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Improving Healthcare Quality

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Improving Healthcare Quality
Improving Healthcare Quality
Purpose
The purpose of this paper is to identify aspects of quality improvement in healthcare. This research is conducted by examining and reviewing various literature regarding the definition and makeup of quality healthcare, need for improvements in healthcare, various quality measures or indicators and weighing the cost of improving healthcare quality.

Defining Healthcare Quality

Before any discussion can take place regarding improving healthcare quality, an examination of the definition of healthcare quality must be conducted. There are legitimately varying perceptions of what is consider to be the critical dimensions of quality healthcare. These views on quality largely results from the perspective one adopts as a patient, healthcare provider, health care manager, purchaser, payer, or public health official. The same health care experience may be assessed differently depending upon the person’s role. For example: ➢ The patient may view his or her experience with the health care system both by its outcome and personal feelings, such as whether the physician listened well, communicated clearly, and was compassionate as well as skilled in delivering healthcare services. ➢ A healthcare provider may view quality in a technical sense, such as whether an accurate diagnosis is made, whether a surgical procedure is performed proficiently and whether the patient’s health has improved. From this view, quality is the difference between what is technically sound and possible, and the actual practice and delivery of healthcare services. ➢ The health care manager, payer, or purchaser (employer health plan, or government program) may want to know if the healthcare services provided are cost effective. ➢ Public health officials may want to know if resources are being utilized appropriately to optimize population health and provided equitably within the population. Quality as defined in Clair G.



References: Beers, M.H. (1997). Explicit Criteria for Determining Potentially Inappropriate Medication use by the Elderly Curtis, LH, et al. (2004). Inappropriate Prescribing for Elderly Americans in a Large Outpatient Population Donabedian, A. (2003). An Introduction to Quality Assurance in Health Care. New York: Oxford University Press Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ), (2007) Fick, D M, et al. (2003). Updating the Beers Criteria for Potentially Inappropriate Medication use in Older Adults Gonzales R, Malone DC, Maselli JH, Sande MA. (2001). Excessive antibiotic use for acute respiratory infections in the United States Fish, L. Garber, M. Kelleher, D.W. Bates. (2003). Incidence and Preventability of Adverse Drug Events Among Older Persons in the Ambulatory Setting. JAMA 289(9):1107-1116. Johnson, J.A. and J.L. Bootman. (1995). Drug-Related Morbidity and Mortality: A Cost-of- Illness Model MacKinnon NJ, et al. (2003). Indicators of Preventable Drug-related Morbidity in Older Adults: Use Within a Managed Care Organization McCaig L.F., Besser R.E., Hughes J.M. (2002). Trends in Antimicrobial Prescribing Rates for Children and Adolescents Meisenheimer, C. G. (1997). Improving Quality: A Guide to Effective Programs (2nd ed.). Nash, D. B. & Goldfarb, N. I. (Eds.). (2006). The Quality Solution: The Stakeholder’s Guide to Improving Health Care National Institute of Allergy and Infectious Diseases, The Common Cold, December 2007, http://www3.niaid.nih.gov/topics/commonCold/overview.htm (July 14, 2008). Rosenstein N, Phillips WR, Gerber MA, Marcy SM, Schwartz B, Dowell SF. 1998. The Common Cold---Principles of Judicious Use of Antimicrobial Agents Simon, SR, et al. (2005). Potentially Inappropriate Medication Use by Elderly Persons in U.S. Health Maintenance Organizations, 2000-2001. Journal of the American Geriatrics Society 53(2):227-232. Zhan, C, et al. (2001). Potentially Inappropriate Medication use in the Community-Dwelling Elderly

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