Human factors systems approach to healthcare quality and patient safety.
Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?.
What are the core elements of patient?centred care?
Empowerment patient centred care and self?management.
The healthcare organization has experienced a decrease in the quality of patient care over the past few months. The Chief Executive Officer has requested an internal analysis based on an increased number of patient complaints. The quality of patient care provided by healthcare organizations and providers is the cornerstone of any successful healthcare organizations.
It has been assumed that the patient complaints are the feedbacks from tee patients and it has been recognized as a vital tool towards the improvement of the service within the sector of health. It is important to mention that the patients often complain when they are dissatisfied with the services that they have received. The complaints generally relate to the costs of healthcare, waiting for care, lac of skills of the care provider, malpractice, medical errors, care and treatment of the patients, patient and provider communication, professional conduct (Hultman et al., 2015). While it is a vital fact that the complaints vary in the severity, resulting to death due to poor care, some kind of loss, most common complaints, and he concerns of the patients are listened to. It has also been assumed that the patient complaints provide a vital insight into the monitoring the quality of care rendered to the patients. Whereas, it is also important to highlight that to effectively utilize the patient complaints, there needs to be a systematic channel of analysing the information and the collection of the same. Analysis of the patient information provides a valuable source of information on the improvement of the patient safety, medical errors (Reader, Gillespie & Roberts, 2014).
Delivering the right care at the right time in the right setting is the core mission of this healthcare organization. Accomplishing this mission can be difficult for organizations that lack quality controls, therefore it is important to have compliance and oversight are needed (1). This healthcare organization is committed to working with federal lawmakers, regulators, and research agencies to create policies and procedures to establish an environment on which patient quality of care can increase.
The Quality Improvement Committee provides oversight of the organization’s quality, and performance improvement activities. Teitelbaum and Wilensky (2013) states having such a committee is important in maintaining the quality of the care provided to patients.
Three quality initiatives implemented within the organization geared towards increasing the quality of care for patients are safety, patient-centeredness and timeliness: The patient centred care can be improved by contributing to the organizational learning, improving the health gain and improving rights of the patients. Improving the rights of the patient takes into account of the various arguments of democratization, that are operationalized in the hospital setting so as to ensure the care issues related to the patient and professional interaction, information on treatment, informed consent, policies that conform to the confidentiality. For some of the patients, rights are an integral part of the quality improvements efforts, and the quality of care so as to strengthen the rights. Improving the health gain is a perspective that addresses the concerns pertaining to the several implication of patient centred care like the outcomes, recovery and patient behaviour (Levesque, Harris & Russell, 2013). Studies have indicated that the patient centeredness is linked with the seeking of the follow up plan, reduced readmission rates, tolerance towards the pain and stress levels, better health and recovery outcomes, patient satisfaction, and better compliance. There are evidences that to increase the effectiveness of the health status and the health behaviour, there is a need to inform about the effectiveness, involve and educate the patients and their care plays a substantial role in patient wellness. Organizational learning is another aspect and research suggests that the patients have the capability to positively contribute towards the healthcare improvements and also through the non-clinical aspects of the care and the care environment. Quality improvement efforts play a major role in overcoming the barriers towards including the contribution of the patient and also in the process of organizational learning (Kitson et al., 2013). This will be measured at the patient level and the usually assessed through the standardized questionnaires, and in-depth interviews conducted within the focus groups so as to explore the views of the patients.
Proper management of scheduling of the appointments play a major role towards the achievement of accessibility and timelines in the healthcare system. However, it is important to note that the majority of the scheduling systems are defective and the unattended appointments actually represent the less utilization of the precious resources of healthcare. There are many factors that affect the performance of the appointment scheduling and it includes the experience level of the scheduling staff, available information technology, preferences of the provider and the patients, variability of the service time and also the arrival time, performance of the appointment scheduling. Thus, it is essential to manage the vital and important bottlenecks in the business and industrial domains. The hospital need to develop the dynamic procedures and policies pertaining to the patient appointment (Cubillas et al., 2014).
The five patient centred strategy that will improve safety of the patient include the provisions of allowing the patients to access the patient data pertaining to clinical notes and EHR data; care for the environment existing within the hospital; creation of a safe patient experience; creation of a timely and a simple appointment scheduling; encouraging the caregiver and family engagement (Pulvirenti, McMillan & Lawn, 2014).
According to Teitelbaum and Wilensky (2013) controlling or reducing healthcare spending does not necessarily mean that quality should be minimized. Therefore, it is important if organizations can reach a balance between spending and quality. The following would be recommended as a way to reduce cost while maintain quality care: The three approaches that can be used to reduce the cost of healthcare without sacrificing the quality of the patient care are: reduction in the expensive turnover and burnout by adoption of selective technology; focusing on the quality of the patient care by the administrative tasks that are repetitive; supporting for the in-home care through the remote monitoring technology. It is important to mention that the when the burden of the patients increases, then the caregivers burned out and caregiver leave a specific healthcare organization so that they have a better working conditions. Training new staffs is always an expensive procedure and it is hard to find the replacement of the caregivers due to the shortage of the nurses. The hospital must help their nurses to not to work harder instead to work smarter. This will impact not only their salary but also their benefit packages. The technologies like the wearable biosensors, predictive analysis tools, and the staff scheduling software can increase the nurse efficiency (Oshima Lee & Emanuel, 2013). Administrative tasks take up as much as 57 percent of the time and this can be reduced by the streamlines usage of the new technologies that will improve the efficiency and the care. The automated vital signs will include the systems that will detect the administering of medications, fall prevention, documentation and monitoring. The automated health record systems will take into account of the vital health signs and the electronic health records of the patients so as to detect the declining health status of a patient. Implementation of the new technologies will incorporate the new workflows into the care delivery procedures and it will reduce the burden from over the caregiver and the patient. The new admit to the home programs can be implemented so as to allow the patient of emergency room to be sent to their homes rather than keeping them in the hospital for recovery. The care team can actively monitor the status of the patients through the vital signs (McGinnis et al., 2013).
