Introduction to Health Care Quality (eBook)

Theory, Methods, and Tools

Yosef D. Dlugacz (Autor)

eBook Download: EPUB

2016
John Wiley & Sons (Verlag)
978-1-118-77959-0 (ISBN)

Infos

Introduction to Health Care Quality explores the issues of quality management in today's health care environment, and provides clear guidance on new and perennial challenges in the field. The idea of 'quality' is examined in the context of a variety of health care situations, with practical emphasis on assessment, monitoring, analysis, and improvement. Students will learn how to utilize statistical tools, patient data, and more to understand new models of reimbursement, including pay for performance and value-based purchasing. They will also learn how to learn how to incorporate technology into everyday practice. Each chapter centers on an essential concept, but builds upon previous chapters to reinforce the material and equip students with a deeper understanding of the modern health care industry. Real-world situations are highlighted to show the intersection of theory and application, while cutting-edge methodologies and models prepare students for today's data-driven health care environment.

Health care quality is defined and assessed according to setting, with factors such as standards, laws, regulations, accreditation, and consumerism impacting measurement and analysis in tremendous ways. This book provides an overview of this complex field, with insightful discussion and expert practical guidance.

Health care today is worlds away from any other point in history. As the field grows ever more complex, quality management becomes increasingly critical for ensuring optimal patient care. Introduction to Health Care Quality helps students and professionals make sense of the issues, and provide top-notch service in today's rapidly changing health care environment.

YOSEF D. DLUGACZ, PHD, is the Senior Vice President and Chief of Clinical Quality, Education and Research of the Krasnoff Quality Management Institute of the Northwell Health system. The goal of the Institute is to bridge the gap between theoretical knowledge learned in the academic setting and the realities of applying quality management methods in today's health care reform environment. Dr. Dlugacz's research focuses on developing models that link quality, safety, good clinical outcomes and financial success for increased value and improved efficiencies.

Inhalt

Figures

Preface/Acknowledgements

The Author

Introduction

PART ONE

QUALITY MANAGEMENT FUNDAMENTALS

1. Foundations of Health Care Quality

2. Understanding the Impact of Health Care Reform

3. Making the Case for Change

4. New Challenges for Health Care Professionals

5. Improving Patient Safety

PART TWO

APPLYING QUALITY TOOLS AND TECHNIQUES

6. Working with Quality Tools and Methods

7. Working with Quality Data

8. Working with Quality and Safety Measures

9. Translating Information into Action

10. Preparing for the Future

Textauszug

INTRODUCTION

Health care is changing—its delivery, its structures, even its underlying philosophy. Wellness, rather than sickness, is now the focus of government concern. The patient experience of health and well‐being, rather than the physician's interpretation, is now central, and patient expectations are measured, communicated, and meaningful for financial success. Smaller health care organizations are banding together to become larger health care systems because financial efficiencies dictate such collaborations. Data are abundantly available to track various aspects of care. All these changes encourage new ways of thinking about health care and the organizations that deliver that care; those professionals who hope to understand and thrive in this new environment require quality tools, techniques, information, and education.

Introduction to Health Care Quality: Theory, Methods, and Tools is designed to familiarize health care professionals and students, administrative and clinical leaders, and policy makers with contemporary issues in quality management in the new health care reform environment. In addition, due to the rapidly changing technology for tracking medical information, such as the electronic health record, quality managers and health professionals will need to have increased familiarity with database development, data analytics and statistics, the role of measurements in monitoring quality, and performance improvement methodologies if health organizations are to succeed in the increasingly competitive marketplace. Because government agencies are linking quality variables to financial success, health professionals today are required to communicate information accurately and transparently and meet newly established benchmarks for the delivery of care. This book is designed to help professionals meet these needs.

Quality professionals, indeed all health care professionals, are required to work within new models of health care delivery, such as the patient‐centered medical home, accountable care organizations, value‐based purchasing, bundled payments, and pay for performance. Community programs that encourage wellness and prevention are now reimbursed whereas under the older models, hospital services and patient volume controlled financial outcomes. It is a new health care world, and those involved in it require new information and new skills.

The purpose of this book is to provide just that: to give professionals and students the tools they need to work effectively within the increasingly data‐driven health care environment. Quality data provide the foundation of care decisions, performance improvement initiatives, prioritization of resources, documentation about meeting expectations, analyzing market competition, and understanding the patient experience. Physicians and other clinicians are expected to work within the quality framework, collect data, report outcomes, collaborate in multidisciplinary teams, and develop communication strategies as never before. Inpatient hospital, ambulatory centers, and health care system leadership have to become involved in quality data and measurements in order to administer effectively and maximize reimbursements. Patients, who are the health care consumers, are more able than ever before to access comparative information about different care facilities and providers and make informed choices about where they spend their health care dollars.

