Unit 2 Individual Project 2
Quality Improvement in Healthcare (HCM672-1904A-01)
Colorado Technical University
Since 2010 and probably before then, the Unites States healthcare system has been in disarray. The quality of care being given to patients was not very good. The US was spending millions of unnecessary amounts of money for healthcare. Repeated testing, over payments for services of Medicare and Medicaid, the veterans weren’t getting proper care or treatment, subpar care and reckless disregard for patients’ rights or privacy. Some things needed to change for our healthcare system to grow, healthcare reform was the answer, a total over haul of the United States healthcare system to improve the quality of care, cut spending and improve healthcare providers performance.
Describe specific initiatives, laws, and accreditation standards that can be leveraged to improve health care quality and enhance performance improvement.
An incentive that is used in healthcare is pay-for-performance incentive (P4P), this incentive is the main strategy used for improving quality in the US healthcare system. With pay-for-performance incentives the plan is to define the performance goals that were selected for quality measures and to offer financial incentives for the provider or an organization or for both. Performance based incentives can be removed and reassigned to areas that need improvement. When a quality measure has been met the incentive is removed an applied to another measure that hasn’t been met yet. Benzer, J., Young, G., Burgess, J., Baker, E., Mohr, D., Charns, M., & Kaboli, P. (2014).
Value-based purchasing programs (VBP) is another incentive, this incentive was adopted by the Centers for Medicaid and Medicare and used in the Veterans Administration hospitals (VA). Under the VBP’s the incentives are awarded to the VA’s facilities and their managers, the facilities and the managers decide what providers receive the incentive. The Centers for Medicare and Medicaid contract with Accountable Care Organizations (ACO). “ACO’s are also the unit of accountability for performance-based incentives, and ACO senior managers have discretion as to whether and how incentive payments are distributed to front-line clinicians.” Benzer, J., Young, G., Burgess, J., Baker, E., Mohr, D., Charns, M., & Kaboli, P. (2014).
The Affordable Care Act (ACA) is the most important piece of legislation passed since Medicare and Medicaid was enacted. The ACA gives previously uninsured Americans access to healthcare through market places or insurance exchanges. The uninsured rate dropped under the ACA, quality of care improved under it, the ACA gives nonelderly persons the right to receive insurance, it also opened Medicare and Medicaid to those individuals who were under the poverty provisions that could not afford healthcare. “The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality.” Obama B. (2016).
“Quality improvement can strengthen health care delivery systems, improve health sector performance and accelerate attainment of the health-related sustainability development goals.” El-Jardali, F., & Fadlallah, R. (2017). Different healthcare systems have implemented strategies to promote quality improvement. Some of the different accreditation systems, performance indicators, clinical guidelines, patient safety systems, total quality management and systems for getting patient views of services they receive. Quality improvement is a collaboration between all key stakeholders, which would include government, healthcare providers, insurers, planners, patients and researchers formulating changes that will benefit patient health outcomes. Enhancing the healthcare system’s performance for an upgraded professional development. El-Jardali, F., & Fadlallah, R. (2017).
In 2011 the US government launched The Public Health Accreditation Board (PHAB), the mission of the PHAB was to promote and protect the health of communities by advancing quality and performance of all public health systems in the US. As part of the PHAB quality improvement mechanisms were created to have a way to check to see how the healthcare systems were performing. Community health assessments (CHA), community health improvement plan (CHIP) and strategic plan are all ways that the PHAB measures quality improvements. In order for a local health department to get accreditation from the PHAB they must complete a CHA, CHIP and a strategic plan. Part of the PHAB accreditation process local health departments must embody all the requirements set forth by the PHAB, which include public health investigations, education and prevention activities, financial management and governance. Carman, A. L., & Timsina, L. (2015).
Develop a communications strategy to achieve effective and efficient communication of performance data and performance improvement initiatives.
“Quality improvement is one of the most challenging aspects to delve into particularly regarding enhancing patient care. Several barriers are often encountered involving different technical, structural and cultural facets. Advancement of knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes.” Asinas-Tan, M., Leonardo, J., Aldana, E., Reboton, W. C., & Libunao, J. A. (2016).
The first step in developing a communication strategy would be to do patient/caregiver satisfaction surveys on inpatient and outpatient, clinical services and facilities, hospitals and community health centers. Offer comments and suggestions on how to improve on servicing the patients better. Formulating and implementing a plan to address the concerns of the survey. Offering educational outreach activities to the employees and patients to address the concerns of the patients Having staff focused meetings and health education forums for patients. Offering team building activities outside of work to facilitate togetherness among the healthcare staff. Public health forums for patients to help them have a better understanding of their illness and address problems they may behaving with their care or finding services for their illness. Making educational materials available to staff and patients. Having a post-intervention audit and feedback to determine success of strategies employed. Asinas-Tan, M., Leonardo, J., Aldana, E., Reboton, W. C., & Libunao, J. A. (2016).
Include a plan for strategic messaging in communications to employees (to effect change) and communications to the general public (for marketing purposes).
“Sharing information with stakeholders, can be considered as Pull Communications. Information is stored within a central location and then stakeholders can access it whenever needed” (Abernathy, 2017). A stakeholder can be a vendor, customer or the general public. Anyone with a vested interest in the company is a stakeholder. External stakeholders give support and feedback on issues such as initiatives, clinical outcomes and more. Having stakeholder input is critical for effective and efficient strategy implementation (Thomas, 2015). Secondary external stakeholders are media, government and creditors and community (Thomas, 2015). People may believe that external communication is just media or public relations, but there is marketing, customers, crisis interventions and investor relations. In health care, making sure that everyone understands the direction the company is going, the mission of the company, company values, what the objectives and goals to be accomplished are. Using information technology, like Facebook, Twitter or video chatting to reach stakeholders. Having a public corporate website is another way of reaching stakeholders. All communication should be thought provoking, to the point and grabbing the attention of those vested in the company.
Communicating initiatives, results and evaluations to everyone may include, reports, newsletters, memos, policy documents, emails, advertising, web forums, social media and focus group discussions. Important things needing to be discussed should be done by conferences, seminars, general meetings, web-ex, performance evaluation meetings.
Abernathy, R. M. (2018). CompTIA Project cert guide. United States: Pearson IT Certification.
Asinas-Tan, M., Leonardo, J., Aldana, E., Reboton, W. C., & Libunao, J. A. (2016). Implementation of quality improvement strategies for better patient care. International Journal of Integrated Care (IJIC), 16(6), 1–2. https://doi-org.proxy.cecybrary.com/10.5334/ijic.2963
Benzer, J., Young, G., Burgess, J., Baker, E., Mohr, D., Charns, M., & Kaboli, P. (2014). Sustainability of Quality Improvement Following Removal of Pay-for-Performance Incentives. JGIM: Journal of General Internal Medicine, 29(1), 127–132. https://doi-org.proxy.cecybrary.com/10.1007/s11606-013-2572-4
Carman, A. L., & Timsina, L. (2015). Public Health Accreditation: Rubber Stamp or Roadmap for Improvement. American Journal of Public Health, 105(S2), S353–S359. https://doi-org.proxy.cecybrary.com/10.2105/AJPH.2015.302568
El-Jardali, F., & Fadlallah, R. (2017). A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan. BMC Health Services Research, 17(1), 568. https://doi-org.proxy.cecybrary.com/10.1186/s12913-017-2528-1
Obama B. (2016). United States Health Care Reform: Progress to Date and Next Steps. JAMA, 316(5), 525–532. doi:10.1001/jama.2016.9797
Thomas, J. (2015). Strategic Management, 1/e. Pearson Education India