Health Care Quality: How Do You Know Your Care Has Improved - Essay Example

"Health Care Quality: How Do You Know Your Care Has Improved?" is a remarkable example of a paper on the health system.
The article begins by observing that deficiencies in the quality of primary care are still evident even in the face of relentless efforts aimed at curtailing the same. These efforts include 2009’s decision by the ACGME to prolong the period residents spend in primary care continuity clinics and choosing to stand by residents’ participation in efforts aimed at quality improvement. The quality of care given by residents is noted to be of special significance in addressing these deficiencies because residents provide a considerable amount of care to uninsured and minority patients. Various researches have shown the increased quality of inpatient care while very little has been offered in the United States’ outpatient care quality as provided by the resident physicians because of an absence of a comparison group or by their emphasis on particular regions or diseases (Carey, 2000). The article thus analyses information obtained from the NHAMCS with a view of comparing the quality of outpatient care as provided by staff physicians and resident physicians based on established quality measures (Zallman, Ma, Xiao, & Lasser, 2010).

Identify and discuss the five categories of quality indicators

The five groups of quality indicators were arrived at depending on the Institute of Medicine’s method of scientific soundness, feasibility for indicator choice, clinical importance, and methodology characteristic to the shortcomings of the source of information. One of the categories was the appropriate use of antibiotics which entailed two measures such as the avoidance of antibiotic use for URTIs. Other categories included chronic disease medical management (which encompassed ten measures like the application of beta-blockers in coronary artery disease), preventative counseling (with three measures such as exercise advice for adults at risk of coronary heart disease, hypertension, diabetes, and so on, and inappropriate prescription of medication in patients that are elderly, that is, those age 65 years and above. The last category of quality indicators was screening tests which had four measures in total, including routine screening of blood pressure (Zallman, Ma, Xiao, & Lasser, 2010).

Discuss what the researchers found when they analyzed the "Performance on Quality Indicators." Were you surprised by their findings?

On both the adjusted and non-adjusted analyses of the ‘Performance of Quality Indicators’, the researchers noted that the resident physicians did better than the staff physicians on 4 of the 19 quality measures. These were the application of angiotensin-converting enzyme inhibitor in congestive heart failure, application of diuretics in hypertension, application of statin in hyperlipidemia, and finally, routine screening of blood pressure. In counseling, resident and staff physicians were at par. Other areas in which they performed similarly included techniques that encompassed poor prescriptions or diagnostic testing over-applications and techniques of appropriate prescriptions (Zallman, Ma, Xiao, & Lasser, 2010). Basically, it was observed that the quality of care provided by resident physicians was either equal to or better than that provided by staff physicians. This was particularly surprising to me as I expected the staff physicians to be better placed based on their experience levels.

Why are there differences in the quality of outpatient care provided by resident and staff physicians? What are some possible strategies organizations can implement to remedy this problem?

Some of the reasons why resident physician care was observed to be of better quality than that of staff physicians are because resident physicians are actively undergoing training and so they learn more concerning contemporary care guidelines and are also under keen observation from their supervisors and superiors which may elicit better performance overall. The parties in care systems provided at non-academic compared to academic institutions could also play a salient role (Carey, 2000). To rectify the problem, continuous staff training is prudent, as well as the installation of performance-based recognition and punitive measures, even for the staff physicians (Smith, 2005). Quality enhancement programs aimed at checking the specific obstacles at the patient, provider, and system levels could be critical in eliminating this discrepancy (Zallman, Ma, Xiao, & Lasser, 2010).