This book addresses these quality issues from the point of view of my personal experience as a quality professional for the past 30 years. It offers experiential, practical, and applied examples of hands‐on implementation of how the fundamentals of quality management can improve efficiency and effectiveness of organizational and clinical processes, based on my career as the Senior Vice President of Quality Management and as the Executive Director of the Krasnoff Quality Management Institute, for Northwell Health (formerly the North Shore‐LIJ Health System), one of the largest integrated health systems in the United States. My goal is to show quality management in action, offering theoretical information and practical examples within each chapter. The exercises at the end of each chapter, “Quality Concepts in Action,” are designed to reinforce the quality concepts discussed in that chapter in applied situations. The references, suggestions for further reading, and useful websites at the end of each chapter provide students of health care quality with rich resource material for further exploration of the quality concepts and ideas in the chapter.

The material in the chapters not only exposes interested professionals to quality management fundamentals but also attempts to provoke creative ways of thinking about the provision of care. In addition to offering new material, each chapter reinforces and integrates previous discussions. I have taken examples from my experience, and although for privacy issues they are hypothetical, the examples are entirely realistic. The first five chapters review quality management theory and fundamentals and the changes necessary to the new reform environment. Chapters 6 through 9 show the application of quality theory with the tools and techniques used for performance improvement. Chapter 10 reviews and concludes the issues highlighted in the previous chapters.

Chapter 1 outlines the basics or fundamentals of quality management, introducing the most influential quality theorists, from Nightingale through Donabedian, and organizations concerned with quality, among them The Joint Commission, the Centers of Medicare and Medicaid Services, and the Institute of Medicine. A discussion of how to develop quality indicators for performance improvement is offered.

Chapter 2 highlights the changes and new models of care required by the health care reform bill, the Accountable Care Act, such as accountable care organizations, bundled payments, pay for performance, value‐based purchasing, the patient‐centered medical home, and so on. In this chapter the role of health information technology is discussed, including the pros and cons of electronic health records. Improving communication between physician and patient, encouraged in the health care reform environment, has led to innovative practices, such as narrative medicine, which is being taught in medical schools to increase professional awareness of how to elicit information.

Chapter 3 introduces in general terms the changing paradigms involved in providing safe quality care in different settings, such as the inpatient hospital and the community. It also stresses the importance of quality measurements in the reform environment and of effective leadership in making productive change. Various techniques to improve multidisciplinary communication, such as huddles, are outlined. The importance of health literacy in improving patient safety is also discussed in this chapter. An example of developing effective structures for moving information throughout a health system is offered, as is the role of quality data and measurements in promoting change for performance improvement.

Chapter 4 examines new challenges for health professionals that the reform environment promotes, such as the importance of statistical information and quality measurements in monitoring quality of care and patient satisfaction. Dashboards of measurements are discussed for their value in assessing care and improving processes, especially for issues involved in chronic disease management. Health information technology and various data sources are also reviewed for appropriateness in monitoring care. Improving communication across the continuum, using microsystems, macrosystems, Lean, TeamSTEPPS, SBAR, and checklists, is discussed.

Chapter 5 stresses the role of administrative and clinical leaders in improving patient safety and how metrics and measurements should be used by leaders to monitor the processes of care and patient safety. Principles of High Reliability Organizations are shown to address patient safety issues in a proactive paradigm. The role of quality management, nursing leaders, and the medical staff in promoting a safety culture is outlined. Examples of effective ways to report data for business intelligence and for decision making are presented. Prioritization issues and the role of dashboards in determining priorities are discussed, as well as how to interpret gaps in care, errors, and leaders' role in monitoring adverse events.

Chapter 6 shows how to work with quality tools and methods to manage problems, identify gaps in care, and target errors with such quality management tools as root cause analysis, failure mode, effects analysis, cause‐and‐effect diagrams, flowcharts, and other graphical displays of information. Basic statistical concepts involved in using data for analysis and quality research are presented. The value of using clinical pathways to improve communication and standardize the process of disease management is argued. Improving performance methodologies, such as the Plan‐Do‐Study‐Act cycle, is defined.

Chapter 7 continues the discussion of the role and challenges of working with quality data to evaluate care and the difference between using data for regulatory compliance and for performance improvement. Issues involved in extracting data from the electronic health record are discussed. Case studies are offered to show the application of data to real‐life hospital situations, such as the appropriate assignment of end‐of‐life patients, chronic disease management, readmission, and...

Produkt-Details

• Erscheint lt. Verlag: 22.11.2016
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Gesundheitswesen
• Themenwelt: Studium ► Querschnittsbereiche ► Prävention / Gesundheitsförderung
• Schlagworte: Öffentlicher Gesundheitsdienst u. Gesundheitspolitik • Business & Management • challenges of modern health care quality • Gesundheits- u. Sozialwesen • Health & Social Care • health care quality analysis • health care quality assessment • health care quality assessment metrics • health care quality assurance • health care quality concepts • health care quality data • health care quality management • health care quality management strategy • health care quality methodologies • Introduction to Health Care Quality: Theory, Methods, and Tools • measuring health care quality • Öffentlicher Gesundheitsdienst u. Gesundheitspolitik • Public Health • Public Health Services & Policy • Qualitätsmanagement • Qualitätsmanagement • Quality management • using patient data • Wirtschaft u. Management • Yosef D. Dlugacz
• ISBN-10: 1-118-77959-2 / 1118779592
• ISBN-13: 978-1-118-77959-0 / 9781118779590