This document summarizes a study that examines healthcare quality measures across different countries to define an approach for improving healthcare quality. It discusses factors such as increasing population growth and changing disease patterns that pose challenges for healthcare systems. It also reviews healthcare quality definitions, metrics like structure, process and outcomes, and approaches some countries use to enhance quality, including developing quality strategies and addressing various quality domains.
Healthcare management status of indian states aninterstate comparison of th...IAEME Publication
The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
Healthcare management status of indian statesiaemedu
The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
An analytical study on investors’ awareness and perception towards the hedge ...iaemedu
The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
The system of delivery within health care has always been on the change and rise due
to technology along with self-care, health care, development, education, and creating a healthy society. As the old saying goes, “where there is good health there is also good financial wealth” and this is where the formation of the ACA took place and a new integrated delivery system created.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
The Effect of Service Quality on Patient Loyalty (A Study on Inpatients of Re...IJAEMSJORNAL
This study aims at examining whether service quality influences customer loyalty, in this case, hospital’s inpatient. Service quality is represented in the form of five independent variables, which are tangibles, reliability, responsiveness, assurance, and empathy. This study is conducted at some regional hospitals in Jakarta, Indonesia, and the respondents are inpatients of the concerned hospitals. The data are analyzed by employing a multiple linear regression method. The research shows that the five independent variables simultaneously, significantly influence patient loyalty. Partially, almost all of the independent variables significantly influence it except the reliability variable.
This document discusses the need for quality improvement in the US healthcare system. It notes that while the US leads in medical innovation, care is often fragmented and inconsistent. Several organizations have found issues with the accessibility and quality of care received. The objectives of proposed changes are to prioritize patient safety and deliver the highest quality care nationwide through better education and training. The rationale includes reports that many Americans don't receive recommended care, quality varies greatly between groups, and 30% of healthcare spending has no benefit to patients. Literature supports that most medical errors stem from flawed systems and processes, not individuals, highlighting the need for quality and safety improvements.
Has Accreditation made a difference in Healthcare Delivery in India by Dr.Mah...Healthcare consultant
There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.
Healthcare management status of indian states aninterstate comparison of th...IAEME Publication
The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
Healthcare management status of indian statesiaemedu
The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
An analytical study on investors’ awareness and perception towards the hedge ...iaemedu
The document is a research paper that analyzes the status of public healthcare management across Indian states using a multi-criteria decision making (MCDM) approach. It ranks the states based on 30 indicators related to healthcare outcomes and resources. The paper uses the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) MCDM method, which identifies ideal and negative-ideal solutions to rank the states based on their distance from these solutions while accounting for the relative weight of each indicator. The paper concludes that states in South India rank higher in terms of public healthcare management compared to other parts of the country.
The system of delivery within health care has always been on the change and rise due
to technology along with self-care, health care, development, education, and creating a healthy society. As the old saying goes, “where there is good health there is also good financial wealth” and this is where the formation of the ACA took place and a new integrated delivery system created.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
The Effect of Service Quality on Patient Loyalty (A Study on Inpatients of Re...IJAEMSJORNAL
This study aims at examining whether service quality influences customer loyalty, in this case, hospital’s inpatient. Service quality is represented in the form of five independent variables, which are tangibles, reliability, responsiveness, assurance, and empathy. This study is conducted at some regional hospitals in Jakarta, Indonesia, and the respondents are inpatients of the concerned hospitals. The data are analyzed by employing a multiple linear regression method. The research shows that the five independent variables simultaneously, significantly influence patient loyalty. Partially, almost all of the independent variables significantly influence it except the reliability variable.
This document discusses the need for quality improvement in the US healthcare system. It notes that while the US leads in medical innovation, care is often fragmented and inconsistent. Several organizations have found issues with the accessibility and quality of care received. The objectives of proposed changes are to prioritize patient safety and deliver the highest quality care nationwide through better education and training. The rationale includes reports that many Americans don't receive recommended care, quality varies greatly between groups, and 30% of healthcare spending has no benefit to patients. Literature supports that most medical errors stem from flawed systems and processes, not individuals, highlighting the need for quality and safety improvements.
Has Accreditation made a difference in Healthcare Delivery in India by Dr.Mah...Healthcare consultant
There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.
Tqm health practices and client satisfaction in a selected health facility in...IAEME Publication
This document summarizes a research study on the impact of total quality management (TQM) health practices on client satisfaction in a health facility in Ghana. The study aimed to identify which TQM health practices, including adequacy of health facility and amenities, doctor-patient relationship, pharmacy staff service delivery, and nurses and midwives service delivery, predict higher levels of client satisfaction. A survey was conducted of 150 patients at a health facility in Ghana. Results of the correlation analysis showed that condition of health facility, doctor-patient relationship, and nurses and midwives service delivery were significantly correlated with higher client satisfaction. A multiple regression analysis revealed that nurses and midwives service delivery was the only unique predictor of client satisfaction. The study concludes that
This document discusses the three pillars of health policy: access, quality, and cost. It defines key concepts related to access such as availability, affordability, and acceptability. Models for determining access like Andersen's Behavioral Model and the Eight Factor Model are presented. Quality is discussed in terms of measures like infant mortality and factors like safety, effectiveness, and disparities. Cost drivers and strategies for lowering costs through prevention and care coordination are also examined.
Presenting this set of slides with name - Healthcare Sector Analysis Powerpoint Presentation Slides. Keep your audience glued to their seats with professionally designed PPT slides. This deck comprises of total of sixty four slides. It has PPT templates with creative visuals and well researched content. Not just this, our PowerPoint professionals have crafted this deck with appropriate diagrams, layouts, icons, graphs, charts and more. This content ready presentation deck is fully editable. Just click the DOWNLOAD button below. Change the colour, text and font size. You can also modify the content as per your need. Get access to this well crafted complete deck presentation and leave your audience stunned.
This document discusses barriers to adoption of mobile health (mHealth) apps by doctors and patients. It conducted a literature review and interviews with Dutch mHealth experts from different stakeholder groups (policymakers, users, developers). Twelve main adoption barriers were identified, with the two most important being "Integration and interoperability" due to closed technology supplier systems, and "Business case". Dutch experts viewed "Privacy and security" and "Conservative culture" differently than the international literature. Experts from different stakeholder groups also disagreed on the importance of "Visionless development" and "Competing payment mechanisms". Overcoming barriers could involve healthcare insurers taking a leading role in funding new open standard initiatives, and international cooperation.
The healthcare sector in India is rapidly expanding due to factors such as a growing population and an expanding middle class. However, there are also significant challenges facing the sector. The physical infrastructure is inadequate to meet current demands and a large portion of the population still lacks access to quality care. While the private sector accounts for over 80% of healthcare spending, government efforts aim to increase capabilities and access at primary care facilities in rural areas. Overall, the Indian healthcare system can be viewed as both facing substantial challenges but also possessing opportunities for growth.
Drhatemelbitar (3)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
This document outlines case management guidelines for workers' compensation cases in Oklahoma. It was developed by the Physician Advisory Committee and adopted by the Administrator of the Oklahoma Workers' Compensation Court. The guidelines define case management, describe the benefits and role of case managers, and outline the case management process. They provide criteria for when a case should be referred to case management, including catastrophic injuries, noncompliance with treatment plans, frequent changes in providers, and issues that require in-person evaluation like language barriers. The guidelines are intended to help case managers provide coordinated, quality care to injured workers.
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
The document summarizes a report about the use of embedded case managers in healthcare organizations. It finds that about half of healthcare organizations embed or co-locate case managers at points of care. The report provides metrics and benchmarks on the prevalence and impact of embedded case management programs. It finds that embedded case management results in more efficient care coordination of high-risk patients and those with chronic illnesses. The metrics are derived from a survey of healthcare organizations that currently embed case managers.
