DB4-40

IMPORTANCE OF EMERGENCY DEPARTMENTS (ER) 6

There are many definitions of quality as seen by the provider, the patient, and the health system.  The IOM defines quality as the “degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Singh, 2019).  This definition comes with several key points: First is the quality performance is measured in a scale that ranges from excellent to unacceptable. Secondly, the health services provided by the delivery system is measured as opposed to individual outcomes and behaviors. Next, quality can be evaluated by the public.  Lastly, “the emphasis on desired health outcomes, and scientific research must identify the services that improve health outcomes” (Singh, 2019).  The dimensions included with the quality of care at the micro level include the clinical aspect, interpersonal aspect, and the quality of life.  The interpersonal aspect is how the healthcare provided is viewed by the individual receiving that care.  Patients tend to evaluate their provider based on their level of compassion and care they show, their interest and time spent. This is important because where there is a positive provider-patient relationship, a successful treatment of more probable. Interpersonal aspects of care are important to the provider because this increases the likelihood of compliance with treatment and returning for follow up care.  The interpersonal relationships span outwardly to the staff in the office as well.  The patient relates their quality of care to start at reception and scheduling, all the way to billing representatives. Interpersonal engagements are also important to the provider because it leads to better patient engagement, a more realistic insight on patient expectations, and can also decrease the chance of error with the patient because the patient is less likely to withhold information vital to their treatment planning. On a further note, is the social role of the patient-provider relationship.  The provider is seen as this person of power, of authority. The patient feels more vulnerable and in need of help, there to ask for support from the provider. This relationship is asymmetric and with the provider having the superiority.  Interpersonally it is important for the provider to realize the feelings of the patient in this manner and bend to the patient to become a team working together to aid illness, build communication and try to break the barrier of this superiority and lessen the likely of disappointment on both sides (Chichirez & Purcarea, 2018).

   There are demographic, clinical, and social factors on the side of the patient that impact interpersonal care delivery.  Socio-demographic influences impact the quality and the type of interactions had between the provider and the patient.  For example, where the patient is from, and the language the patient speaks. A patient who’s primary language is not English would have a difficult time comprehending the directors given to them from the provider even if they agree to the understanding. There is also the social impact of religion and culture, some patients are banned from consuming medications based on their religion. Clinically, there is also the idea hardwired into some people that without medication, an illness cannot be cured.  This impacts the patient and the providers because the patient without full understanding may seek care from another provider to obtain the drugs, they believe are the only cure. There is also the patient’s financial status included under the social umbrella that affects the quality of health services they receive. If a patient cannot afford the testing and the prescribed treatments, they may choose to forgo care.  “Quality of patient care depends directly on the quality of patient education and responsibility; knowledge of their rights influences their expectations of quality services” (Mosadeghrad, 2014).