Assessing Quality Healthcare
ASSESSING QUALITY HEALTHCARE
Introduction
·
Quality in health care refers to the extent to
which health services provided to individuals and populations improve desired
health outcomes.
·
Assessing attributes includes
o Safety
o Effectiveness
o Patient-centeredness
o Timeliness
o Efficiency
o Equity
o Accessibility
Attributes of a Good Patient–Practitioner
Relationship
- Trust:
The patient must feel confident in the practitioner’s competence and
integrity.
- Respect
and Empathy: Practitioners should show
understanding and concern for patients’ conditions and emotions.
- Effective
Communication: Clear explanation of diagnosis,
treatment options, and follow-up instructions.
- Shared
Decision-Making: Engaging patients in decisions
about their care.
- Confidentiality:
Maintaining privacy of patient information.
- Continuity
of Care: Building long-term relationships
that improve outcomes over time.
Measurement of Quality
- Structure
Measures: Assess the setting of care (e.g.,
facilities, equipment, staff qualifications).
- Process
Measures: Evaluate how care is delivered
(e.g., adherence to guidelines, communication).
- Outcome
Measures: Focus on the results of care (e.g.,
patient health status, satisfaction, recovery rates).
- Patient
Feedback: Surveys and interviews assessing
patient satisfaction and experiences.
- Clinical
Indicators: Infection rates, mortality rates,
readmission rates, etc.
Procedure for Formulating Explicit
Criteria and Standards
- Identify
the Area of Care: Choose specific conditions or
services for which standards are to be developed.
- Review
Evidence and Guidelines: Collect clinical
evidence, research studies, and best practices.
- Formulate
Criteria:
- Structure
Criteria: Requirements for resources and
infrastructure.
- Process
Criteria: Best practices in clinical care.
- Outcome
Criteria: Expected results and indicators of
success.
- Set
Performance Standards: Define acceptable levels of
performance.
- Validation
and Expert Review: Involve healthcare
professionals for consensus and refinement.
- Implement
and Monitor: Use standards for auditing and
quality improvement.
- Review
and Update: Periodically revise based on new
evidence and practices.
Determinants of Quality
- Human
Resources: Skills, training, attitudes, and
number of healthcare providers.
- Infrastructure:
Facilities, equipment, technology, cleanliness, and accessibility.
- Policies
and Protocols: Guidelines, regulations, and
adherence to standards.
- Management
and Leadership: Organizational culture, leadership
style, and administration.
- Patient
Factors: Demographics, health literacy,
socioeconomic status, and preferences.
- Financial
Resources: Funding for healthcare services,
affordability, and insurance coverage.
Donabedian Model: Structure – Process –
Outcome
Avedis Donabedian proposed a widely used model to
assess healthcare quality:
a) Structure
- Refers
to the environment in which healthcare is provided.
- Includes:
- Physical
facilities and equipment
- Staff
qualifications and training
- Organizational
characteristics
- Example:
Number of ICU beds, availability of MRI machines.
b) Process
- Refers
to how healthcare is provided.
- Includes:
- Diagnosis
and treatment procedures
- Communication
and education
- Adherence
to clinical guidelines
- Example:
Percentage of diabetic patients receiving annual eye exams.
c) Outcome
- Refers
to the results of healthcare.
- Includes:
- Recovery
rates
- Mortality
and morbidity statistics
- Patient
satisfaction
- Example:
Reduction in hospital-acquired infections.
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