Drhatemelbitar (2)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
This document discusses new models of healthcare delivery that aim to improve care coordination. It describes two prominent models - patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) - that are working to eliminate fragmented care through coordinated care. The case manager plays a key role in coordinating care across settings and providers in these new models, as their role in care coordination is becoming increasingly important with growing care complexity. The document uses Geisinger Health Plan as an example of an ACO that has successfully implemented a medical home program with embedded case managers to coordinate care.
Drhatemelbitar (4)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
This document provides an overview of case management programs and evaluations in long-term care. It defines case management as a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates services to meet individual needs. The goals of case management can be client-oriented, such as improving access to services, administrative, such as improving efficiency, or system-oriented, such as promoting a high-quality service system. Common models of case management include traditional models within long-term care, brokerage models, managed care models, and integrated models. Quality is evaluated based on structure, process, and outcomes. Current ongoing evaluations of case management programs seek to assess outcomes and costs. The document concludes that case management shows promise but more
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
1. The document discusses issues with the current healthcare system including lack of coordination between institutions, dehumanization of care, and rising costs.
2. It introduces case management as a promising solution, defined as a method that aims for continuity of services and quality clinical outcomes through efficient management of available resources for specific clientele.
3. Case management relies on thorough knowledge of client needs, estimating patient stay lengths, and planning coordinated treatment processes to improve care quality while controlling costs.
Adoption of Integrated Healthcare Information System in Nairobi County: Kenya...Editor IJCATR
Health care information systems are aimed at facilitating the smooth running and interoperability of the health care
delivery processes to ensure efficiency and effectiveness; however, the complexity, heterogeneity and diversity of the health care
sector especially in Kenya poses serious challenges especially in relation to integration of the systems. There is a large disconnect
between the public and private health care delivery systems characterized by fragmentation of services, locally within hospitals
(among primary, secondary and tertiary health care settings) and across different health care centers. This research is aimed at
examining the adoption of integrated healthcare information system in Nairobi County; Kenyatta National Hospital represents the
public sector and The Mater Hospital the private sector. A sample size of 100 users on information system from the two hospitals
picked from the primary secondary and tertiary levels were selected and questionnaires administered to them. Data was analyzed
through descriptive statistics with the aid of SPSS. The results of the study indicated that there was a huge disparity between
healthcare information system adoption in the public and private sectors with the private sector’s adoption being at an advanced
stage. The major barriers to adoption including social political barriers, financial constraints and technical/technological barriers
also presented.
This document outlines a study on improving Myanmar's national healthcare system. It includes an introduction describing Myanmar's growing population and need to improve healthcare. It then performs a SWOT analysis of the current system and provides facts and figures on its organization and challenges. The objectives are to identify factors that strongly affect healthcare system improvement and determine which variables like technology, budget, training, and facilities most relate to improvement. The research question asks what factors affect improvement of Myanmar's national healthcare system.
This document discusses the need to harmonize the process for reporting potential conflicts of interest in health care and life sciences. It notes that individuals are currently required to provide this information to various organizations in non-identical, time-consuming ways. The document proposes creating a common set of disclosure elements and a standardized digital format that individuals can use to easily report relationships to multiple requesting organizations. This would reduce burden on individuals and allow organizations to access standardized data more efficiently. It outlines goals and approaches discussed by working groups to define common elements and a process for centralized storage and retrieval of disclosure information.
Linking clinical workforce skill mix planning to health and health care dynamicsIme Asangansi, MD, PhD
Current health workforce planning methods are inadequate for the complexity of the task. Most approaches treat the workforce supply of individual health professions in isolation and avoid quantifying the impact of changes in skills mix, either planned or unplanned. The causes and consequences of task delegation and task substitution between or within health professions is particularly important in handling workforce shortages in developing countries and understanding and planning possible responses to both rapid catastrophic health demands and slower background trends in their social and political environment. As well as the contextual environment, interactions and delays in supplying and balancing health resources and configuring clinical services are required to address the geographic, profession-specific and quality imbalances. These supply side resources include knowledge and research, skills and attitudes of clinicians, buildings and equipment, medications and medical technologies, information and communications technologies and any other methods and models to improve the provision of clinical services. The interaction between demand
and supply could adjust for feedbacks of health services outcomes, policies and governance on population expectations, funding, political and social supports and explicitly link these to clinical workforce supply in a useful, rigorous and relevant tool. The challenge is capture the relevant essence of the dynamic complexity of health and healthcare for this purpose.
The document discusses pay for performance (P4P) incentives in healthcare and their impact on quality, cost, and financing. It provides background on quality improvement efforts and defines key concepts like structure, process, and outcomes. It then outlines current legislation and initiatives like the Affordable Care Act that link reimbursement to quality metrics. P4P aims to change how care is delivered and financed to improve outcomes while reducing waste. However, it also impacts providers' finances as payments may decrease for preventable readmissions or hospital-acquired conditions.
Impact on Health Reform on Device Development and FundingUBMCanon
The document discusses the impact of US healthcare reform on medical device development and funding. It summarizes that healthcare reform through the Affordable Care Act and other policies is driving major changes in health insurance purchasing and moving payments from fee-for-service to bundled payments and accountable care organizations. This shift to alternative payment models will require device manufacturers to understand how provider reimbursement is changing to ensure their devices provide value within the new systems.
Health sector is considered as one of the most important sectors in any economy because the
wellness of a country depends on the wellness of its citizens. This can be only achieved when there is an efficient
and effective health system in the country. Despite many government interventions to ensure that services are
not interrupted in public hospitals in Kenya, there are still many challenges as pertains to efficient stock
management leading to frequent stock outs
The National Academies Health and Medicine DivisionAbout U.docxdennisa15
The National Academies
Health and Medicine Division
About UsPublicationsActivitiesMeetings
Announcement
Crossing the Quality Chasm: The IOM Health Care Quality Initiative
In 1996, after releasing America's Health in Transition: Protecting and Improving Quality, the IOM launched a concerted, ongoing effort focused on assessing and improving the nation's quality of care.
The first phase of this Quality Initiative documented the serious and pervasive nature of the nation's overall quality problem, concluding that "the burden of harm conveyed by the collective impact of all of our health care quality problems is staggering" (Chassen et al., 1998).
IOM Definition of Quality
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
This phase built on an intensive review of the literature conducted by RAND to understand the scope of this issue (Schuster) and a framework was established that defined the nature of the problem as one of overuse, misuse and underuse of health care services (Chassen et al). More specifically, the report Ensuring Quality Cancer Care (1999) documented the wide gulf that exists between ideal cancer care and the reality many Americans with cancer experience.
During the second phase, spanning 1999-2001, the Committee on Quality of Health Care in America, laid out a vision for how the health care system and related policy environment must be radically transformed in order to close the chasm between what we know to be good quality care and what actually exists in practice. The reports released during this phase—To Err is Human: Building a Safer Health System(1999) and Crossing the Quality Chasm: A New Health System for the 21st Century(2001)—stress that reform around the margins is inadequate to address system ills.
The series of IOM quality reports have included a number of metrics that illustrate how wide the quality chasm is and how important it is to close this gulf, between what we know is good quality care and what the norm is in practice.
To Err is Human put the spotlight on how tens of thousands of Americans die each year from medical errors and effectively put the issue of patient safety and quality on the radar screen of public and private policymakers. The Quality Chasm report described broader quality issues and defines six aims—care should be safe, effective, patient-centered, timely, efficient and equitable—and 10 rules for care delivery redesign.
Phase three of the IOM's Quality Initiative focuses on operationalizing the vision of a future health system described in the Quality Chasm report. In addition to the IOM, many others are working to create a more patient responsive 21st century health system, including clinicians/ health care organizations, employers/consumers, foundations/research, government agencies, and quality organizations. This collection of efforts focus reform a.
