Analyzing Quality Measurement Proposal

Quality Measurement Proposal

The focus of quality measurements is, generally, care processes or structures having an established relationship with positive healthcare outcomes, and being under the healthcare system's control. The technical definition of quality measures provided by the Agency for Healthcare Research and Quality (AHRQ) is: a mechanism for assigning quantity to care quality through comparison to some criterion. One can apply quality measures to the evaluation of managed care organizations, healthcare providers, health programs/plans, and hospitals (U.S. Department of Health and Human Services, 2012).

Healthcare quality measurement denotes a process of utilizing data for the purpose of performance assessment of healthcare professionals and health plans against accepted quality standards. There are many forms a quality measure may assume. These measures assess healthcare across the entire array of care settings, right from hospital systems to physician offices and imaging facilities (Families USA, 2014).

Measurement of healthcare quality is an essential step in the improvement of care quality. Quite often, substandard care is delivered to patients in the U.S. Quality measurement may be employed in the improvement of American healthcare delivery through: 1) Determination of what is helpful and what isn't, for driving healthcare improvements; 2) Prevention of misuse, overuse, and underuse health services and assurance of patient safety; 3) Accountability of healthcare providers and health insurance schemes in providing superior quality patient care; 4) Assistance to healthcare consumers (i.e. patients) in making informed care-related choices; and 5) Measurement and attention to disparities in care delivery and health outcomes.

Methods of Quality Measurement Used by Health Care Organization

Structure Measures

These measures assess healthcare infrastructure (e.g., physician offices and hospitals) to determine if they are capable of delivering appropriate care. Structure measures include healthcare facility staffing, healthcare worker capabilities, resource availability in healthcare organizations, and policy environment of care delivery settings. For instance, do ICUs (intensive care units) have critical care professionals on hand round the clock? Regulators and insurance firms frequently utilize structure measures for ascertaining if a provider possesses necessary capacities for delivering superior quality care (e.g., whether a healthcare facility has an electronic system for ordering prescription drugs). The healthcare field also widely employs structure measures in the accreditation or certification of health providers and plans (Families USA, 2014).

Process Measures

Process measures are employed in ascertaining how far healthcare providers consistently offer specific services to patients that are in line with recommended care guidelines. They are often linked to treatments or procedures recognized as having the capacity to prevent further health issues or complications, and enhance patient health status. In most scenarios, assessment of whether a healthcare professional meets process measure requirements is very clear: Were patients delivered recommended care? Process measures prove valuable as they offer providers straightforward, actionable feedback as well as an easy means to better their performance. But overdependence on these measures when tracking performance and administering provider incentives may prove problematic, for a number of reasons. For instance, do nurse practitioners regularly examine diabetes patients' feet for any wounds? Do physicians prescribe appropriate medication to patients diagnosed with diabetes? (Families USA, 2014)

Outcome Measures

These measures assess patient health resulting from the care given to them. To be more specific, outcome measures examine the unintentional and desired impacts of healthcare on patient health, functioning and health status. Furthermore, they assess whether care goals have been achieved or not. These measures are when the rubber hits the road: a patient is only interested in improving his/her health and surviving an ailment. The processes supporting the above outcomes are of no consequence to him/her. For instance, what amputation rate has been recorded for diabetics? What is the percentage of remission of patients suffering from cancer? What quality level of pain alleviation was provided to knee surgery patients (Families USA, 2014)?

Patient Experience Measures

Such measures offer feedback on the experiences of patients in care settings, including healthcare's interpersonal facet. However, these measures also evaluate numerous other care aspects, right from physician information accessibility and clarity, to quickness of patient appointment scheduling for urgent care, to whether or not physicians inform patients of their test results. Research indicates that positive experiences of patients have a well-recorded association with clinical quality: a patient with superior care experience will usually adhere better to treatment regimens, be better engaged in the care process, and show better receptiveness to the advice given by healthcare providers (Aligning Forces for Quality, n.d.) For instance, for what duration did a patient have to await appointment? Does the doctor provide patients with easily understandable information, instructions, and advice that effectively address their health concerns or questions? Did any staff member from the physician's office care to follow up with regard to any lab results (e.g., x-ray or blood-test results) (Families USA, 2014)?