Clinical preventive services are medical treatments, testing, or counseling that healthcare providers do in a clinical context to avoid illness and improve well-being, as opposed to medical interventions that are in response to symptomatology. Such programs include vaccines, screening tests, and counseling targeted at altering patients’ health practices prior to the onset of clinical illness (Maciosek et al., 2017). Given the effect of issues such as smoking, alcohol, and illegal drug use; risky sexual conduct; and lack of physical activity and poor nutrition on health, the significance of counseling is evident. Physicians’ delivery of services like vaccines may be enhanced using monetary incentives and data-driven quality monitoring techniques.
Medicare Coverage of Preventive Services
Preventive care is essential for older persons because it may minimize premature morbidity and death, maintain function, and improve quality of life. However, the Medicare scheme was not intended to emphasize prevention, and the procedure for adding preventive therapies to the Medicare coverage package is complicated and challenging. Preventive services are open to a higher level of scrutiny and a requirement for a higher level of performance, but there is no standard mechanism for conducting such evaluations. Including Medicare coverage for preventive treatments may increase older individuals’ usage of preventive services.
Different Measurement and Assessment Tools Used to Evaluate Quality
Assessment of quality is the review of the quality of healthcare services provided. A quality assessment evaluates the discrepancy between anticipated and actual performance to discover areas for improvement. Most facets of quality, such as technical skills, effectiveness, safety, efficiency, and coverage, are conducive to establishing performance standards. When standards are specified, a quality assessment monitors performance following those standards.
For aspects of quality where goals are more challenging to define, such as continuity of treatment, a quality assessment summarizes the present level of performance to enhance it. In order to overcome the inherent biases of each approach alone, a quality evaluation often integrates many data collection methods (Berman, 2022). Generally, these approaches entail either direct observation of health professional performance or indirect assessment, such as testing of providers, patient interviews, or record reviews. Some examples of such techniques include observation of service delivery, interviewing health care professionals, computer-based testing, and patient exit interviews.
The patient’s experience is a crucial indicator of service quality. When patients express satisfaction with the services delivered, they perceive the services to be of good quality. The patient’s experiences contribute to the formulation of care-related policy. Therefore, the patient experience is of the utmost importance since patient-centered care is the hallmark of great treatment. The patient must feel that their needs have been handled appropriately. Thus, the feedback from the patient is the most accurate indicator of care quality.
Role of Utilization Management and how Physicians and Non-Physicians are
Responsible for Managing Healthcare Resources Effectively
Utilization management in the healthcare system refers to a collection of approaches employed by healthcare benefits to control the cost of treatment by influencing clinical decision-making. Utilization management performs a crucial role in preventing facilities from getting retrospective claims, rejections, or being required to return previously received funds. Utilization management in a hospital context comprises a healthcare facility’s operations guaranteeing patients get the proper and essential treatment (Giardino & Wadhwa, 2022).
Government-funded hospitals receiving Medicaid and Medicare must formulate a utilization management strategy. The utilization management strategy gives vital information on all hospital employees engaged in various tasks. The utilization strategy also outlines the essential processes for determining the medical need of admissions. It is also crucial in healthcare since it ensures the implementation of many quality-enhancing measures.
Utilization management enables healthcare institutions to evaluate the requirements of clients and the resources required to deliver optimal treatment. Physicians have a crucial role in recommending the resources needed to provide great services to patients. Utilization review gives health insurance organizations a chance to examine hospitals’ requests for medical care. During the evaluation, insurance companies assess the appropriateness of the prescribed therapy.
To prevent waste, physicians utilize healthcare resources with professionalism. Hospital administrators are among the non-physicians charged with overseeing healthcare resources. After obtaining insurance payments from insurance firms, hospitals are accountable for ensuring the availability of healthcare resources. Therefore, physicians and non-physicians who work in medical facilities must collaborate to guarantee the sensible use of healthcare resources.
Conclusion
The provision of appropriate medical care at the proper time, in accordance with the requirements and preferences of service recipients, is an essential component of high-quality health care. Effectiveness, safety, patient-centeredness, timeliness, equality, and efficiency are the six measurable criteria that define quality health care. These characteristics are aligned to increase the chance of achieving the desired health outcomes. If there is potential for improvement in health outcomes in a region, regardless of its level of income, there is also potential for improvement in the quality of treatment provided in that region.
References
Bellio, E., & Buccoliero, L. (2021). Main factors affecting perceived quality in healthcare: A patient perspective approach. The TQM Journal 33(7), 176-192. Web.
Berman, J. (2022). Methods & Tools:Measuring Quality. Qaproject. Web.
Busse, R., Dimitra Panteli, & Quentin, W. (2019). An Introduction to Healthcare Quality: Defining and Explaining its Role in Health Systems. Nih.gov; European observatory on health systems and policies. Web.
Giardino, A. P., & Wadhwa, R. (2022). Utilization Management. Web.
Maciosek, M. V., LaFrance, A. B., Dehmer, S. P., McGree, D. A., Flottemesch, T. J., Xu, Z., & Solberg, L. I. (2017). Updated priorities among effective clinical preventive services. The Annals of Family Medicine, 15(1), 14–22. Web.
Tariq, R. A., Rishik Vashisht, Sinha, A., & Yevgeniya Scherbak. (2022). Medication Dispensing Errors and Prevention. Nih.gov; StatPearls Publishing. Web.
WHO. (2018). Delivering Quality Health Services a Global Imperative for Universal Health Coverage. Web.