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
The Joint Commission Has Instituted A Number Of Goals...Valerie Burroughs
The Joint Commission has instituted several goals nationally to improve patient safety. The goals focus on areas of concern in healthcare like patient identification, communication between caregivers, and medication safety. The Joint Commission accredits hospitals and other healthcare organizations to evaluate them based on performance standards related to patient care, safety, and rights.
Tqm health practices and client satisfaction in a selected health facility in...IAEME Publication
This document summarizes a research study on the impact of total quality management (TQM) health practices on client satisfaction in a health facility in Ghana. The study aimed to identify which TQM health practices, including adequacy of health facility and amenities, doctor-patient relationship, pharmacy staff service delivery, and nurses and midwives service delivery, predict higher levels of client satisfaction. A survey was conducted of 150 patients at a health facility in Ghana. Results of the correlation analysis showed that condition of health facility, doctor-patient relationship, and nurses and midwives service delivery were significantly correlated with higher client satisfaction. A multiple regression analysis revealed that nurses and midwives service delivery was the only unique predictor of client satisfaction. The study concludes that
This document discusses the three pillars of health policy: access, quality, and cost. It defines key concepts related to access such as availability, affordability, and acceptability. Models for determining access like Andersen's Behavioral Model and the Eight Factor Model are presented. Quality is discussed in terms of measures like infant mortality and factors like safety, effectiveness, and disparities. Cost drivers and strategies for lowering costs through prevention and care coordination are also examined.
Presenting this set of slides with name - Healthcare Sector Analysis Powerpoint Presentation Slides. Keep your audience glued to their seats with professionally designed PPT slides. This deck comprises of total of sixty four slides. It has PPT templates with creative visuals and well researched content. Not just this, our PowerPoint professionals have crafted this deck with appropriate diagrams, layouts, icons, graphs, charts and more. This content ready presentation deck is fully editable. Just click the DOWNLOAD button below. Change the colour, text and font size. You can also modify the content as per your need. Get access to this well crafted complete deck presentation and leave your audience stunned.
This document discusses barriers to adoption of mobile health (mHealth) apps by doctors and patients. It conducted a literature review and interviews with Dutch mHealth experts from different stakeholder groups (policymakers, users, developers). Twelve main adoption barriers were identified, with the two most important being "Integration and interoperability" due to closed technology supplier systems, and "Business case". Dutch experts viewed "Privacy and security" and "Conservative culture" differently than the international literature. Experts from different stakeholder groups also disagreed on the importance of "Visionless development" and "Competing payment mechanisms". Overcoming barriers could involve healthcare insurers taking a leading role in funding new open standard initiatives, and international cooperation.
The healthcare sector in India is rapidly expanding due to factors such as a growing population and an expanding middle class. However, there are also significant challenges facing the sector. The physical infrastructure is inadequate to meet current demands and a large portion of the population still lacks access to quality care. While the private sector accounts for over 80% of healthcare spending, government efforts aim to increase capabilities and access at primary care facilities in rural areas. Overall, the Indian healthcare system can be viewed as both facing substantial challenges but also possessing opportunities for growth.
Drhatemelbitar (3)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
This document outlines case management guidelines for workers' compensation cases in Oklahoma. It was developed by the Physician Advisory Committee and adopted by the Administrator of the Oklahoma Workers' Compensation Court. The guidelines define case management, describe the benefits and role of case managers, and outline the case management process. They provide criteria for when a case should be referred to case management, including catastrophic injuries, noncompliance with treatment plans, frequent changes in providers, and issues that require in-person evaluation like language barriers. The guidelines are intended to help case managers provide coordinated, quality care to injured workers.
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
The document summarizes a report about the use of embedded case managers in healthcare organizations. It finds that about half of healthcare organizations embed or co-locate case managers at points of care. The report provides metrics and benchmarks on the prevalence and impact of embedded case management programs. It finds that embedded case management results in more efficient care coordination of high-risk patients and those with chronic illnesses. The metrics are derived from a survey of healthcare organizations that currently embed case managers.
Drhatemelbitar (2)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
This document discusses new models of healthcare delivery that aim to improve care coordination. It describes two prominent models - patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) - that are working to eliminate fragmented care through coordinated care. The case manager plays a key role in coordinating care across settings and providers in these new models, as their role in care coordination is becoming increasingly important with growing care complexity. The document uses Geisinger Health Plan as an example of an ACO that has successfully implemented a medical home program with embedded case managers to coordinate care.
Drhatemelbitar (4)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
This document provides an overview of case management programs and evaluations in long-term care. It defines case management as a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates services to meet individual needs. The goals of case management can be client-oriented, such as improving access to services, administrative, such as improving efficiency, or system-oriented, such as promoting a high-quality service system. Common models of case management include traditional models within long-term care, brokerage models, managed care models, and integrated models. Quality is evaluated based on structure, process, and outcomes. Current ongoing evaluations of case management programs seek to assess outcomes and costs. The document concludes that case management shows promise but more
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطارد حاتم البيطار
1. The document discusses issues with the current healthcare system including lack of coordination between institutions, dehumanization of care, and rising costs.
2. It introduces case management as a promising solution, defined as a method that aims for continuity of services and quality clinical outcomes through efficient management of available resources for specific clientele.
3. Case management relies on thorough knowledge of client needs, estimating patient stay lengths, and planning coordinated treatment processes to improve care quality while controlling costs.
Adoption of Integrated Healthcare Information System in Nairobi County: Kenya...Editor IJCATR
Health care information systems are aimed at facilitating the smooth running and interoperability of the health care
delivery processes to ensure efficiency and effectiveness; however, the complexity, heterogeneity and diversity of the health care
sector especially in Kenya poses serious challenges especially in relation to integration of the systems. There is a large disconnect
between the public and private health care delivery systems characterized by fragmentation of services, locally within hospitals
(among primary, secondary and tertiary health care settings) and across different health care centers. This research is aimed at
examining the adoption of integrated healthcare information system in Nairobi County; Kenyatta National Hospital represents the
public sector and The Mater Hospital the private sector. A sample size of 100 users on information system from the two hospitals
picked from the primary secondary and tertiary levels were selected and questionnaires administered to them. Data was analyzed
through descriptive statistics with the aid of SPSS. The results of the study indicated that there was a huge disparity between
healthcare information system adoption in the public and private sectors with the private sector’s adoption being at an advanced
stage. The major barriers to adoption including social political barriers, financial constraints and technical/technological barriers
also presented.
This document outlines a study on improving Myanmar's national healthcare system. It includes an introduction describing Myanmar's growing population and need to improve healthcare. It then performs a SWOT analysis of the current system and provides facts and figures on its organization and challenges. The objectives are to identify factors that strongly affect healthcare system improvement and determine which variables like technology, budget, training, and facilities most relate to improvement. The research question asks what factors affect improvement of Myanmar's national healthcare system.
This document discusses the need to harmonize the process for reporting potential conflicts of interest in health care and life sciences. It notes that individuals are currently required to provide this information to various organizations in non-identical, time-consuming ways. The document proposes creating a common set of disclosure elements and a standardized digital format that individuals can use to easily report relationships to multiple requesting organizations. This would reduce burden on individuals and allow organizations to access standardized data more efficiently. It outlines goals and approaches discussed by working groups to define common elements and a process for centralized storage and retrieval of disclosure information.
Linking clinical workforce skill mix planning to health and health care dynamicsIme Asangansi, MD, PhD
Current health workforce planning methods are inadequate for the complexity of the task. Most approaches treat the workforce supply of individual health professions in isolation and avoid quantifying the impact of changes in skills mix, either planned or unplanned. The causes and consequences of task delegation and task substitution between or within health professions is particularly important in handling workforce shortages in developing countries and understanding and planning possible responses to both rapid catastrophic health demands and slower background trends in their social and political environment. As well as the contextual environment, interactions and delays in supplying and balancing health resources and configuring clinical services are required to address the geographic, profession-specific and quality imbalances. These supply side resources include knowledge and research, skills and attitudes of clinicians, buildings and equipment, medications and medical technologies, information and communications technologies and any other methods and models to improve the provision of clinical services. The interaction between demand
and supply could adjust for feedbacks of health services outcomes, policies and governance on population expectations, funding, political and social supports and explicitly link these to clinical workforce supply in a useful, rigorous and relevant tool. The challenge is capture the relevant essence of the dynamic complexity of health and healthcare for this purpose.
