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Quality Improvement Organization (QIO): Roles, Benefits, and Limitations

What is a Quality Improvement Organization (QIO)?

Quality improvement organization The Federal government of the United States has established the Centers for Medicare and Medicaid Services (CMS) that is responsible for maintaining and improving medical quality for beneficiaries. CMS has in turn realized the importance of working with the Quality Improvement Organizations (QIO) mandated to perform three crucial roles of better care, better healthcare, and the one affordable at lower costs for beneficiaries (Centers for Medicare and Medicaid Services (CMS) (2019).

CMS defines QIO as a group of quality experts, clinicians, and consumers mandated with the responsibility of making sure that Medicare beneficiaries receive quality services. QIO is important in healthcare because it helps the government to streamline its services and make sure that the services are delivered to the consumers. Benefits and Limitations of QIO One of the advantages of the QIO is that it is a group of experts that work directly with the department of health and CMS.

This program makes sure that there is transparency in delivery of care and makes sure that beneficiaries only pay for services that are meeting their needs. QIO looks at the mandatory aspect of quality to make sure that consumers receive the best service from healthcare organizations while at the same time making sure that consumers do not lose confidence in Medicaid and Medicare services (McArdle, 2016). Additionally, QIP protects the rights of beneficiaries by acting on their complaints, reviewing the services delivered from healthcare organizations, and making sure that the healthcare organizations deliver quality services as stipulated in the QIO framework.

The other significant advantage of QIO program is that the program carries out national awareness campaigns by educating beneficiaries of their rights and what to expect from healthcare organizations. In spite of its benefits, the QIO program has suffered from significant limitations that have affected its efficiency in the United States. One of the setbacks is that the program is that it has failed in reducing the costs of healthcare in the United States. According to McArdle (2015), research has established that the quality of care in the U.S hospitals is still high. There are still high causes of medication errors in the U.S, contributing to two thirds of deaths in the in-patient facilities. This indicates that the QIO program has failed to yield positive outcomes.

The Role of Nurses in Client Teaching on QIO The role of nurses is not restricted to administering medications alone. Nurses play a significant role in educating patients about their rights and informing them about their role in improving quality of care. One of the ways that they can impact the QIO is to empower clients by informing them about their rights and how to report activities that undermine their safety. QIO reports directly to congress each fiscal year and it collects the views of consumers to make decisions about the efficiency of healthcare (Quality Improvement Organizations, 2018).

The report collected by QIO is essential in the funding and financing of Medicare and Medicaid trust funds. As a result, nurses can keep consumers informed about the flow of information between the QIO and the federal government to make sure that the quality of care is of the expected standards. When nurses educate consumers about the way to interact with QIOs, it becomes easy to have an effective healthcare system for all. In conclusion, the QIO program is an essential component of the CMS in the United States. The program helps the Centers for Medical and Medicaid Services (CMS) to deliver quality care to patients while at the same time taking into consideration the costs associated with medications. The importance of QIO is that it liaises with professionals and congress to identify quality issues in healthcare and making necessary improvements.

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