Quality Measurement Methods
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Quality Measurement Methods
Introduction
Quality measurement methods are important in the assessment of care across all stages of delivering service. These methods are applicable at all levels starting from a single health practitioner to an entire organization or institution. In this paper, I am going to discuss the structure and outcome-based measures.
Structure Measures
Structure measures focus on necessary facilities, services, and installations in a healthcare environment. These include hospitals, offices, and determining whether these healthcare providers can effectively perform their roles. It is assumed that the system’s characteristics have a substantial effect on the quality of care (Donabedian,2003) This method makes use of measures such as the number of staff and how these staff members are capable of performing, policies in place and the level to which resources are available. This method indirectly measures quality since the factors considered are general (Donabedian,2003)
When establishing whether a particular hospital possesses the necessary attributes, regulatory bodies and insurers utilize the structure measures. For instance, they check whether a provider is capacitated well enough to use electronic prescription of medicine. Structure measures are also necessary when certifying and accrediting health plans and healthcare centers. If a healthcare provider has been certified or accredited by the relevant bodies, then a patient is likely to get quality service at such centers, and there is a high chance that the outcomes will be desirable.
Structure measures are mainly used because the features in a healthcare setting greatly influence the quality. Also, when these infrastructures are up to standards, there is a benefit of high-quality services (Cleary & O’kane. 2020). When compared to other methods, structural measures are much easier to come up with. Structure measures are vital as they give an insight into the capacity of healthcare providers. However, this approach of measurement may fail to provide sufficient information. For instance, the methods may provide information about the capacity of a health facility but do not go further to determine whether this capacity is utilized optimally to translate to better care delivery. A health facility possession of the necessary infrastructure may, in some instances, not be an effective metric of determining quality. Some providers may have poor service delivery even when the required equipment is in place, maybe because they were just bought to meet compliance.
Therefore, structural methods are not used in isolation and are combined with process and outcome methods to get a complete picture of the quality level. In illustrating instances when structural measurements are used, we can use the example of where assessment determines whether a provider has established hygiene protocol or if the doctors have electronic drug prescription facilities at their disposal. Another example of how structural measures can be applied is when assessing a nursing home. The quality in such facilities usually revolves around the fundamental aspects of the setting. Working on the structure can result in better quality. If the staff members are enough and adequately trained, and an enabling environment is in place e.g., better working conditions, then high quality can be attained. Another example is the case of NFQ 0650. This system determines the number of patients in all age groups who have currently been diagnosed with melanoma or have in the past had the condition and had their details entered into the system at least one time in a period of one year.
Outcome Measures
There are different reasons why outcomes are measured. They can be used to guide decisions by providers, developing interventions to improve care, forming benchmarks, doing studies, and holding practitioners accountable. Use of outcome measures in identifying areas that may require improvement help in enhancing value for patients. Outcome measures developed from health records are important in improving the quality of care (Kampstra et al., 2018). The health institutions’ preparedness and how they handle situations also affect the attainment of quality goals.
Outcome measures usually focus on the health outcomes in patients after receiving healthcare services. In particular, these approach focuses on the effects whether intentional or unintentional that the health services have impacted on the wellbeing and function of the patients. These measures also analyze if the intended goals have been achieved. Outcome measures are considered the most critical measures since patients mostly care about recovering from sickness and not the other factors that contribute to the achievement of these positive results. These measures take into account traditional metrics such as mortality, morbidity, and issues to do with health.
Determination of people’s satisfaction from care takes into account the patients’ feelings about the services and how they compare with the anticipation(Measuring the Quality of Health Care, 1999) Enhanced tools for determining the impact of adjustments in the healthcare system are widely used in many places and are improved now and then. Outcome measures take into account patients’ feedback about the services they receive, but it is argued that these approaches do not assess the patient’s experience to the fullest. Despite outcome measures being essential for both providers and patients, they are limited by challenges that come with developing them. Detailed data that is only found in health records is necessary for outcome measurement, and obtaining this data is costly and not easy. Collecting sufficient information to develop a specific outcome can be very challenging. Social factors that impact health, like accessibility to sources of livelihood and proper housing, have a significant effect on the health results, but linking them to confounding impact has not been given so much attention.
Another challenge is that patient’s behaviors and decisions can make the achievement of positive outcomes difficult. It would not be fair to blame this on the quality of a provider. Also, different populations are characterized different chronic conditions and different levels of sicknesses. Therefore, achieving a particular outcome may be more difficult for some providers than others. Some outcomes may require an extremely long time to develop, and it is hard to identify elements of health outcomes that can be linked to the provider.
Examples of outcome measures include determining the percentage of diabetic patients with their body parts amputated, and remission rates among cancer patients.
These outcomes measures are considered to be the most valuable measures, and it is crucial to formulate them around the needs, likings, and values of patients (Kampstra et al., 2018). When coming up with the outcome measures, the experts need to consider the impact that social factors are likely to have on health a well as the difference between different patients’ populations. Outcome measures become very helpful when selecting the best providers for patients. Professionals concerned with improving quality recommend that looking at the progress of an institution in terms of the rate of improvement in services is more suitable than using static measures (Measuring the Quality of Health Care, 1999).
Conclusion
Both outcome and structural measures can be used to determine the quality of care. Combining all the different measures produces a much more clear picture of the quality, and therefore the measures should complement each other.
References
Cleary, p., & O’kane, M. (2020). OBSSR e-Source – Evaluating the Quality of Health Care – 1. Learning Objectives. Retrieved 17 May 2020, from http://www.esourceresearch.org/tabid/794/default.aspx
Donabedian, A. (2003). An Introduction to Quality Assurance in Health Care. New York: Oxford University Press
Kampstra, N., Zipfel, N., van der Nat, P., Westert, G., van der Wees, P., & Groenewoud, A. (2018). Health outcomes measurement and organizational readiness support quality improvement: a systematic review. BMC Health Services Research, 18(1). doi: 10.1186/s12913-018-3828-9
Measuring the Quality of Health Care. (1999). doi: 10.17226/6418