The document discusses pay for performance (P4P) incentives in healthcare and their impact on quality, cost, and financing. It provides background on quality improvement efforts and defines key concepts like structure, process, and outcomes. It then outlines current legislation and initiatives like the Affordable Care Act that link reimbursement to quality metrics. P4P aims to change how care is delivered and financed to improve outcomes while reducing waste. However, it also impacts providers' finances as payments may decrease for preventable readmissions or hospital-acquired conditions.
Impact on Health Reform on Device Development and FundingUBMCanon
The document discusses the impact of US healthcare reform on medical device development and funding. It summarizes that healthcare reform through the Affordable Care Act and other policies is driving major changes in health insurance purchasing and moving payments from fee-for-service to bundled payments and accountable care organizations. This shift to alternative payment models will require device manufacturers to understand how provider reimbursement is changing to ensure their devices provide value within the new systems.
Health sector is considered as one of the most important sectors in any economy because the
wellness of a country depends on the wellness of its citizens. This can be only achieved when there is an efficient
and effective health system in the country. Despite many government interventions to ensure that services are
not interrupted in public hospitals in Kenya, there are still many challenges as pertains to efficient stock
management leading to frequent stock outs
The National Academies Health and Medicine DivisionAbout U.docxdennisa15
The National Academies
Health and Medicine Division
About UsPublicationsActivitiesMeetings
Announcement
Crossing the Quality Chasm: The IOM Health Care Quality Initiative
In 1996, after releasing America's Health in Transition: Protecting and Improving Quality, the IOM launched a concerted, ongoing effort focused on assessing and improving the nation's quality of care.
The first phase of this Quality Initiative documented the serious and pervasive nature of the nation's overall quality problem, concluding that "the burden of harm conveyed by the collective impact of all of our health care quality problems is staggering" (Chassen et al., 1998).
IOM Definition of Quality
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
This phase built on an intensive review of the literature conducted by RAND to understand the scope of this issue (Schuster) and a framework was established that defined the nature of the problem as one of overuse, misuse and underuse of health care services (Chassen et al). More specifically, the report Ensuring Quality Cancer Care (1999) documented the wide gulf that exists between ideal cancer care and the reality many Americans with cancer experience.
During the second phase, spanning 1999-2001, the Committee on Quality of Health Care in America, laid out a vision for how the health care system and related policy environment must be radically transformed in order to close the chasm between what we know to be good quality care and what actually exists in practice. The reports released during this phase—To Err is Human: Building a Safer Health System(1999) and Crossing the Quality Chasm: A New Health System for the 21st Century(2001)—stress that reform around the margins is inadequate to address system ills.
The series of IOM quality reports have included a number of metrics that illustrate how wide the quality chasm is and how important it is to close this gulf, between what we know is good quality care and what the norm is in practice.
To Err is Human put the spotlight on how tens of thousands of Americans die each year from medical errors and effectively put the issue of patient safety and quality on the radar screen of public and private policymakers. The Quality Chasm report described broader quality issues and defines six aims—care should be safe, effective, patient-centered, timely, efficient and equitable—and 10 rules for care delivery redesign.
Phase three of the IOM's Quality Initiative focuses on operationalizing the vision of a future health system described in the Quality Chasm report. In addition to the IOM, many others are working to create a more patient responsive 21st century health system, including clinicians/ health care organizations, employers/consumers, foundations/research, government agencies, and quality organizations. This collection of efforts focus reform a.
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
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Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
The Joint Commission Has Instituted A Number Of Goals...Valerie Burroughs
The Joint Commission has instituted several goals nationally to improve patient safety. The goals focus on areas of concern in healthcare like patient identification, communication between caregivers, and medication safety. The Joint Commission accredits hospitals and other healthcare organizations to evaluate them based on performance standards related to patient care, safety, and rights.
Quality and Cost of Accreditation's In Healthcare by Mahboob ali khan ,MHA,CPHQ Healthcare consultant
Accreditations and quality assurance systems have also been observed to reduce the average cost of hospitalization. This clearly indicates that accreditations and quality assurance systems help hospitals to streamline their functions and processes, minimize wastage and thereby aid in enhancing quality and reducing cost of care.
The document discusses the impact of the Affordable Care Act on the U.S. healthcare system. It notes that while 30 million people were estimated to sign up, the actual number is 11.8 million. It explores how the healthcare system is changing across the U.S. due to provisions of the ACA, such as the insurance exchanges. Some critics argue the ACA gives the government too much control over health insurance and delivery systems. Overall, the effects of the sweeping healthcare reform remain to be fully seen as the law continues to be implemented.
Data Analysis ....Stepping Towards Achieving Universal Health Coverage(UHC) b...Nazmulislambappy
The document discusses a study on Shasthya Surokhsha Karmasuchi (SSK), a special health care project in Bangladesh aimed at ensuring quality health services without financial hardship. The study aims to assess if SSK can meet universal health coverage requirements and reduce out-of-pocket health expenditures. Interviews were conducted with SSK patients and health providers. Findings indicate SSK successfully eliminates costs for admitted patients but many still face health costs. SSK coverage and services need expansion to better achieve financial protection goals. Challenges include limited treatments covered, scarce resources, and poor infrastructure.
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Patience Nehikhare
healthcaredeliverysystemchanges.docx
Summary
1175 Words
Running Head: HEALTHCARE DELIVERY SYSTEM
THE U.S. HEALTHCARE DELIVERY SYSTEM 2
Healthcare Delivery System
Patience Nehikhare
Grand Canyon University
December 22, 2019
The U.S. Healthcare Delivery System
There is a rapid change within the healthcare system in the United States. The
changes that have occurred were made for the purpose of improving quality,
rewarding value and not volume, as well as integrating and coordinating the care
(Seshamani & Sen, 2018). As such, this paper will seek to put into consideration
current healthcare laws within the U.S. and the nurse’s role within this continuously
changing environment; the manner in which quality measures and pay for performance
affect patient outcomes. Furthermore, the emerging trends in the healthcare system,
professional nursing leadership, and management roles will be discussed.
The Emerging Health Care Laws and their Effects on Nursing Practice
One of the most crucial healthcare legislat ions that has been enacted in the United
States since the inception of Medicare and Medicaid in 1965 is the Affordable Care
Act (Obama, 2016). The ACA was enacted in 2010. Issues relat ing to affordability,
ease of access, and the care quality within the United States healthcare system were
some of the driving factors that formed the list of many t ime spanning challenges
that compiled the init iat ion of this legislat ion. Between 2010 to 2015 there was a
decrease in the number of uninsured cit izens in the U.S. by forty three percent as an
effect of the Affordable Care Act.
The payment systems in healthcare are undergoing some changes and the access to
care has also improved (Obama, 2016). The ACA promotes preventive healthcare
models that put emphasis on quality care, primary care, and the funding of community
health init iat ives (Lathrop and Hodnicki, 2014). Millions of previously uninsured cit izens
are also provided insurance coverage and also some healthcare areas that need
reforms so as to meet the needs of patients’ improved healthcare outcomes are
highly focused by the act. The act has an effect on nursing practice in several ways.
The first effect is that the act creates a high demand for healthcare professionals
that are sufficiently trained to provide healthcare services that are up to the acts’
standards. The second effect is that Advanced Practice Registered Nurses (APRNs)
who hold the Doctor of Nursing Practice (DNP) are required to be prepared so that
they can meet the increased needs through the provision of leadership skills in
community health centers. These professionals are also held accountable for direct ing
and advocating for future init iates as well as ser.
