Quality monitoring is becoming more and more accepted for patients and healthcare providers. With the past advances in quality measurement over the last ten years, many challenges have yet to be addressed so that quality monitoring can realize its potential as a counterforce of the demands of costs.
The structure of the health care system is rapidly changing, primarily due to the response to concerns about the increased costs of services for health treatments. Many of these changes create challenges for health care professionals to provide proper treatment and the way patients may seek care. As these problems may cause an inconvenience to both patients and clinicians in the short run, we want to know the long-term effect of these strategies on the health care of the population.
Quality Assessment offers a single method for evaluating the results of changes in the organization. The purpose of this article is to discuss the many challenges that must be addressed in order to achieve strong quality assurance.
The following are five challenges with quality assurance.
To a certain extent, quality is in the eye of the beholder and with that comes certain expectations as the value associated with various aspects of care are likely to vary among organizations. A national monitoring system must include specific measures that assess dimensions of care that are relevant to patients, purchasers, and health care experts.
But how do their different perspectives include the choice of the quality measures?
Patients tend to evaluate their care regarding responsiveness from the health care team who treats their individual needs. As medicine has made significant advances of the past century, patients expect modern medicine to be able to treat most, if not all health problems.
The expectations of patients about the health care system may differ from those of professionals in the health care field and purchasers. This may lead to different quality evaluations. The perceived limits on access to the choice of providers and health care may be valued by purchasers while patients may feel negative about having little access.
The short visit lengths will also reduce the cost of ambulatory care which may play an adverse role on the patient’s ability to make their choices for their care. Purchasers evaluate the value of services as the cost-consciousness impress greater concern of the unnecessary use of services.
As a result, physicians are caught in between efforts to control their own judgment and costs about the best course of treatment for a patient as well as the values of the patient. Cost control is often achieved as third parties made decisions about their services and what is covered by providers who offer those services.
Develop Accountability Framework
Levels within the health care system must be held accountable for quality. But how can this be actually accomplished? The answer is that we must hold all levels of the system accountable. This includes the individual physicians, hospitals, health plans and medical groups. The accountability framework reflects on the expectations about the professional responsibility.
Establish Explicit Criteria
The explicit criteria have been used the most for evaluating technical quality as opposed to interpersonal quality. Clear criteria are also used to assess the skill level of health care employees. Some might even make inferences about the skills based on the characteristics of the physician. Criteria are often developed during the initial effort without making provisions for ongoing reviews and revisions.
Choosing Indicators for Reports
The importance of relevance is due to the results of laying a foundation for the dialogue among the related parties. The area is measured for quality assessment as preference should be given to those areas where the better performance will enhance the overall health. Many quality measures send a signal to the health care system to increase health services such as cancer screening, treatments, and early prevention.
Facilitate Information System Development
Today, two of the biggest gaps in information systems are the availability of detailed information and a routine assessment from the consumer’s perspective. Choosing the measures is determined by the availability of automated data. Quality monitoring has developed for claims data to capture the concept of interest. These types of tests require eligibility criteria such as age, gender, length of enrollment and claims that are generated.
Many are concerned about how they will get the care they need in a system that focuses on cost control if they experience a serious condition such as cancer, heart disease or diabetes. Assessing the quality of care requires data that can only be found in claims data systems.