Quality is dependent upon having knowledgeable, caring providers who have a thorough understanding of preventive, diagnostic, and therapeutic strategies and the link amongst their application and improved health outcomes. For this to be accomplished, providers as well as the organization must understand the various payer systems, free market versus single payer systems.
Quality in a free market healthcare system and a single payer government system has distinct differences. The single payer system has some benefits and they are listed as under.
In the free market healthcare, the prices of the healthcare decreases over time due to the increasing presence of competition. The second example is that the free market system to a large extent out produces the other countries that the socialized medicines. This takes place in terms of the medical technology and development of new drugs. Thirdly, availability of the healthcare- this means that the supply of the healthcare providers, hospitals and the doctors will always be in ample number and the demand will not fluctuate (Godman & Gustafsson, 2013).
Teitelbaum and Wilensky (2013) states common law is premised on the traditions and customs of society. These common laws are important in ensuring quality in healthcare. Three common law quality initiatives that are still found in 21st century healthcare organizations are: The three common laws: Laws that govern the safety of the staff, public and patient in the hospital premises (AERB safety code on Radiation pollution); the laws that govern the research (ethical guidelines for biomedical research); laws that govern the environment safety (Environment protection Act) (Martin & Sutton, 2015).
The importance of healthcare quality for the healthcare organization is paramount. The Institute of Medicine (IOM) defined healthcare quality as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Quality of healthcare rendered to the patient is always important because the patient safety of the patients is always the first priority of the healthcare organizations, considering the life and death situations. Secondly, it is important to mention that the healthcare must be rendered in a patient centred care approach so that the preferences of the individuals are taken into account and the clinical decisions are taken depending on the situation. Thirdly, the quality of healthcare must be improved so as to improve the delay in healthcare. The reason is that delay in healthcare can have fatal outcomes (Carayon et al., 2014).
Protecting patient information is mandatory for all healthcare organizations. The Health Insurance Portability and Accountability Act (HIPPA) of 1996 is a federal act that established standards of privacy and protection of patient information. Every healthcare organization must have a plan in place to protect patient information that complies with all legal requirements. Health care workers have a responsibility to protect patient records from unauthorized access. The following plan outlines the process to protect patient information at Memorial Healthcare System: The plan is to protect the health information of the patients and the HIPPA states that the health professionals that work with the vital health insurance information of the patients must handle the same ethically. The reason is that without seeking permission from the patient it is unethical to share information to another healthcare organization or for any other commercial purpose. The plan is to follow the HIPPA guidelines when dealing with the sophisticated healthcare insurance information of the patients (McGraw, 2013).
From the above discussion it can be concluded that for some of the patients, rights are an integral part of the quality improvements efforts, and the quality of care so as to strengthen the rights. Quality improvement efforts play a major role in overcoming the barriers towards including the contribution of the patient and also in the process of organizational learning. There are many factors that affect the performance of the appointment scheduling and it includes the experience level of the scheduling staff, available information technology, preferences of the provider and the patients, variability of the service time and also the arrival time, performance of the appointment scheduling. Training new staffs is always an expensive procedure and it is hard to find the replacement of the caregivers due to the shortage of the nurses. The hospital must help their nurses to not to work harder instead to work smarter.
Bengoa, R. (2013). Transforming health care: an approach to system-wide implementation. International journal of integrated care, 13(3).
Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied ergonomics, 45(1), 14-25.
Cubillas, J. J., Ramos, M. I., Feito, F. R., & Ureña, T. (2014). An improvement in the appointment scheduling in primary health care centers using data mining. Journal of medical systems, 38(8), 89.
Filc, D., Davidovich, N., Novack, L., & Balicer, R. D. (2014). Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?. International journal for equity in health, 13(1), 115.
Godman, B., & Gustafsson, L. L. (2013). A new reimbursement system for innovative pharmaceuticals combining value-based and free market pricing. Applied health economics and health policy, 11(1), 79-82.
Hultman, C. S., Gwyther, R., Saou, M. A., Pichert, J. W., Catron, T. F., Cooper, W. O., & Hickson, G. B. (2015). Stuck in a moment: an ex ante analysis of patient complaints in plastic surgery, used to predict malpractice risk profiles, from a large cohort of physicians in the patient advocacy reporting system. Annals of plastic surgery, 74, S241-S246.
Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of patient?centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of advanced nursing, 69(1), 4-15.
Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International journal for equity in health, 12(1), 18.
Martin, C. J., & Sutton, D. G. (Eds.). (2015). Practical radiation protection in healthcare. Oxford University Press, USA.
McGinnis, J. M., Stuckhardt, L., Saunders, R., & Smith, M. (Eds.). (2013). Best care at lower cost: the path to continuously learning health care in America. National Academies Press.
McGraw, D. (2013). Building public trust in uses of Health Insurance Portability and Accountability Act de-identified data. Journal of the American Medical Informatics Association, 20(1), 29-34.
Oshima Lee, E., & Emanuel, E. J. (2013). Shared decision making to improve care and reduce costs. New England Journal of Medicine, 368(1), 6-8.
Pulvirenti, M., McMillan, J., & Lawn, S. (2014). Empowerment, patient centred care and self?management. Health Expectations, 17(3), 303-310.
Reader, T. W., Gillespie, A., & Roberts, J. (2014). Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf, 23(8), 678-689
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