An Overview of Patient Satisfaction and Perceived Care of Qualityijtsrd
This paper aims to audit the patient satisfaction literature, precisely survey methods used, which fundamentally analyses its hypothesis and use at that point to introduce proof for perceived service quality as a discrete and further advanced construct. Findings Patient satisfaction has been widely reviewed and significant efforts have gone into creating survey instruments to estimate it. Although, most surveys have been critical of its utilization, since there is seldomly any hypothetical or calculated development of the patient satisfaction theory. The construct has little normalization, low accuracy and undetermined validity. It keeps on being utilized interchangeably with, and as an intermediary for, perceived health service quality, which is a conceptually extraordinary and predominant construct. Practical Implications The persistent utilization of patient satisfaction to assess the patients perception of the quality of a healthcare service is truly flawed. The way to settling this dilemma might be for the healthcare division to concentrate on perceived healthcare service quality by considering the particular theories and models that can be found in the administrations advertising literature. This literature offers further developed consumer theories which are preferred differentiated and tried over existing healthcare satisfaction models. Conclusion This paper brings up that there is a critical requirement for differentiation and normalization of patient satisfaction and healthcare service quality definitions and constructs, and argues for examination to concentrate on estimating perceived healthcare service quality. Shubham Chaurasia | Shivani Dadwal Salaria | Rakhi Ahuja | Amit Sharma "An Overview of Patient Satisfaction and Perceived Care of Quality" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31548.pdf Paper Url :https://www.ijtsrd.com/management/public-sector-management/31548/an-overview-of-patient-satisfaction-and-perceived-care-of-quality/shubham-chaurasia
As part of the government’s national strategy, the United Arab Emirates is seeking to raise the quality of healthcare to international best practice standards by 2021. What are the main quality gaps to be overcome in this period? How are changes such as mandatory insurance laws, management outsourcing of public facilities, regulatory devolution and increased rates of accreditation and data collection influencing quality of care?
Factors Influencing the Realization of Quality Improvement in Healthcare Disc...sdfghj21
Factors Influencing the Realization of Quality Improvement in Healthcare Discussion
This document discusses several factors that have influenced quality improvement in healthcare, including:
1) Historical, social, political, and economic trends over the last century such as rising costs, an aging population, and legislation like the Affordable Care Act.
2) Reports from the Institute of Medicine in the 1990s and 2000s that helped establish a framework for improving safety and quality in the 21st century healthcare system.
3) Initiatives from organizations like the Joint Commission and Agency for Healthcare Research and Quality that have aimed to decrease errors, establish standards, and improve outcomes.
An Empirical Study on Patient Delight and the Impact of Human and Non-Human F...IOSR Journals
Health, one of the Fundamental Human Rights has been accepted in the Indian Constitution. Today the healthcare industry has emerged as one of the most challenging sectors as well as one of the largest service sector industries in India. Patient perceived service quality become the prominent aspect to choose between hospitals. The purpose of this paper is to evaluate patient perceived service quality in Indian hospitals. Further the impact of the dimensions on patient satisfaction and patient delight is examined. A questionnaire was administered to the in-patients and multiple regression analysis has been used to examine the impact of the dimensions on patient satisfaction and patient delight. Findings emphasize eight distinct dimensions of patient perceived service quality and the impact on patient satisfaction and patient delight. A positive and significant relationship with patient satisfaction and patient delight has been found, except two dimensions. The results of this study are limited, as they are based on Indian hospitals. The contribution of this research paper, incorporate patient delight in health care sector. In addition, this paper highlights the importance of emotional attachment for patient satisfaction and patient delight in health care.
This document outlines concepts related to health care quality assessment. It describes key definitions, such as quality referring to services that increase health outcomes and are consistent with current knowledge. It also discusses perspectives on quality from practitioners, patients, and communities. Additionally, the document outlines different levels of quality analysis from national policies to individual care provision and lists examples of common quality indicators assessed in the US, such as patient satisfaction, mortality rates, and adherence to treatment protocols.
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This document discusses quality improvement in health care in developing countries. It defines quality as the degree of excellence and doing the right thing in the right way. Quality is viewed from the perspectives of clients, service providers, and managers. Elements of quality include structure, process, and outcomes. Improving quality requires addressing factors like resources, training, and cultural norms. While resource constraints are an issue, high quality care is still possible with limited resources. Ensuring quality providers through training is important for improving health outcomes in developing nations like Nepal. Economic benefits of quality include individual and social gains like increased productivity and reduced costs.
Paper #1 - Due March 8Posted Feb 22, 2018 949 AMPaper #1 - Ad.docxbunyansaturnina
Paper #1 - Due March 8
Posted Feb 22, 2018 9:49 AM
Paper #1 - Advice for Success
Please, use: File Name: HCAD610-Paper1-[Last Name]-Spring-2018
(And it would be nice if each page had your name and a page number...!)
Given how rapidly HIT has evolved over the last decade, HIT references greater than 5 years old need to have a relevant historical context or clear justification for their use. Every assertion that you make needs to have a clear source and be supported by references. EVERY factual statement Must be referenced, individually, from a credible and verifiable source...
No Abstract or Cover Page Needed...
I hope the guidance below helps...!
Dr Freeman
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You are the director of strategic communication for a non-profit suburban community hospital. The CEO has asked you to prepare a 3-7 page briefing paper that answers the following questions posed by the Board of Directors:
What does the US government mean by the concept “meaningful use?” How do myriad HIT systems support each other? Or do they?
Due End of Week 4.
1. Explain Gov’t term: “meaningful Use”; (15 points)
2. What US HIT systems have Problems and WHY? (25 points)
3. What Changes are needed in US HIT Systems? (25 points)
4. What HIT Strategy Steps are needed BY Hospital? (25 points)
5. Grammar, Referencing, Page Restrictions (10 points)
Evaluate U.S. HIT
Compare with that of other advanced nations? What contributes to this?
U.S HIT is behind when compared to other developed countries in the world. According to Davis, Stremikis, Squires, and Schoen (2014), “other countries have led in the adoption of modern health information systems, but U.S. physicians and hospitals are catching up as they respond to significant financial incentives to adopt and make meaningful use of health information technology systems.” What baffled me the most is that the U.S healthcare system remains the most expensive in the world and there is nothing to show for the high cost when compared to performance rating with other developed nations. The U.S remains at the bottom when it comes to healthcare performance in terms of quality care, access, efficiency, equity, and healthy lives (Davis et al., 2014).
I believe our government is to be blamed for poor HIT advancement in the U.S. This is because the U.S government is ten years late in making HIT a national major concern to support and invest in. I was surprised to find out that the U.S is one of the first nations in the world to fund and use HIT. So the question is how did end on the back bench when it comes to HIT advancement. Sullivan, Watkins, Sweet, and Ramsey (2009) reports that most of the early initiatives such as government funding and policies put in place to foster the growth of HIT have been either changed or stopped as a result of political, financial, and commercial pressures. “A National Center for .
The document provides an overview of the healthcare sector in India. It discusses key aspects of the Indian healthcare system including its structure, the growing private sector, expanding middle class, changing demographics, and technological advancements. It also analyzes the sector using PEST and SWOT frameworks, highlighting political, economic, social, and technological factors as well as strengths, weaknesses, opportunities and threats. The Indian healthcare industry is large and growing rapidly but still faces challenges in providing universal access to high quality care.
Running Head LIMITED ACCESS TO HEALTHCARE1LIMITED ACCESS TO.docxwlynn1
Running Head: LIMITED ACCESS TO HEALTHCARE1
LIMITED ACCESS TO HEALTHCARE6
Limited Access to Healthcare
Arnaldo Perez-Frometa
Capella University
Developing a Health Care Perspective
Access to healthcare services is very essential for sustainable level of living and good health. Several scholars have described access as “the timely use of personal health services to achieve the best possible health outcomes”. One of the issues facing many countries across the world including those with systems for universal healthcare is providing appropriate and timely healthcare access for deprived patients. Currently there is limited information on how those patients living in a context of social and material deprivation perceive obstructions in the system of healthcare. In this paper we shall discuss several resources addressing the issue of access to services in the healthcare system.
