As it has already been found out, quality of medical care is a highly significant sphere of attention from the side of controlling institutions, so particular care should be witnessed from the side of every medical institution staff to ensure continuous work on healthcare improvement taking place. Having discussed the necessity of healthcare improvement, it is logical to proceed to the identification of the spheres that may require improvement in particular healthcare establishments, namely hospitals.
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One should understand that it is impossible to work out a quality improvement plan in case weak sides have not been identified and all measures witnessing the current state of multiple aspects of the hospital’s functioning have not been assessed and analyzed. For this reason, the present paper will consider a set of quality assessment tools that give a clearer idea of the quality of care level the hospital possesses in various dimensions. The paper will also investigate some quality improvement tools that will help analyze and control the improvement process as well as provide the efficient basis for its final qualitative and quantitative assessment.
As it has been previously discussed, hospitals are institutions with a too broad spectrum of activities – they either take up too many functions or specialize narrowly in some specific spheres. So one can identify such weak sides of quality care performance in hospitals as handling administrative data and taking proper care of individual patients. For this reason, the record cards, collecting primary data, and dealing with CareMaps have been chosen for consideration as quality assessment tools.
Record cards have always been considered a powerful tool for the generalization of health information of patients to create one general database of symptoms, diagnoses, and treatment methods. In case the work with record cards is arranged properly it will be much easier to make an accurate diagnosis, to choose the best way of treatment, and to save resources for analysis and tests. Such an efficient framework for handling patients is still in the project, however much is done on the way to improve the quality of record cards arrangement. Among the main indicators important for assessment, record cards include all data about the patient as well as the financial information that may be highly helpful in managing the administrative and accounting issues in the hospitals’ activity.
“Individuals involved with public health and health care administration should examine the different kinds of report cards so that they can evaluate them. To properly evaluate report card information and use it effectively, administrators should know the source of the data, the reason for the collection, and the intended audience” (Dlugacz, 2006, p. 162).
The quotation given above enumerates the main actions that may be undertaken with record cards to assess the quality of care in a hospital, thus emphasizing their importance in this health institution’s daily operations. However, introducing a record card system in the whole country in the digital form is still rather costly, thus postponing the completion of the process (Beaver, 2003). Besides, record cards are still considered secondary data sources. In this connection it is important to mention a collection of primary data that gives information of basically different types and acquires different significance than that of record cards:
“By collecting primary data about specific diseases, the state forced clinicians to document specific data points in the medical record. From this information, a model was developed by a task force of experts from around the state that attempted to explain why people died, not simply encode that they did die” (Dlugacz, 2006, p. 139).
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The third data collection tool is the CareMap:
“The original intent of the CareMaps was to define the patient flow and to provide information for monitoring length of stay (LOS). CareMaps outline expected key interventions and outcomes along a timeline for specific disease processes” (Dlugacz, 2006, p. 160).
Thus, the CareMap is a very helpful and informative assessment tool that provides accurate data on the direct treatment process from the side of the patient, not only the administrative kind of information. These three tools provide the majority of essential information concerning patient care and help specialists evaluate the quality of care in a hospital. All three tools give complete data about the patients, their health record and treatment as well as expenses they have to depend on the disease. However, they differ in angles of this information representation. For example, the record card does not get deep into the reasons for death or survival just recording the fact. Primary data is more detailed and deep, while the CareMap considers the patient not from the side of the administrative staff but more closely, in the whole period of his or her treatment and stay in hospital.
Making inferences from these quality assessment tools, it becomes possible to identify some of the key quality improvement tools that may appear efficient in the process of QI plan implementation. These are, first of all, physician and provider profiling and measuring and improving patient experiences of care.
Physician and provider profiling is a potentially useful tool for the improvement of physician performance, which is essential in the medical care process. The profiles including all substantial information about physicians and providers will afford to make a grounded conclusion on their competencies, pitfalls, qualifications, current productivity, etc thus helping to decide on whether to continue cooperation or not (Ransom, Joshi, Nash & Ransom, 2008).
This is an objective piece of information that should be available both for the administration of the hospital and for patients. Being informed is an essential part of the QI plan, this is why possessing the comprehensive, full profile of the physician who is treating them, patients will feel much more comfortable, which results in more positive feedback for the hospital.
Measuring and improving patient experiences of care represent the subjective piece of information consisting of reflections from the customers about the quality of care they receive in a hospital (Ransom et al., 2008). They surely cannot objectively evaluate the work of medical experts because of the absence (more often) of medical education; however, they are the main customers of the services the hospital provides. This is why a low level of patient satisfaction should become a matter of concern for the administration and quality improvement team. Besides, prompt response of customers about their medical care experiences will assist in timely detecting the pitfalls of the hospital’s functioning and will help fix the emerging problems in a timely and constructive manner.
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Surely, these quality improvement tools provide substantially different information – from objective, standardized ones to personal, subjective reflections. However, they both deal with the quality of performance shown by physicians – through the eyes of objective medical professionals and on the level of perception of biased patients. In any case, they both provide highly important information that can be continuously applied in the current quality improvement process and help achieve much better performance results and indicators.
Beaver, K. (2003). Healthcare Information Systems. CRC Press.
Dlugacz, Y. D. (2006). Measuring Health Care. John Wiley & Sons.
Ransom, E.R., Joshi, M.S., Nash, D.B., & Ransom, S.B. (Eds.). (2008). The Healthcare Quality Book (2nd ed.). Health Administration Press, Chicago.