Measurement Systems and Methods Primary Care Setting

DISCUSSION: MEASUREMENT SYSTEMS AND METHODS

Discussion: Measurement Systems and Methods

For this discussion, I elected to focus on a primary care setting. The said nursing practice setting uses scorecards or dashboards to measure patient experience and improve goals. Primary care, according to the Institute of Medicine (1996), could be conceptualized as the provision of accessible and integrated personal healthcare services by accountable clinicians. Personal healthcare needs could be inclusive of a wide range of concerns from patients, i.e. psychosocial and physiological concerns. It would be prudent to note that patient concerns could fall into various categories - some of which may not be in the scope of primary care. According to the Institute of Medicine (1996), primary care manages patients concerns that fall into the following categories; coordination of referrals, prevention and early detection, chronic care, and acute care. In a primary care setting, quality happens to be an essential component in ensuring consistent and desired healthcare outcomes that align with the current knowledge of the nursing profession. To ensure that there is quality in primary care, quality is measured by assessing performance systems and clinician’s performance (Institute of Medicine, 1996).

Scorecards and dashboards are important tools in healthcare for measuring accountability and improvement. There are various measures on dashboards or scorecards where patients’ experience of care is tracked and measured so as set improvement goals. According to Nash et al (2019), patients experience of care could be measured on dashboards via; respiration rate, temperate, blood pressure, and pulse rate. On the other hand, scorecards are used to measure patient experience through quality measures which are inclusive of, but they are not limited to; timely, equitable, patient-centered, efficient, safe, and effective care. Essentially, timely measures are used to track whether care is delivered when patients need it, equitable care ensures that there is no discrimination in care delivery, patient-centered measures ensure that patient values and preferences are measured, efficient care measures the costs and resources, safe measures involve measurement of medication errors and falls, while effective care measure clinical quality (Nash et al, 2019).

It is important to note that in a primary care setting, the goals of quality measures are well established. For instance, timely care measure is established in the accessibility goal of primary care which will ensure that patients are able to access care. The measure of equitability has been established through ethical behavior whereby clinicians are required to be accountable to patients. Patient-centered care has been established in the goal of delivery of continuous care. Efficiency measure has been established in the goal of ensuring efficiency, coordinated, and comprehensive care (Institute of Medicine, 1996). Safety measure is established in the goal of ensuring comprehensive care while effective care is established in the goals of efficient, accessible, continuous, and integrated care. It is important to note that some of these attributes are currently not being met in primary care settings. This is more so the case given that the said attributes require adequate knowledge of some aspects of primary care and embrace of diverse contemporary scenarios i.e. with regard to diversity.

There are various impacts of meeting or not meeting the said metrics in primary care. When the said metrics are met, the Institute of Medicine (1996) suggests that the primary care setting mandate of providing integrated care on personal health is achieved. On the other hand, when the said metrics are not met, then the said goal of primary care would be neglected. This would likely result in undesirable clinical outcomes.