Defining and Measuring Quality in Health Care Organizations Quality is never an accident. It is always the result of intelligent effort. —John Ruskin Quality is multidimensional and involves the perspectives of various stakeholders, including patients and families. As noted in this week’s Learning Resources, defining quality is not a simple, straightforward task. Yet, it provides an essential foundation for being able to measure and assess quality, and, ultimately, to improve it. In this Discussion, you consider definitions and measurements of quality. As you proceed, think about why it is important for organizations to be able to quantify quality and compare current performance to previous performance, to a set of standards, and/or to performance in other organizations. To prepare: •Review the information in the Learning Resources, especially the chapters in the Sadeghi, Brazi, Mikhail, and Shabot course text, focusing on how quality is or could be defined and measured. •Think about a health care organization with which you are familiar. It may be the same organization you are focusing on for your Course Project, or a different one. How do you think various stakeholders in this organization would define quality? How would you define quality as it relates to this organization? •Review the information on quality standards and / or aims in the Learning Resources, and consider the following: ◦Which outcomes related to quality are currently being monitored in the organization that you have selected? ◦How is related data collected and evaluated? ◦Does the organization use health information technology in this regard? If so, how? ◦How is quality-related information (e.g., data, needs for improvement) communicated throughout the organization? ◦What do you consider to be the strengths and weaknesses of the current approach to quality in this organization?
By Day 3 Post a definition of quality for your selected organization. Describe at least one quality-related measure that is currently being monitored within the organization.
Summarize the data collection process for this measure, and explain how this information is communicated to or among the staff. Identify at least one strength and one weakness related to how quality is defined, measured, and/or monitored within the organization.
Required Readings
Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.
•Chapter 6, “Evaluating of Health Care Information Systems and Patient Care Technology” (pp. 143-170) This chapter examines federally mandated use of health information technology to improve health care and care delivery. Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. (2013). Integrating quality and strategy in health care organizations. Burlington, MA: Jones & Bartlett Learning.
•Review Chapter 3, “General Concepts in Quality” (pp. 45–82) (assigned in Week 4) The authors discuss historical perspectives of quality in various industries, and explain the multifaceted nature of defining quality in health care settings. •Chapter 4, “Current State of Quality Measurement: External Dynamics” (pp. 83–98) This chapter describes many of the government, nonprofit, and for-profit groups / organizations that contribute to the establishment quality standards and support research to improve the quality of health care. •Chapter 5, “Current State of Quality Measurement: Internal Dynamics” (pp. 99–110) This chapter focuses on mandatory and voluntary quality measurement in organizations. •Chapter 6, “Measuring Quality of Inpatient Care” (pp. 111–132) This chapter explains the terminology use in quality measurement (e.g., measures, indicators, metrics), and notes that measurement is a critical foundation for the ultimate aim of creating effective changes to improve quality.
•Chapter 8, “Quantifying the Quality Performance Gaps” (pp. 161–177) This chapter addresses how to quantify current performance and set targets. Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Kolb, R. C., & Stark, L. J. (2010). Sustained improvement in pediatricians’ ADHD practice behaviors in the context of a community-based quality improvement initiative. Children’s Health Care, 39(4), 296–311. Retrieved from the Walden Library databases. Researchers evaluate a quality improvement project on pediatric care of ADHD patients and the sustainability of the improvement over a two-year period.
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