Quality is never an accident

Defining and Measuring Quality in Health Care Organizations
Quality is never an accident. It is always the result of intelligent effort. —John Ruskin  Quality is multidimensional and involves the perspectives of various stakeholders, including patients and families. As noted in this week’s Learning Resources, defining quality is not a simple, straightforward task. Yet, it provides an essential foundation for being able to measure and assess quality, and, ultimately, to improve it.  In this Discussion, you consider definitions and measurements of quality. As you proceed, think about why it is important for organizations to be able to quantify quality and compare current performance to previous performance, to a set of standards, and/or to performance in other organizations.   To prepare: •Review the information in the Learning Resources, especially the chapters in the Sadeghi, Brazi, Mikhail, and Shabot course text, focusing on how quality is or could be defined and measured. •Think about a health care organization with which you are familiar. It may be the same organization you are focusing on for your Course Project, or a different one. How do you think various stakeholders in this organization would define quality? How would you define quality as it relates to this organization? •Review the information on quality standards and / or aims in the Learning Resources, and consider the following: ◦Which outcomes related to quality are currently being monitored in the organization that you have selected? ◦How is related data collected and evaluated? ◦Does the organization use health information technology in this regard? If so, how? ◦How is quality-related information (e.g., data, needs for improvement) communicated throughout the organization? ◦What do you consider to be the strengths and weaknesses of the current approach to quality in this organization?
By Day 3  Post a definition of quality for your selected organization. Describe at least one quality-related measure that is currently being monitored within the organization.
Summarize the data collection process for this measure, and explain how this information is communicated to or among the staff. Identify at least one strength and one weakness related to how quality is defined, measured, and/or monitored within the organization.
Required Readings
Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.
•Chapter 6, “Evaluating of Health Care Information Systems and Patient Care Technology” (pp. 143-170) This chapter examines federally mandated use of health information technology to improve health care and care delivery.   Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. (2013). Integrating quality and strategy in health care organizations. Burlington, MA: Jones & Bartlett Learning.
•Review Chapter 3, “General Concepts in Quality” (pp. 45–82) (assigned in Week 4)    The authors discuss historical perspectives of quality in various industries, and explain the multifaceted nature of defining quality in health care settings.     •Chapter 4, “Current State of Quality Measurement: External Dynamics” (pp. 83–98)    This chapter describes many of the government, nonprofit, and for-profit groups / organizations that contribute to the establishment quality standards and support research to improve the quality of health care.     •Chapter 5, “Current State of Quality Measurement: Internal Dynamics” (pp. 99–110)    This chapter focuses on mandatory and voluntary quality measurement in organizations.     •Chapter 6, “Measuring Quality of Inpatient Care” (pp. 111–132)    This chapter explains the terminology use in quality measurement (e.g., measures, indicators, metrics), and notes that measurement is a critical foundation for the ultimate aim of creating effective changes to improve quality.
•Chapter 8, “Quantifying the Quality Performance Gaps” (pp. 161–177)    This chapter addresses how to quantify current performance and set targets.   Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Kolb, R. C., & Stark, L. J. (2010). Sustained improvement in pediatricians’ ADHD practice behaviors in the context of a community-based quality improvement initiative. Children’s Health Care, 39(4), 296–311.  Retrieved from the Walden Library databases.     Researchers evaluate a quality improvement project on pediatric care of ADHD patients and the sustainability of the improvement over a two-year period.

Environmental Issues

Environmental Issues

  1. Choose one of the assignments below and post your answers or ‘editorial’ in this forum.
    1. Select an article from the mass media (newspaper) that deals with an “environmental” health issue. Analyze and critique the article by answering the following questions:
      • What are the characteristics of the community involved?
      • What appears to be the sources of the problem?
      • What evidence is provided in the article to substantiate the cause?
      • Does the news coverage describe health effects?
      • What population is at risk?
      • Does the coverage provide adequate information for consumers to understand the problem and seek any needed assistance?
      • How would you improve this article for better public awareness?
    2. Identify an environmental health problem in your community.
      • Familiarize yourself about this problem by interviewing or talking with experts in the area, reading recent literature and research reports, and searching the Internet for information about the problem.
      • Contact your Senator or Congressperson who has been involved in legislation related to the problem and learn what he or she plans to do about it.
      • Summarize what you have learned and present it in writing as a letter to the editor of your local newspaper.
      • Share the letter in this Discussion Forum
  2. Your response should be 500 words.

Culture and Health

Culture and Health
Instructions:

  1. Please answer the following question:
    • How does culture influence health?
    • Give examples of dominant ethnic and biomedical cultural influences on the health of individuals or populations?
  2. Your response should be 300 words.

Long-Term Care for All

Case
Long-Term Care for All
The newly elected governor of a small state in which the elderly comprise 26% of the total population—twice the national average—is eager to fulfill his campaign promise. He had run for office on the slogan “long-term care for all.” The elderly in the state had overwhelmingly voted for him. Now in office about 9 months, his advisors tell him that providing long-term care services for all citizens in the state will be next to impossible because of high demand for the services. The governor, however, remains undeterred. The cornerstone of his proposed policy includes three things: (1) Develop a state-sponsored long-term care insurance plan. The insurance premiums will be income based, and will cost at least 15% less than a midlevel private long-term insurance plan being sold in the state. (2) Make it mandatory for all citizens, old and young, to purchase LTC insurance, either from the state or from a private insurance company. (3) Place restrictions on the use of nursing home and assisted living services in favor of community-based services.
Questions
1.  Give specific reasons why the governor’s policy may not work, pointing out specific problems that would likely arise.
2.  Will the policy work in a large state, everything else being equal? Give reasons.