According to Andersen, Davidson, & Baumeister (2014), in their article titled “improving the access to care”, access refers to the actual utility of individual services for heath as well as everything else that can facilitate or impede their use. In this article they present research and policy issues as well as basic trends which are related to evaluating and monitoring the access to healthcare services. They show how evaluating and monitoring offers the platform for the prediction of health services, promotion of social justice and the improvement of efficiency and effectiveness for the delivery of health services. They analyzed access and healthcare outcomes using a behavioral model which provides a systematic framework of individual and contextual framework
They expanded the behavioral model by emphasizing on two new aspects. They include the life quality as an input and healthcare outcome and genetics as a factor for predisposing. They also examined some examples of access indicators which include efficiency and effectiveness measures, utilization, potential access and healthcare needs. Changes that occurred in these indicators over time were tracked using trend data. Finally they did observations on access and the present status as well as new areas of improving access via ACA which has played a big role in improving access to health care.
Next we are going to analyze the article written by Acharya et al., (2017) titled “Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal”. This article provides an understanding on the contribution of mental illness on the worldwide burden diseases which are non communicable. However, the authors note that there has been an extremely limited access to ethnically sensitive, appropriately contextual and high quality service for mental healthcare. Despite the availability for interventions to improve outcomes for the patients, this situation still persists. The authors suggest that there is need for the development of partnerships network for adaptation.
The macro trends in healthcare and the associated careershivani rana
This document discusses emerging macro trends in the US healthcare system and their impact on future healthcare jobs. It identifies key trends like changes in demographics, lifestyle, technology, and government policy that are shaping the healthcare system and employment landscape. The aging population and rise of chronic diseases will increase demand for roles like home health aides. Growing technology usage will create jobs for health IT analysts. Changes to government policy like the Affordable Care Act aim to provide more accessible insurance and create a need for health policy analysts. These macro trends will significantly impact both the healthcare industry and the jobs of the future.
NURS 6050 GCU Nursing in Florida Presentation.docxstirlingvwriters
This document discusses a presentation for NURS 6050 on nursing regulation in Florida. It provides an overview of boards of nursing and professional nursing associations. The presentation assignment requires describing differences between these groups, the board that regulates nursing in Florida, and how federal and state regulations influence nursing practice and healthcare delivery, costs, and access. Key sources on nursing organizations are also provided.
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Customer’s Acceptance of Internet Banking in Dubaiiosrjce
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IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Student`S Approach towards Social Network Sitesiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladeshiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...iosrjce
1. The document describes a study that designed a balanced scorecard for a nonprofit organization called Yayasan Pembinaan dan Kesembuhan Batin (YPKB) in Malang, Indonesia.
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Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Media Innovations and its Impact on Brand awareness & Considerationiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer experience in supermarkets and hypermarkets – A comparative studyiosrjce
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- The study provides insights for retailers on key determinants of customer experience in each format to help them improve strategies and competitive positioning.
Social Media and Small Businesses: A Combinational Strategic Approach under t...iosrjce
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Secretarial Performance and the Gender Question (A Study of Selected Tertiary...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Implementation of Quality Management principles at Zimbabwe Open University (...iosrjce
This document discusses the implementation of quality management principles at Zimbabwe Open University's Matabeleland North Regional Centre. It begins with background information on ZOU and the importance of quality management in open and distance learning institutions. The study aimed to determine if quality management and its principles were being implemented at the regional centre. Key findings included that the centre prioritized customer focus and staff involvement. Decisions were made based on data analysis. The regional centre implemented a quality system informed by its policy documents. The document recommends ensuring staffing levels match needs and providing sufficient resources to the regional centre.
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...Donc Test
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
A Study of Healthcare Quality Measures across Countries to Define an Approach for Improving Healthcare Quality
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 12 Ver. V (Dec. 2015), PP 87-97
www.iosrjournals.org
DOI: 10.9790/0853-141258797 www.iosrjournals.org 87 | Page
A Study of Healthcare Quality Measures across Countries to
Define an Approach for Improving Healthcare Quality
Jitendra Shreemali,
Associate Professor, SPSU, Rajasthan, India
Abstract: Assessing healthcare quality is a dire need on account of huge costs of mistakes by healthcare
practitioners. The growth in world population as well as change in illness patterns among populations while the
availability of doctors as well as healthcare indicators are not the same across the world adds another
dimension to challenges faced by the healthcare sector in different countries. Maintaining or improving
healthcare quality is an aim that national governments as well as hospital managements are keen on. However,
the metrics employed for measuring healthcare quality would vary greatly depending upon the perspective of
measurement i.e., whether it is the perspective of patients/customers, doctors/practitioners or employers. This
study is in the nature of a desk study and discusses the path from research to finalized quality measures and
then presents metrics employed in different parts of the world as well as approaches that are employed for
successfully enhancing healthcare quality.
Key words: Heathcare quality, metrics, health care indicators.
I. Introduction
Healthcare is among the most ancient human needs. As regards India, the Indian healthcare sector is
extremely large in terms of revenue as well as employment it offers. ONICRA Credit Rating Agency of India
(2013) placed the valuation in 2011-12 at USD 74 Billion with the hospital industry contributing over 80% to
this. The challenges faced by Indian healthcare sector include inadequate infrastructure, inadequate investments
to meet the huge demand and inadequate trained resource for the need at hand. Factors like a growing
population, growing economy, urbanization, growing middle class, increasing incidence of certain diseases as
well as improved health awareness have led to increasing demand for healthcare. The figure below shows
estimates of these changes from 2012 onwards.
Figure 1: Increasing Demand for Care of Hospitalized Patients (Estimated)
Source: ONICRA Report (2013). Emerging Trends: Indian Health Care Industry, pp 4.
Retrieved from: www.onicra.com/images/pdf/Healthcare-industry-report-Transparent.pdf
2. A Study of Healthcare Quality Measures across Countries to Define an Approach for Improving…
DOI: 10.9790/0853-141258797 www.iosrjournals.org 88 | Page
All the three categories above are often referred to as life style diseases. Their increasing incidence
places an enormous burden on family budgets, partly, because of a higher share of private sector in health care
delivery in India as compared to several other countries. The report cites World Bank estimates of private sector
accounting for 64% of hospital beds, 80-85% of doctors, 80-% of out-patients and 75% on in-patients in 2012.
The overall share of private sector in Indian healthcare is around 69.7% and expected to grow to 81% by 2015.
Private sector expenditure of healthcare as percentage of total healthcare expenditure is compared for different
parts of the world and presented in the figure below.
Figure2: Private Sector Expenditure as Percent of Total Healthcare Expenditure in Different Parts of the World
Source: ONICRA Report (2013). Emerging Trends: Indian Health Care Industry, pp 9.
Retrieved from: www.onicra.com/images/pdf/Healthcare-industry-report-Transparent.pdf
Dhawan (2015) in Deloitte report on 2015 Health Care Outlook placed the health care spending in 2013
at 96.3 Billion USD with a projected growth rate of 12% taking this figure to 195.7 Billion USD by 2018. The
large numbers may not necessarily reflect the limitations of the Indian public health care system that is
described as, “…… patchy, with underfunded and over crowded hospitals and clinics, and inadequate rural
coverage……”. KPMG Report on Healthcare: Reaching out to the masses (2010) highlights India‟s lower status
on healthcare indicators.
