Evaluation, Final

Quality Indicators

By

Maria Estevez

HCM4002

South University

June 20, 2017

Safety Report Examination

Patients’ safety is important and injuries arising from healthcare processes need be avoided at all costs. Based on the safety report of the Methodist hospital – Jefferson Health, the hospital had a rating of ‘Better Than Expected’ in one safety indicator, ‘As Expected’ rating in nine safety indicators and ‘Worse Than Expected’ in three safety indicators. Patients Safety Ratings indicate how well hospital safeguards patients from potential complications which are preventable at the provider or system level (Ross, J., 2010). The safety indicator ratings depict the level of quality of health service provision at the facility and as such play a central role in the choice of a hospital. From the patient’s point of view, the report indicates that the hospital is not exemplary in quality service provision as evidenced by the ‘Worse Than Expected’ ratings in three safety indicators and only one ‘Better Than Expected’ indicator rating.

Most Critical Indicators

In my view, the patient safety indicators are most critical of the three categories as they assess the unwarranted negative experiences that patients go through due to subjection to the treatment processes (Hart & Sweeney, 2006). These events are preventable by change at the provider or system level (Ross, J., 2010). The indicators focus on potentially avoidable incidences of complications and other iatrogenic events that compromise patient safety in the inpatient setting (Hart, J., & Sweeney, G., 2006).

Safety Indicators Pertaining to Surgery

Safety indicators pertaining to surgery include; foreign remains left during medical procedures, postoperative respiratory failure, postoperative sepsis, postoperative hemorrhage, accidental puncture or laceration, postoperative wound dehiscence, transfusion reaction (Hart & Sweeney, 2006).

Indicators for measurement

Accidental puncture or laceration

This patient safety quality measure is used to assess the ratio of accident punctures or lacerations during a procedure for patients aged 18 years and older (Hart & Sweeney, 2006). The Accidental puncture or laceration indicator is meant to reduce complications that result from technical difficulties in medical processes especially ones involving an accidental puncture or laceration. The indicator is measured through getting the ratio of surgical and medical discharges of over 18 year olds to discharges among cases meeting the inclusion and exclusion rules. (Gallagher, Cen, & Hannan, 2013).

Chronic obstructive pulmonary disease admission rate

This is an estimate of patients suffering from Chronic obstructive pulmonary disease discharged but then readmitted (Gallagher, Cen, & Hannan, 2013). The measure was developed as an alternative to existing measurement (Ross, J., 2010) and is measured through getting ratio of ‘predicted’ readmissions to ‘expected’ readmissions as a product of national unadjusted readmission rate.

Inpatient mortality

The Inpatient Mortality Indicators are a subset of quality indicators that hospitals apply to measure internal hospital mortality. They consist of medical processes for which mortality rates may vary significantly across institutions (Zorowitz, R. D., 2010). For instance, pediatric heart surgery rate of mortality indicates the number of deaths per 100 heart surgeries in patients aged below 18 years (Gallagher, Cen, & Hannan, 2013). It’s measured through getting the number of deaths per 100 surgeries in patients under age 18 years (Gallagher, Cen, & Hannan, 2013).

Indicator coverage of quality in Surgery

From the above indicators, Accidental puncture or laceration and transfusion reaction are patient safety indicators (Gallagher, Cen, & Hannan, 2013). Chronic obstructive pulmonary disease admission rate is a prevention quality indicator (Ross, J., 2010) while inpatient mortality indicator is an inpatient quality indicator (Zorowitz, R. D., 2010). Put together, these indicators cover all the three quality areas; patient safe indicator, inpatient quality indicator and prevention quality indicator for the program high-risk area.

References

Carretta, H. J., Chukmaitov, A., Tang, A., & Shin, J. (2013). Examination of Hospital Characteristics and Patient Quality Outcomes Using Four Inpatient Quality Indicators and 30-Day All-Cause Mortality. 46-55. doi:10.1177/1062860612444459

Gallagher, B., Cen, L., & Hannan, L. E. (2013). Validation of AHRQ's Patient Safety Indicator for Accidental Puncture or Laceration. NY: BMJ Publishing Group.

Hart, J., & Sweeney, G. (2006). Integrating Patient Safety Indicators into Patient Safety Programs. Journal For Healthcare Quality, 28(6), 18-28. doi:10.1111/j.1945-1474.2006.tb00640.x

Rindani, P. (2014). Chapter-11 Monitoring Clinical and Managerial Indicators. Handbook of Healthcare Quality and Patient Safety, 137-149. doi:10.5005/jp/books/12287_11

Ross, J. (2010). Improving Patient Safety Through Quality Indicators. Journal of PeriAnesthesia Nursing, 25(2), 112-113. doi:10.1016/j.jopan.2010.01.001

Zorowitz, R. D. (2010). Stroke Rehabilitation Quality Indicators: Raising the Bar in the Inpatient Rehabilitation Facility. Topics in Stroke Rehabilitation, 294-304. doi:10.1310/tsr1704-294