DQ 5-2

DQ 5-2

1.

Quality of care is essential to increase patients' visits to hospitals while helping to improve the profit in healthcare transactions; it measures the hospital's excellence in terms of patient care and promotes a sense of security among communities due to its effectiveness for healing people. The definition of quality of care changes per profession, entity, or person who evaluates it. Exploring and discussing characteristics that make the quality of care different between government, healthcare providers, and patients will help everybody to meet in a common ground and improve this significant misunderstanding.

 

Per Government:

According to the IOM study committee, "quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." (IOM,1990) The standard is defined by hospitals, medical organization, physicians, nurses, and anybody in the healthcare field who is knowledgeable of their impact in any ill patients.

Ex. CMS is visiting hospitals nationwide to make sure their guidelines are applied to promote general patient safety and better quality of care.

 

Per Healthcare Providers:

In order to provide quality of care, the healthcare provider should perform any task with effectiveness, efficiency, centering on the patient, while promoting safety and equity. All of these should be performed in a timely manner that does not jeopardize any of the other patients.

Ex. Nurses are making sure their patients are being heard by other healthcare providers while providing care compassionately and safely possible.

 

Per Patient:

Patients tend not to have that much knowledge in health matter, so their definition of care is less technical and more focus on the experience. Some of the factors that draw their attention are:

- Staying healthy, which include illness avoidance. 

- Getting better that involves healthcare professionals helping them to recover from illnesses and injuries. 

- Living with chronic conditions; before, during, and after their condition

- Coping with the end of life (AHRQ, 2018)

Ex. A patient that comes to the ER with an allergy reaction, and it is treated quickly, safely, respectfully, and holistically from the beginning to the end of their care. 

 

Thanks

 

References:

AHRQ. (2012, September 01). Understanding Quality Measurement. Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/understand/index.html

Institute of Medicine (US) Committee to Design a Strategy for Quality Review and Assurance in Medicare. (1990, January 01). Defining Quality of Care. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK235476/?report=reader

2.

Quality used in this case is an ambiguous term. Per website Dictionary.com, quality is defined as a noun, “Character with respect to fineness, or grade of excellence.” Quality can mean different things to different people, it is important to be able to have a standard that we can use when identifying quality care so there is an expectation to be met. In the classroom textbook, Economics Of Health and Medical Care (6th Edition) written by Lanis L. Hicks on page 138, high quality runs parallel with high technology. “High quality is frequently associated with high technology; in other words, highly trained specialists and sophisticated equipment (Hick 2014).”

For the government, they provide programs such as Medicare and Medicaid that cover individuals for healthcare. In terms of quality, the government believes that if you have coverage then its quality care and I would assume this based off the fact that there are programs to help individuals though they vary state to state if you are low income which allows for the states to decide their own quality of care. Therefore, I believe the governments version of quality care is since healthcare can be provided.

Healthcare providers work in the field of healthcare. As a rule of thumb, and what I hope most health care providers and clinical staff believe in is treat others how you want to be treated. When I went to go get my wisdom tooth pulled, there was no after-care instructions, I was not given any materials to assist with the active bleeding in my mouth as well as when I was being taken out of the surgical room, my friend who was driving me felt that they had rushed me out and not given me time to recuperate since I was completely hysterical after the ketamine nap. To me that was horrible quality of care, I can’t imagine what patients expect. With people who have no medical background they could believe that its normal not to receive these basic healthcare amenities.

Patients can view quality of care completely differently, especially if they do not come from a healthcare background. You could not provide them with education or discharge instructions and they have no idea that may be inappropriate or you could have another view where if the patient is unable to obtain a prescription or receive the pain medications they want they may deem the healthcare organization to not be providing quality care that they are uphold to. It is dependent on individuals how they view quality care.

Quality care should cater to the individual appropriately where abuse of substances does not occur. Healthcare providers should always want to do good and no harm. Providing education is quality care as well as creating an appropriate plan of care to ensure the longevity of the patient.

 

References:

Hicks, L. L. (n.d.). Economics Of Health and Medical Care. 

Quality. (n.d.). Retrieved from https://www.dictionary.com/browse/quality

3.

The federal government provides options on a marketplace website for those of us who need health insurance through the Affordable Care Act website. The federal government states that there are insurance plans to meet the needs of the purchaser and with these plans comes network doctors, hospitals, pharmacies, and depending on the plan, should meet the needs of the recipient requesting and purchasing health care plans.

The plans come in "metal level's" - Bronze, Silver, Gold, and Platinum.

Examples and quick synopsis of what is provided:

EPO, (Exclusive Provider Organization is a plan that works for a limited list of doctors and facilities in this network.

HMO, (Health Maintenance Organization) - The physicians are contracted with HMO generally one would not be covered out of network. You may have to live in designated areas to qualify for an HMO plan. HMO plans provide preventative care options.

POS, (Point Of Service), A plan that is tied to the use of doctors on the network, and a referral is needed for specialists.

PPO, (Preferred Provider Organization), This plan has network physicians, but you are allowed to use MD's from outside for additional cost.

 

Patient views of quality medical care:

As a patient and recipient of health care through my employer, I am extremely unpleased with health insurance today as opposed to the past. Through employers today, we also have plans offered such as described above. (Adventist Health) My thoughts are that if I work hard, find jobs that provide health insurance coverage, why am I being penalized? To qualify for the Bronze package (through Adventist Health) employees must pay for a biometric screening, or we can go to the lobby and get blood drawn and weight monitored etc. in front of a room full of people. It is degrading and breeches privacy. Mine, (and many citizens) feel penalized for having had good insurances and decent co-pays from private sectors that we have lost our coverage and are having to choose from mediocrity. Something else I have observed recently where I currently work is, the RN staff get hired (because we hire new grads) and after a year move on to Sutter North (local hospital chain) or Kaiser Permanente. Afterwards, we are left with subpar nursing staff that remain at AH because they cannot get hired by these opposing corporations. Mainly because they do not possess the skills and knowledge that would be required. Quality, it is lacking and if it weren't, we would not be losing strong staff to better covered and quality facilities. I wish I had the stats on the turnover, but I don't really need them, I see it firsthand. The qualified RN's move on. They are disgruntled with the insurance and can go where they are not being penalized and treated as if they should have to be scrutinized negatively to get what should rightfully come with a health care job, quality insurance!

The problem I see with government involvement is that the money goes to the big companies and the private sector as it is dissolved by government laws and stifling refinement leaves only the hospitals and facilities that have a monopoly and we all know that a monopoly drives prices up, it leaves no room for competitors and this means waiting for things to get done, building, where to build, supplies, technology, and the FDA too is keeping drugs from helping, medications that could save lives. (Healthcare 2017)

In a journal on quality health care, the journal did a study on patient opinion of quality health care. The conclusion of top priorities are things like; hospital organization, (do you trust the workers) the competence of the health care workers, the nurse, physician relationship, general atmosphere on the units, size of the hospital, patient capacity, comfortable environment, staying in a newer hospital that is clean and spacious had a positive impact on the minds of patients. (Grøndahl et al.) It is surprising to read that these are the priorities, but then it makes sense because even if patient care isn't the best when coming from a new shiny clean building it seems more reputable.

Healthcare. (2017, February 23). Retrieved June 15, 2019, from https://www.lp.org/issues/healthcare/

Adventist Health. (n.d.). Retrieved June 15, 2019, from https://www.adventisthealth.org/employee-health-plans/my-health-benefits/

Grøndahl, V. A., Kirchhoff, J. W., Andersen, K. L., Sørby, L. A., Andreassen, H. M., Skaug, E., . . . Helgesen, A. K. (n.d.).