Figure 3: Comparison of Select Countries on Healthcare Indicators
Source:
Source: KPMG Report on Healthcare: Reaching out to the Masses at PanIIT Conclave 2010, pp 3. Retrieved
from: https://www.kpmg.de/docs/Healthcare_in_India.pdf
3. A Study of Healthcare Quality Measures across Countries to Define an Approach for Improving…
DOI: 10.9790/0853-141258797 www.iosrjournals.org 89 | Page
Even within India, there is a big disparity across states. Given below is a comparison on healthcare
indicators across select states within the country.
Figure 4: Comparison of Healthcare Spending Patterns at Select Countries
Source: KPMG Report on Healthcare: Reaching out to the Masses at PanIIT Conclave 2010, pp 8. Retrieved
from: https://www.kpmg.de/docs/Healthcare_in_India.pdf
For a sector as large and diverse as the Indian healthcare sector, ensuring high quality of service and
care remains a herculean challenge. Healthcare quality provides enormous benefits to society all across the
world just as errors in treatments place huge costs on victims. Merry and Crago (2001) cite Institute of
Medicine‟s report, “To Err is Human” that placed the number of annual hospital deaths due to medical errors
between 44000 and 98000. Quality healthcare could be achieved through the: (a) Regulatory route that revolves
around rules, regulations and associated penalties; (b) Learning Science route encompassing the earlier route on
rules, regulations, penalties and research at academic institutions; and (c) Management Science route
incorporating the best values of medicine‟s learning route, building an organizational culture, developing
leadership practices to deal with the challenges of healthcare sector, developing necessary communication
techniques that come close to eliminating human imperfection as a source of error, and developing a review
mechanism to help interested organizations achieve six sigma quality.
An understanding of quality of healthcare requires defining quality in the context of health care. Buttel,
Hendler and Daley (2007) discuss the prevalence of multiple definitions of quality of health care. The choice of
definition depends upon the perspective of the constituent and these could be patients themselves, their family
members, practitioners or their employers besides others. The authors present a definition by expanding upon
the IOM (Institute of Medicine) definition of 1990, “Quality consists of the degree to which health services for
individuals and populations increase the likelihood of desired health outcomes (quality principles), are
consistent with current professional knowledge (professional practitioner skill), and meet the expectations of
healthcare users (the marketplace).” Successful implementation of high quality healthcare requires ensuring high
standards of leadership, healthcare quality based on metrics, reliability of healthcare, practitioner skills and
sensitivity to marketplace to manage costs, volume and revenues.
National Commission on Quality Assurance‟s The Essential Guide to Health Care quality quotes
IOM‟s (Institute of Medicine) definition of quality healthcare in 2001 as, “safe, effective, patient-centered,
timely, efficient and equitable”. The healthcare quality problems in the US fall into three categories: (a)
Underuse or not receiving required care; (b) Misuse or getting erroneous care; and (c) Overuse or receiving care
that is either not needed or has a much lower cost alternative. The objective of high quality healthcare is to
utilize resources in a manner that shifts people to a low risk state and keeps them there as shown in the figure
below:
4. A Study of Healthcare Quality Measures across Countries to Define an Approach for Improving…
DOI: 10.9790/0853-141258797 www.iosrjournals.org 90 | Page
Figure 5: Health Care Quality in Terms of Spending and Risks
Source: NCQA Report on The Essential Guide to Health Care Quality. Retrieved from:
https://www.ncqa.org/Portals/0/Publications/Resource%20Library/NCQA_Primer_web.pdf
Measuring health care quality presents a big challenge for researchers as well as practitioners. Morris
and Bailey (2014) discuss the existence of hundreds of different quality measures in healthcare and that these
can broadly be classified into four categories: (a) structure; (b) process; (c) outcome; and (d) patient experience.
Table 1: Types of Quality Measures for Healthcare
Source: Morris, C. and Bailey, K. (2014). Measuring Healthcare Quality: An Overview of Quality Measures.
FamiliesUSA: The Voice for Health Care Consumers, pp 3. Retrieved from:
http://familiesusa.org/sites/default/files/product_documents/HSI%20Quality%20Measurement_Brief_final_web.
pdf
Structure measures help assess the healthcare centre‟s capacity, process measures help assess the
healthcare centre‟s consistency in providing patience specific services as per recommended guidelines for care,
outcome measures help assess the intended/unintended effects of the treatment/care received on the patient and
patient experience measures help assess the patient‟s experience while under care. Meyer et.al. (2004) discuss
factors that contribute to the development of high performing hospitals. These include internal elements like: (a)
developing the right culture; (b) retaining the best people; (c) establishing the right in-house processes; and (d)
giving staff appropriate tools including IT based tools for the job as well as external elements like (a) market
competition; and (b) health quality standards. The study observes that „racial‟ and ethnic minorities are more
likely to receive lower quality health care as seen through higher death rates through HIV, cancer or heart
disease even though income status, insurance status, age as well as severity of ailment are comparable. This
points to a very high need for quality measures that can be the basis of ensuring consistently high quality.
Evolution of quality measures is an extended process that involves several steps. Given below are the steps for
evolving specific quality measures.
5. A Study of Healthcare Quality Measures across Countries to Define an Approach for Improving…
DOI: 10.9790/0853-141258797 www.iosrjournals.org 91 | Page
Figure 6: Evolution of Quality Measures for Health Care
Source: Morris, C. and Bailey, K. (2014). Measuring Healthcare Quality: An Overview of Quality Measures.
FamiliesUSA: The Voice for Health Care Consumers, pp 9. Retrieved from:
http://familiesusa.org/sites/default/files/product_documents/HSI%20Quality%20Measurement_Brief_final_web.
pdf
Availability as well as utilization of health care vary enormously across countries and economies with quality
being one of the contributing factors.
II. Utlization Of Health Care Facilities And Need For Suitable Metrics
Bernstein et.al (2003) include the following factors as contributing to increased utilization of US health services:
a. Increase in availability of health services;
b. Increase in population especially the elderly population;
c. Availability of new procedures and technologies (eg. Knee/hip replacement, MRI etc.);
d. New disease entities (eg. HIV/AIDS or bio terrorism);
e. Increased coverage of health insurance;
f. Availability of new drugs and enhanced use of existing drugs; and
g. Consumer preferences for some specific treatments (eg. Cosmetic surgery)
The study highlight changing pattern in health care and associated facilities in the US. For instance,
while the number of community hospitals in US declined from 5384 in 1990 to 4915 in 2000 and number of
beds/1000 population fell from 4.2 to 3.0 in the same period, there was a quantum jump in out-patient
department visits from 860 to 1852/1000 persons in the same period caused, at least partly, by an aging
population. Further, there was also an increase in full time equivalent personnel from about 3.42 Million to 3.91
6. A Study of Healthcare Quality Measures across Countries to Define an Approach for Improving…
DOI: 10.9790/0853-141258797 www.iosrjournals.org 92 | Page
Million from 1995 to 2000 though a large number of these were being employed for management or
administration and not patient care.
DeFrances et.al (2008) show the changing pattern in inpatient care in USA on account of an aging
population.
Figure 7: Distribution of Hospital Discharges by Age from 1970 to 2006
Source: DeFrances, C.J., Lucas, C.A., Buie, V.C. and Golosinskiy, A. (2008). 2006 National Hospital
Discharge Survey. National Health Statistics Reports, No. 5, July 30, 2008, pp 1. Retrieved from:
http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf.
With enhanced use of IT to collect as well as process data relating to healthcare, Padman and Tzourakis
(1997) highlight the need to assess the quality of data gathered for it to describe quality of healthcare accurately.
The data needs to be complete, correct, consistent and timely to provide a suitable feedback on quality of
healthcare. Campbell et.al (2002) discuss factors that are important in developing healthcare indicators: (a)
Clearly identify the stakeholder whose perspective the indicator reflects; (b) Identify aspects of healthcare being
measured; (c) Actual data relating to the indicator. Besides the systematic process for defining quality indicators
described in Figure 6 above, quality indicators can also be developed using non systematic approach like the
case study method though it does suffer from a shortcoming of not tapping into all available evidence. Raleigh
and Foot (2010) list the uses of healthcare quality indicators as including: (a) Local teams using measures for
day-to-day monitoring and benchmarking; (b) Organizations reporting on quality to local
communities/authorities; (c) Health authorities driving improvements; and (d) National authorities comparing
performance across countries and setting priorities.
