Inpatient Health Quality of Care

Inpatient Health Quality of Care Indicators for Bluegrass Hospital

In this essay, the author will be acting as the Manager of Epidemiology at Bluegrass Hospital who is tasked with identifying current health care industry standards and apply them to pediatric heart in the hospital. According to the author, we must begin from scratch in the sense that a new approach is necessary. The professional literature has articles that support new paradigms in health care such as formula pit stop and aviation safety models. These are particularly applicable in hospital situations such as are found in the emergency room or between intensive care and surgery where time and safety are the most critical. Once we consider these innovative gold standard approaches in a brief literature review, we will consider the case study questions and how they reflect upon our issues.

In a 2009 article in Health Affairs, the authors contrast improvement in the success of aviation safety in the 1990s. After a major 1995 plane crash, the U.S. government and the aviation industry created the Commercial Aviation Safety Team to reduce fatal accidents. This unprecedented public-private partnership of safety and technical experts has been responsible for the decreased average rate of fatal aviation accidents. In this vein, the authors have propose a similar combination in health care to coordinate national efforts in patient safety and quality and therefore to move forward just has there have been advances in the aviation industry in terms of safety. In the opinion of the authors, strong intervention in the health care industry like that which had succeeded in aviation needed to be applied in hospitals for similar results. Government agencies were stakeholders with a strong interest in improvements in patient safety and their involvement would whip the industry into shape despite its conservatism (Pronovost, 2009, 476-485).

In an article in Pediatric Anesthesia, the authors aimed to improve the safety and quality of patients handed over from surgery to intensive care using the innovative analogy of a Formula 1 pit stop and also expertise from aviation. An intervention study measured the change performance before and after the inauguration of a new handover protocol that was developed via detailed consultations with a Formula 1 racing team and aviation training captains. Fifty before post surgery patient hand overs to the intensive care were observed. Checklists were employed to measure and record technical errors and information omissions. Teamwork amongst hospital staff members was scored using a Likert scale. In addition, the duration of the patient handover was measured additionally. The improvement on all indicators was some 95%, including the mean number of technical errors, information handover errors, and the duration of handover. The introduction of the new handover protocol lead to dramatic improvements in all aspects of the handover of patients due to the introduction of expertise and methodology from other industries into the field of medicine (Catchpole, et al, 2007, 1).

Now to compare these standards with Bluegrass hospital, in case study 5.3, it is supposed that the Kentucky Health Association did what the articles above propose in the evaluation of the epidemiology efforts of Bluegrass hospital. This author has focused on 12 healthcare indicators that are related to mortality since logically this is a hospital's top priority is to save life. Mortality prevention is certainly an area where the strongest interventions are most justified.

Bluegrass Hospital Quality of Care

Industry Comparison Quality of Care Standards

("Patient safety and," 2011)

1. Based upon the report card alone, the hospital is deficient in esophogeal resection, pancreatic resection, abdominal aortic aneurysm repair, coronary artery bypass grafts, craniotomies and acute myocardial infarctions. Gastrointestinal hemorrhages were just slightly above the national average and within the standard deviation.

2. As an administrative official, it is prudent to check the internal data charts personally at a departmental level to make sure the data is accurate and was collected correctly and without bias.

3. The QI teams would then determine the specific on site measures needed to rectify the problems and the level of interventions necessary. These interventions would be more stringent with regard to the above factors due to fact that patient mortality could be involved.

4. Recommendations would be as to whether in-service retraining on a departmental level would be sufficient or if personnel changes are necessary. Major interventions would address larger issues additionally such as equipment and organizational effectiveness. Less major interventions would be more narrowly focused on technical issues.

1. What differences did you find between Current Industry Value data that you researched and the values reported in Table 5.5 for each of the 12 Inpatient Quality Indicators you selected to use in your study? The major difference between industry leaders (such as teaching hospitals) is that many of the procedures are bundled together. This is for not just administrative purposes, but also for the purpose of insurance contracts with major insurance providers and Medicare. The Medicare bundling standards are becoming more widely applied as the "Obama" care regime in introduced.