The Quality Standards Being Applied in the Healthcare Sector - Coursework Example

Core Measures as Quality Indicators

Introduction

In the current times, there has been a growing concern among patients and other people responsible for paying for healthcare services. This concern relates to the quality standards being applied in the healthcare sector. There has been an increase in the number of avoidable deaths that could have been managed by improving the standards in health care facilities and the systems used to achieve the same. The pervasive nature of the existing challenge seems to highlight some of the essential and recognizable processes, such as administering beta blockers, particularly after the acute myocardial infarctions, which are forcing healthcare practitioners to identify improvement mechanisms. One of the most probable options is to establish a series of Centers of Excellence for improving patient outcomes and the standards of practice in healthcare. However, the idea that high-volume hospitals and surgeons offer effective and quality patient outcomes has remained controversial. This has seen a lot of opposition to the concept of regionalizing surgical procedures as a way of improving the quality of patient care. Those who oppose believe that by undertaking this approach, the healthcare system will be undermining the ability of the low-volume centers to offer emergency services that require surgical procedures. The low and negative public perception of these hospitals raises the need for further research studies on the regionalization of surgical procedures in healthcare.

Problem Statement

Improving patient outcomes is an important process that aims to enhance the people’s confidence in the healthcare sector. Emergency situations are always highly unpredictable and need effectively functioning healthcare centers to handle them whenever they arise. According to Sibbald and Bion (2002), some of the incidences that require surgical procedures tend to be highly critical. Hamilton (2013) explains that by establishing effective systems and approaches for addressing them, it is possible to enhance the achievement of the highest patient outcomes. In as much as the development of Center of Excellence has been a highly contested matter, their development can be an important step towards developing quality indicators in healthcare. Regionalization of major surgical operations can help to solve many avoidable deaths because these centers can be equipped with quality health improvement strategies that can help to improve patient outcomes. It is important to realize that getting the consensus on the development of these programs, while empowering low-volume health care facilities remains a major problem that needs to be solved. In solving the prevailing challenge, healthcare organizations are able to attain their set objectives and improve the patient outcomes.

Literature Review

In the current times, critical care has become a highly complex exercise. It is resource intensive and expensive healthcare system for a majority of the people. Due to the aging population in the country, it is expected that the demand for these services will continue to rise. The idea of regionalization of critical care services, such as surgery has been gaining momentum as a strategy that can improve the patient outcomes. It is believed that regionalizing of these services, will help increase efficiencies in the surgical services that involve critical care. Jeffrey and Russell (2009) explain that the regionalization process involves a careful allocation of the scarce resources on account of their geography. The decision to undertake this process in improving healthcare practice is informed by the fact that it has so far been done in the pediatrics, neonatal, and trauma care. According to Sibbald and Bion (2002), the decision to regionalize critical surgical care procedures in healthcare would result in the development of a tiered system of various critical units. In this program, the system will allow specialty referral centers to allow patients in transfer to access and be treated. However, referrals will only be done in instances where the services required are lacking completely. According to Cutchin (2002), the implementation of the program does not make the low-volume healthcare organizations redundant. On the contrary, it is essential in solving the various challenges that are inherent in the healthcare and able to provide solutions to the needs of the patients. This approach will only allow referral cases to be done for critical care incidences, which are absent in the region.

Regionalization has been credited for improving patient outcomes. According to Sibbald and Bion (2002), the regionalization process plays an important role in reducing costs health care costs by reducing and avoiding the duplication of certain expensive healthcare infrastructure and resources. However, Brent et al. (2005) warn that in the implementation of this program should consider the impact of transporting patients outside the settings in which they were first admitted and treated. Health care experts and practitioners have differed on the decision of whether such a move will make healthcare centers “good” or “bad. According to Jeffrey and Russell (2009), the regionalization process offers an important trade-off between the benefits and risks associated with effective healthcare practice. Hamilton (2013) explains that so far, there has not been a universal answer regarding the core measures used as a quality indicator. The balance of benefits and risks that are derived from the different approaches and systems used differs considerably from one place to another. From their analysis, Jeffrey and Russell (2009) say that regionalization of health care in a majority of the large and high-risk populations offer substantial benefits. This is important despite the assumptions regarding efficacy where millions of lives can be saved from avoidable deaths. This perspective emphasizes the need to improve the patient outcomes by undertaking the regionalization process in the majority of the critical care needs of the patients.

Potential solutions to improving quality in healthcare practice

Healthcare is an essential system, in the lives of all people in the world. The process of creating core measures to enhance the efficiency and effectiveness of the sector offers critical quality indicators of the achievement of patient outcomes. Owing to the increasing nature of critical care services, it is important to regionalize these services for purposes of attending to the majority of the healthcare needs of the patients. From the foregone discussion, it is evident that regionalization of critical care services that involve surgical procedures is highly demanded a variety of factors. The success of this process will depend on a cost-benefit analysis of the project. It is important to note that by conducting a cost-benefit analysis helps to outline the expected risks and benefits that can be experienced from the plan.

Expected costs for the attainment of the plan

Financial strain

It is expected that if a patient is to be transferred to another hospital and they have someone taking care of them; the process places extra financial costs on them. This costs can be avoided by allowing the patients to be treated in the hospitals they were initially admitted.

Personal strain

Undertaking this process may require a person to reach to far-off destinations that they did not expect for their loved ones when they fell sick. Therefore, the best option is to have proper mechanisms where people can access treatment without creating disturbances for the patient.

