Healthcare Quality Improvement Programs
In order to understand continuous quality improvement (CQI) in healthcare, it is first important to understand the history. This knowledge is helpful in assessing CQI, especially when healthcare has utilized many ideas from other sectors of industry, such as manufacturing.
Modern quality improvement in medical care dates back to the Florence Nightingale period. She associated the enhanced result of the injured with the quality of nursing care (Sadeghi, Barzi, Mikhail, & Shabot, 2013). Her use of statistical instruments to interpret information is the heart of evidence-based nursing.
The first physician Ernest Codman was the first physician to officially show interest in the contemporary ideas of medical care quality and quality assessment, which his idea was to follow surgical patients in hospitals and then assess the outcomes, or “end results” in his own words, of these surgeries, including any complications that occurred (Sadeghi, Barzi, Mikhail, & Shabot, 2013). He hoped to set up a database that would allow him to acknowledge diagnostic and therapy mistakes and link them to the result then make these accounts public so that patients could choose where to get care (Sadeghi, Barzi, Mikhail, & Shabot, 2013). He was the founder of the American College of Surgeons ‘ Hospital Standardization Program in 1917 (which later became the Joint Healthcare Organizations Accreditation Commission) (Sadeghi, Barzi, Mikhail, & Shabot, 2013). The fundamental theme in his program was dependence on skilled physicians, communications between physicians, and licensing and oversight of physicians and equipment. From this view, it is evident that quality has been seen as a product of professional judgement and not based on any particular criteria or measure.
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In 1952, the American College of Physicians, the American Hospital Association, the American Medical Association and the Canadian Medical Association joined the American College of Surgeons to create the Joint Commission on Hospital Accreditation, which was eventually renamed the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), now known as the Joint Commission, in 1987 (Sadeghi, Barzi, Mikhail, & Shabot, 2013).
Perhaps the most well-known person with significant contributions to quality evolution and its definition in health care is Avedis Donabedian. In many ways, he was the first to acknowledge the systemic nature of healthcare delivery. Donabedian believed that the quality of healthcare is a result of science and technology and its healthcare applications. He has given a framework for assessing the quality of medical care by identifying three aspects that affect care delivery: structure that relates to the environments of care given, process that relates to actions involving the provision and receiving of care, and outcome of the results is the impacts of patient care (Sadeghi, Barzi, Mikhail, & Shabot, 2013).
It took several decades for government and private organizations to embrace the structure of Donabedian for quality measurement in medical care. Interest in more accurate measurement gained momentum with the emergence of two critical developments, the increasing cost and pressure from payers and the public identifying report of bad quality care (Sadeghi, Barzi, Mikhail, & Shabot, 2013).
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Much of today’s stress on healthcare is its price. There are many practices that continue to suffer from this. When a person thinks about productivity, it might be the term sales that comes to mind. This could be measured by the products and services a patient could receive when it comes to healthcare (Burrill, Parker, & Fitzgerald, 2019). This could imply prescriptions, hospital visits or stays, or just visiting a primary care physician. There are many things that come into play when we speak about results in health care. Some of these would be and are not restricted to diet, practice, earnings, or perhaps even substance abuse (Burrill, Parker, & Fitzgerald, 2019). These contribute directly to the status as well as to our access to medical care.
The Affordable Healthcare Act became the healthcare reform law of the nation in March 2010 (Health Reform, 2010). It called for the reform of private and public health insurance. Not only has this law helped ensure hundreds of individuals and fund health prevention, but it has also permitted customers to lower their expenses (Parry, 2018).
The quality of health care is very crucial, it informs us how the health care system performs and eventually leads to improved health care. This then leads to an overall improvement in healthcare. One of the greatest healthcare characteristics is to prevent misuse of services (Levitt, Claxton, Cox, Gonzales, & Kamal, (n.d.). Also, the overuse of healthcare facilities (Levitt, Claxton, Cox, Gonzales, & Kamal, (n.d.). For instance, for one medical problem, somebody might see various physicians at various practices. Some do this in the hopes that the same prescription will be issued many times. Today’s opioid crisis is at an all-time high, and this crisis can be controlled with physicians, pharmacies, and prescription drug monitoring.
- Retrieved from https://home.kpmg/xx/en/home/insights/2019/01/continuous-quality-improvement-in-health.html
- Health Reform. (n.d.). Retrieved from https://www.apha.org/topics-and-issues/health-reform
- Levitt, L., Claxton, G., Cox, C., Gonzales, S., & Kamal, R. (n.d.). Assessing the performance of the U.S. health system. Retrieved from https://www.healthsystemtracker.org/brief/assessing-the-cost-and-performance-of-the-u-s-health-system/#item-start
- Parry, G. J. (2018). Article Tools. Retrieved from https://ascopubs.org/doi/full/10.1200/JOP.2014.001436
- Sadeghi, S., Barzi, A., Mikhail, O., Shabot, M. M. (2013). Integrating Quality and Strategy in Health Care Organizations. [Purdue University Global Bookshelf]. Retrieved from https://purdueuniversityglobal.vitalsource.com/#/books/9781284070729/
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