Most people believe that the hospital is the safest place to go in an emergency. However, few are aware that the Hospitals themselves are the cause of crisis for many individuals. Hospital errors are very costly and cause many people their lives. It has been suggested that between 44,000 and 98,000 people die every year due to these blunders. It is estimated that the cost to the taxpayers is 37.6 to 50 billion dollars each year. Some are easily preventable while other mistakes are more intricate. Regardless of the type of error, the families of the victim always want answers, while everyone else seeks to learn the preventative measures the hospital should take to keep the accident from occurring in the future. Within this paper we will examine what Quality healthcare is, how it is given and how it has been improved.
Healthcare Quality is defined as the “degree to which health services for individuals or populations increase positive outcomes and are consistent with the current standards of knowledge”(p.82) .
There are several distinct aspects of Quality Care that must be adhered to in order to satisfy the aforementioned definition. One is that the health services should achieve desired health outcomes for people and populations while meeting their individual preferences. A second aspect that must be satisfied is that it must abide by regulation and rules implemented by policy makers and third party subscribers. Another important element of healthcare quality and performance is the relevant use of its sparse resources. Historically policy makers have focused their undivided attention on the quality of healthcare. Examples of these are Codex Hammurabi and the Hippocratic Oath. Modern versions are amended and adhered to by physicians as well as used in training. These policies have greatly influenced every position I have held in health care. Without it the industry will not hold the position it now does.
A leading 21st century Physician, Avis Donabedin, introduced an idea that quality could be viewed from a systematic perspective. He placed this theory in three main categories: structural, processes, and outcome. The structural elements include the material, physical, and human resources of an organization. This would also include the building itself. The process element involved the interaction between client and staff. Furthermore, it takes into consideration the required as well supplementary activities of the patient. Lastly, outcomes are the resulting health status of the client. By utilizing this approach physicians are able to measure the effectiveness and the quality of the care that was provided. Moreover, quality assurance is associated with reforms and observations made by Florence Nightingale. Her observation of unhygienic conditions promoted reformation in hospital sanitation. Similarly, Donabedin’s theory included the observation approach. Ernest Codman built upon Nightingale’s concept. He proposed that hospitals examine whether that the services they provided to patients were beneficial and did they address the reasons for failure. Codman implemented a system called “The End Result System” in 1910. This system articulates three main points of quality assurance. The first principle is to examine quality measures to determine if problems are patient, system, or clinician-related. Secondly he proposed assessing the frequency and prevalence of quality deficiencies. The last principle is to evaluate and correct any deficiencies so that they do not reoccur. However, some complications can arise within healthcare quality and can be seen in three forms: underuse, overuse, and misuse (p. 82).
Underuse is when proven procedures and treatments are not used due to a number of reasons. One example is with vaccinations. Although we now have clinical research that supports the use of vaccinations, some parents do not utilize them because of fear or there isn’t a lot of knowledge available about them. Overuse can be described as a procedure that are prescribed despite growing evidence of the treatments ineffectiveness to treat or cure. While misuse is medical errors that cost the hospitals as well as the taxpayers dearly. However with simple oversight these issues can be rectified. Programs like the Hospitalization Standardization Program of the American College of Surgeons utilizes Codman’s “End Result System” because it has been proven to be effective in order to ensure quality healthcare. Codman’s program established basic requirement that focused on the quality of care within hospitals, including the organizing of hospital medical staffs. It stated that only competent, licensed, and well trained staff was given membership and it restricted all others. His program included a framework of policies and procedures to ensure staff meetings and clinical reviews. It ensured accurate recording of medical histories and developed diagnostic as well as treatment facilitates under physician watch (p.88). These programs assure that the performance of the hospital stays within the status quo. Similarly, organizations like the Joint commission accreditation program developed authenticating and tracking polices to benchmark standards. My company was threatened to lose our accreditation because our numbers were off. Because our superiors were fearful of the results we had to work harder to ensure success. Policies such as these assures clients that they will receive professional and beneficial healthcare at every accredited hospital.
Many measures have been put into place to better regulate the quality of healthcare provided to the American citizens. It has been my experience that the more oversight the less chance for error. This will lessen the risks of misuse, overuse, and underuse and will greatly decrease the impact on the system overall. The customer will still benefit from the high level of quality they have grown to expect from a premium healthcare provider. The amount of money that will be saved can be reinvested into new research and technology that will help improve the current system.
Buchbinder, S. B., & Shanks, N. H. (2007). Introduction to health care management. Sudbury, MA: Jones and Bartlett.