Discussion

Discussion 1

The business case is presented in the form of a document or verbal communication, which describes the reasons for initiating a task. In this, always the expense of money and effort is always correlated with the expected output from a business point of view (means, it must satisfy the business needs).

For example, upgrading software improves the performance of the system (general case). If we observe it in business case view, improved system performance increases customer satisfaction and also reduces the effort (as processing time decreased) and thus, the maintenance costs.

The business case for health-care quality improvement involves different methods of reducing medical errors, improving patient safety, patient satisfaction, patient outcomes, as well as reducing the cost of care over time.  Investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. These four groups of people will benefit from quality improvement: patients, providers, insurers, and employers. Investing in quality improvement (QI) work can bring about financial results for healthcare organizations over time, have beneficial organizational effects, and improve outcomes for patients.

Discussion 2

The business case for healthcare quality improvement essentially writes itself. The industry defines quality as limiting waste, high reliability, high productivity and a return on investment as measured by outcomes. The price of poor quality in health care costs the U.S. $1.2 trillion every year, and that price tag is paid by the whole community in the increasing costs of healthcare and the loss of health and life of affected patients. It has been shown that patients, providers, insurers, and employers all benefit when healthcare dollars are invested in developing quality improvement outcomes (Swensen). It is not only important to invest in quality improvement because organizations see a return financially, but they also see a return in public opinion. Process improvement enhances an organizations reputation with the community and with its own workforce. As I have stated previously, almost every healthcare professional goes into the field to help people and to do as little harm as possible. It is not fair to place such a high cost on the hearts and minds of healthcare professionals involved in these avoidable healthcare errors. It is a healthcare organization’s moral and financial responsibility to invest in quality improvement.

Swensen, Stephen. The Business Case for Health-Care Quality Improvement. https://pubmed.ncbi.nlm.nih.gov/23429226/ (Links to an external site.).  Accessed 3 March 2021

Discussion 3

The business case for quality improvement in health care rests on realization of value - both for the provider of the service and the consumer of the service. Value can be viewed as monetary return on investment for a hospital, physician practice or medical supply company. From the consumer perspective - this commonly gets defined as getting more in service than you pay in insurance premium or out of pocket cost, and from an insurer or payer it gets measured in a similar fashion - ergo how much was billed that we didn't have to pay?  The business case for quality improvement in health care should be defined as improvement in health relative to the costs incurred to achieve it.  For all the money spent on health care services and products, does the number of days of work lost due to illness or injury go down? Does the amount of money spent on disability benefits due to medical illness such as diabetes complications or morbid obesity go down. Reduction in errors that lead to injury is a short term gain, but changing a culture that values low cost to one that values fitness and health as real measurable outcomes of healthcare services and products is the true value proposition of quality health care. 

According to Deming, process improvement has three classes of outcomes: 

1. A physical outcome: the product or service.

2. A service outcomes: the interaction between the producer of a product or service and its consumer (in the care delivery experience, patient satisfaction).

3. A cost outcome: the resources used to operate the process.

Applying these ideas to health care generates five health care quality opportunities:

1. Massive variation in clinical practices (making it impossible that all patients receive good care).

2. High rates of inappropriate care (where the risk of harm inherent in the treatment outweighs potential benefit).

3. Unacceptable rates of preventable care-associated patient injury and death.

4. A striking inability to “do what we know works” (crime of omission).

5. Huge amounts of waste, leading to spiraling prices that limit access to care.

As a practicing physician who has worked in government, private for-profit, and private non-profit settings, all of these opportunities exist. However, there is a sixth opportunity which is a healthy population. We don't have one. The true indicator of value, and hence the business case for improved health care quality is a population resistant to pandemic disease, that is able to live independently and productively, in short, that ultimately doesn't need a whole lot of health care services and products. 

 

 

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References

1. https://www.healthcatalyst.com/insights/healthcare-quality-improvement-as-a-business-strategy