III. Practices In Achieving Achieveing High Quality
The challenges nations face in raising healthcare quality comes, at least, partly from the sheer
magnitude and size of the sector. WHO lists the features of a well-functioning health care that responds in a
balanced way to population‟s requirements and expectations by: (a) improving health status of communities and
its members; (b) defending the population against threats to its health; (c) mitigating against the financial
consequences of ill health; (d) providing equitable access to health care; and (e) developing ways whereby
people can participate in making decisions impact their health as well as health systems. National healthcare
systems could be subjected to forces that do not necessarily facilitate rational decision making. These include
disproportionate focus on specialist curative care, fragmentation on account of multiple competing projects,
programs, and institutions, and increasing commercialization of health care delivery especially in poorly
regulated systems.
Kumaraswamy (2012) carried out a study of corporate and non-corporate health care centres to find
that the important service quality factors in health care centres are: (a) atmospherics; (b) operational
performance; (c) physician behavior; and (d) supportive staff with supportive staff and atmospherics being the
important discriminating factors as regards service quality. Mosadeghrad (2014) worked on identifying factors
that healthcare quality in Iran through in-depth individual and focus group interviews with 222 stakeholders to
find that healthcare quality is a function of personal factors of the provider and patient as well as factors related
to health care , .
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DOI: 10.9790/0853-141258797 www.iosrjournals.org 93 | Page
WHO report on Quality of Care aims to provide national decision makers with a generic process to
design and implement effective interventions aimed at promoting high quality in health care systems by
optimizing use of available resources. The figure below present a process for building a strategy for quality:
Figure 8: Generic Process for Building a Strategy for Quality
Source: WHO Report on Quality of Care: A Process for Making Strategic Choices in Health Systems, pp 14.
Retrieved from: http://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf
An effective strategy for quality in health care, thus involves detailed analysis as well as implementation that in
turn includes an implementation process and monitoring of progress against established goals of the process.
Various domains come into play in achieving this. These include leadership at the health care centre that
influences use of appropriate information and quality measures, engagement with patients and the population at
large, conformance to regulatory standards, building organizational capacity for improved health care and
putting in place a model of health care ideally suited to the market place and local conditions. The figure below
shows these linkages with leadership being the core of all quality interventions and different domains being
interconnected to each other, thus influencing each other making high quality care a bigger challenge than any
unidirectional approach can achieve.
Figure 9: The Different Domains of Quality Intervention
Source: WHO Report on Quality of Care: A Process for Making Strategic Choices in Health Systems, pp 21.
Retrieved from: http://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf
The Position Statement of Health and Public Policy Committee and Office of Health Policy (2012)
highlights the complexities in attaining quality because of different perspectives on it besides the parameters
themselves being multi-dimensional and inter-related. The Position Statement lists the following ten principles
for achieving high quality health care:
i. The specific dimensions of quality need to be relevant to stakeholders and actionable by them for
stakeholders to contribute to improvements;
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ii. The improvement in quality need to be quantifiable and measurable besides being linked to desired
goals;
iii. Quality improvement systems must not be just another bureaucratic layer nor should they impede or
detract from health professionals‟ duties or interfere with health professionals‟ ability to provided
required services throughout the continuum of health care;
iv. Outcome of the treatment/care as well as services provided need to reflect a culture of safety;
v. Healthcare quality improvement necessarily requires a learning culture, upgrading competencies and
professional development to invigorate quality practices;
vi. Health care quality improvement can be greatly facilitated by governments through incentives,
investments and collaboration among government agencies for improved knowledge sharing;
vii. Health care quality improvement is critically dependent upon collaborative sharing of knowledge,
transparency as well as accountability;
viii. Health care service providers must conform to a patient centered systems approach;
ix. The responsibility for health care quality improvement lies at an individual as well as group level as
regards physicians and others engaged in providing health care services;
x. Quality improvement systems need continuous and active involvement of physicians and others
engaged in providing health care services.
The Centres for Medicare and Medicaid Services (CMS), an agency within the Department of Health
and Human Services (HHS) in USA identified 33 measures across four domains, namely, Patient experience of
care received, Care and coordination on patient safety, Preventive health and At-risk population. Data for these
is collected through surveys (7 measures), claims (3 measures), CMS Web Interface (22 measures) and HER
Incentive Program Reporting (1 measure).
A Report prepared by the CMO Office Department of Health for the Irish Health System by examining
various quality metrics derived from Hospital In-patient Enquiry (HIPE) data to ascertain possibility of
monitoring healthcare quality based on these. The Hospital In-patient Enquiry System provides discharge data
from publish funded acute hospitals in Ireland. The list of indicators included number of in-hospital mortality
cases:
1. Within 30 days after AMI (acute myocardial infarction)
2. Within 30 days after ischaemic stroke
3. Within 30 days after haemorrhagic stroke
4. Within 30 days following hip fracture surgery
5. Within 30 days after colectomy for emergency admissions
The other measures included:
6. Time to hip fracture surgery measuring time from diagnosis to surgery for patients 65 years or more.
7. Age at orchidopexy
Rosenthal et.al (2012) present the recommendations of over 75 researchers coming together to identify a
core set of standardized measures aimed at evaluating patient centered medical homes with focus on clinical
quality and cost/utilization.
Table 2: Core Cost and Utilization Measures for Cross Study Comparison of Patient-Centered Medical Home
Source: Rosenthal, M.B., Abrams, M.K., Bitton, A., and The Patient Centered Medical Home Evaluators’
Collaborative (2012). Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost,
Utilization, and Clinical Quality, pp 3.
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Based on a modified Delphi process, the researchers came up with the consensus metrics given in the
table below. Mere metrics do not suffice as regards measuring quality since such evaluation requires applying a
validated measure for collecting data and it is important to use an appropriate mix of process and outcome
measures for evaluating patient-centered medical homes.
Table 3: Core Recommended Technical Quality Measures for Adults for Patient Centered Medical Homes
Source: Rosenthal, M.B., Abrams, M.K., Bitton, A., and The Patient Centered Medical Home Evaluators’
Collaborative (2012). Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost,
Utilization, and Clinical quality, pp 5
Contd.
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Source: Rosenthal, M.B., Abrams, M.K., Bitton, A., and The Patient Centered Medical Home Evaluators’
Collaborative (2012). Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost,
Utilization, and Clinical quality, pp 6.
IV. Conclusions And Recommendations
This study highlights the challenges faced in measuring health care quality. These challenges begin
with devising appropriate measures that take into account the perspectives of different stakeholders. This is
because the metrics that measure quality from the perspective of employers, practitioners and patients are quite
different from each other. It is not only the measures themselves that present a challenge, with increased use of
IT in collecting healthcare data, its essential to establish that data collected is complete, correct, consistent and
timely if it has to provide credible feedback on healthcare quality. After defining metrics, a quality improvement
plan formulated after ensuring buy-in of medicare practitioners and driven by leadership that focuses on
enhancing staff competencies as well as organizational capacity needs to be put in place. The metrics itself need
to take into account country or region specific needs before a programme is put in place for its implementation.
V. Limitations Of The Study And Scope For Further Research
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This study was in the nature of a desk study that looked at practices from different parts of the world.
Data for this study is secondary in nature. Such data tends to be at a higher level of abstraction than what an
individual health care centre often requires. Thus individual health centres striving for improvements may need
to review the metrics listed here to establish their appropriateness for the health care centre in question. The
same applies at the national level as well with some but not necessarily all metrics being relevant to any given
country. These limitations point to the need for a deeper study in the Indian context as well as in the context of
any given state in India.
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