Associated benefits

Saves costs

Regionalization of health care for the critical services enables the state and the federal government to have few health specialists to attend to patients from a regional center. This proposes the costs of setting up similar centers in various place, particularly where certain services may not be in demand. In this regard, regionalization helps to address critical conditions in the patients while devolving the rest of the care to the low –volume hospitals.

Reduces duplication of health services

By regionalizing critical health services, health practitioners can allow specialization in the provision of healthcare services. This means that the ministries and other healthcare departments can concentrate on building capacity in the areas that they can handle best and leave the rest to other hospitals to handle and advise their patients accordingly.

Timeline for the implementation of this proposal

Activity

Wk 1

Wk 2

Wk 3

Wk 4

Wk 5

Wk 6

Wk 7

Wk 8

Formative evaluation of the current healthcare procedures

Formulating the research questions

Data collection

Data analysis

Writing recommendations

Engaging stakeholders

Implementation of research

Effective Stakeholder Engagement

Insurance companies

Creating a structure and mechanism for engaging with the stakeholders will be imperative for the success of this project. The regionalization of health services will require a lot of approvals from the relevant ministries and agencies. Therefore, involving all the relevant stakeholder will be an important process for purposes of building consensus on the implementation of the exercise. First, there will be the need to include insurance companies offering methods of payment for patients seeking different kinds of critical care services. This stakeholder group is a major player in the healthcare sector because it ensures people can take health care policies and pay for the premiums to access healthcare services. In the past, insurance companies have been effective in enabling all the citizens to access and enjoy healthcare services in the country. Therefore, the regionalization of critical health care services will also require the input of these stakeholder-groups in the development and formulation of medical premiums to be used by the consumers of this program.

Health ministries and Departments

Secondly, health ministries and related agencies will also be vital in the regionalization process. The ministry will prepare the policy framework that will be used in guiding the process of establishing regional centers of excellence. The ministry is also important in offering the demographic characteristics that will be used in identifying the places where the Centers of Excellence will be established. At the same time, there also be a need to meet and discuss with policymakers to draft some bills in the parliament for purposes of getting approval for the funding of these projects. In the implementation of the regionalization program, there will be the need of establishing timelines to be followed. Establishment of pilot programs will be vital in establishing the effectiveness of these programs before they can be rolled over in different parts of the state. The inputs of all the stakeholders in this exercise will be vital for purposes of encouraging diversity of ideas in getting an amicable solution to the challenges affecting healthcare organizations.

Non-governmental Organizations

Other stakeholders in this project may include non-governmental organizations in charge if different healthcare issues in the society. For instance, the homes of the aged can provide important information needed in the development of systems and strategies for treating the aged. The organizations in charge of such persons can provide information regarding some of the diseases that these people suffer from and how they can be treated. This means that the information provided will be used as a benchmark in the development of referral systems and procedures to be used by the healthcare practitioners, who handle these people. This is informed by the fact that not all the diseases will be placed for referral into the regional healthcare centers. This means that nurses and other practitioners need a system that outlines the process of making a referral, considering it is only done for critical healthcare needs that are not available in the regional center. Other NGOs and agencies will include the WHO, which will outline some of the qualitative aspects regarding the establishment and management of the regional healthcare centers. The WHO comes in as an important player in ensuring the success of this program. The organization will assist in the development of an effective framework that will be useful in outlining effective healthcare policies that will guide the implementation of this program.

Detective and manager of the healing environment

In this project, the detective manager will also play a significant role in the achievement of the right patient outcomes. The detective manger will ensure that the nurses follow the right procedures in making referrals of the patients to the Centers of Excellence. According to Sibbald and Bion (2002), the function of detective personnel ensures that nurses do not neglect the cases they handle but only make referrals when it is due. The detective manager will work in liaison with the manager of the healing environment to achieve the set goals and objectives. Sibbald and Bion (2002) say that the effectiveness of this program will be achieved by a proper coordination of the functions outlined and checked by the quality assurance department. Therefore, the role of the detective manager plays a major role in this project

Assessment of stakeholder engagements

Assessment and evaluation of the stakeholder engagement exercise will be essential in identifying the effectiveness of the process. The assessment and evaluation process will be done by a quality assurance team that will comprise of a team of health experts and policymakers. These people will prepare the sheet that will be used in the evaluation of the implementation of the set goals and objectives. The role of scientists will be given a top priority because health is a vital element that safeguards the lives of many people. In this process, the scientists will be expected to prepare a thorough analysis of the various diseases that can be referred to the centers of the excellence as established in the policy framework. This is important because not all the medical cases will be referred to the centers. The low-volume hospitals will be given a chance in giving the primary care before they can make the referral for the same. The evaluation process will seek to examine the efforts that the medical practitioners put in place to treat the patients before making a referral to the centers of excellence. The assessment and evaluation process will also make recommendations that will be implemented in the process of improving the healthcare practice in the region.

Conclusion

In conclusion, regionalization of critical healthcare services will be highly welcome in the improvement of patient outcomes. The development and implementation of this robust program will call for dialogue and building of consensus on the right procedure for undertaking the exercise. This understanding presents the need for including relevant stakeholders in building a consensus on the effective development and implementation of the new program in the healthcare sector. If all the people identified are included in the program, the future of the healthcare sector looks bright, having the capacity to handle the needs of patients in line with the quality of the stipulated standards.