Measurement of quality in healthcare

Question 1

quality

Answer 1

degree to which healthcare services for individuals and populations increase likelihood of desired health outcomes and are consistent with current professional knowledge

(Institute of Medicine)

Question 2

6 aims of quality healthcare

Answer 2

• timely
• effective
• safe
• efficient
• equitable
• patient-centered

(IOM)

Question 3

outcomes research

Answer 3

long-established field of health research

focuses on end results of patient care

Question 4

Donabedian’s model of quality

Answer 4

structure: physical and organizational characteristics where healthcare occurs
process: focus on care delivered to patients (eg services or treatments)
outcome: effect of healthcare on the status of patients and populations

Question 5

magnet recognition program

Answer 5

American Nurses Credentialing Center (ANCC)

recognizes organizations for quality patient care, nursing excellence, and innovations in professional nursing practice

linked w/ better patient and nurse outcomes

~7% of nation’s hospitals

Question 6

comparative effectiveness research (CER)

Answer 6

designed to inform healthcare decisions by providing evidence on effectiveness, benefits, and harms of different tx options

generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver healthcare - systematic reviews or intervention studies

promotes shared decision-making b/w provider and pt

however, remember that each pt is different! (circumstances, medical hx, values)

Question 7

benchmarking

Answer 7

representative reference point that establishes standard for making comparisons and gauging progress in achieving desirable quality outcomes

internal: trends over time, differences b/w units
external: peer institutions - size, location, pt population, etc.

Question 8

National Database of Nursing Quality Indicators (NDNQI)

Answer 8

established in 1998 by the ANA

1800+ participating hospitals

purpose: to provide data for benchmarking and for research related to nursing and pt outcomes

participants gather data and assess data at hospital, state, regional, and nat’l levels

Question 9

hospital value-based purchasing (VBP) program

Answer 9

part of ACA - began in FY 2013

CMS makes value-based incentive payments to acute care hospitals, based either on how well hospital performs on certain quality measures OR how much hospital’s performance improves

higher a hospital’s performance/improvement, higher the value-based incentive payment

Question 10

VBP measures

Answer 10

Healthcare Consumer Assessment of Providers and Systems (HCAHPS) survey: inc overall rating of hospital, communication w/ nurses, responsiveness of hospital staff

process of care measures: inc % of HF pt who rec’d d/c instructions, % surgical pt who rec’d appropriate thromboembolism prophylaxis, % AMI pt who rec’d fibrinolytic therapy within 30 mins of hospital arrival

outcome measures: 30 day mortality rate for AMI, HF, pneumonia pts