Different Methods of Quality Measurement

Different Methods of Quality Measurement

​Patients do not seek to pay for quantity but quality. Doyle et al. (2017) urge healthcare providers to implement quality measures to curb unsustainable spending in the sector (1). Besides, the authors note that United States (US) healthcare system struggles with efficiency and quality improvements, and experts continually note variations in patient outcomes (2). Notably, if the American facilities were operating at fullpotential and efficiency, there would be no gaps between what medical systems provide and what Americans receive (Doyle et al, 2017, p. 2). In this regard, most US healthcare organizations use quality measurement tools like patient experience and safety of care to improve service delivery for specific reasons. 

Quality Measurement Tools Summary

​Patient Satisfaction and Experience

​Patient satisfaction depends on a patient’s medical experience and the person-centeredness of care for specific reasons. Foremost, Larson et al. (2019) argue that persons receiving treatment deserve to be treated with respect and dignity when they are being treated (564). Additionally, healthcare services must be person-centered and the services must match health outcomes with every healthcare utilization(564). Therefore, Person-centeredness imply hospitals should be accountable to their patients on the account of quality improvement evaluations (Larson et al.,2 019, p. 565; Riebling et al., 2018). Healthcare organizations’ leadership must ensure quality measurement tools’ effectiveness. 

​ Patient satisfaction and experience reflect interpersonal aspects of healthcare that patients receive since they are critical process indicators. The tool contains three domains: emotional support, dignity and respect, and effective communication (Larson et al.,2 019, p. 566). Factors like the type of service, patients’ characteristics, and facility characteristics may modify the three domains. Examples of these factors include clinical history, sociodemographic traits, and availability of resources(566). The modifiers depend on the health system and country, and experts them to determine patients’ values, expectations, and needs (Riebling et al., 2018). Accordingly, a patient’s experience directly determines their satisfaction and indirectly impacts their values, expectations, and needs depending on social factors like education and age. 

Safety of Care

Healthcare stakeholders must reduce the neglect of quality of care by implementing policies that focus on expanding access to basic health services and improving population health. Notably, a key barrier to universal health coverage independence is the poor quality of care, and people have continually recognized the fact and acted in perfect rationality (Hanefeld et al., 2017, p. 368). In this regard, the authors agree that with the expansion of care and enhanced priority interventions, the quality and safety of care will improve across the US (368). Nevertheless, Hanefeld et al. (2017) add that essential inputs like trained health workers, pharmaceutical supplies, operational facilities, and technology are key determiners of healthcare quality (369). Therefore, strategies that aim to increase the safety of care also aim to increase access to these important inputs across the country. 

How can doctors use Safety of Care to enhance healthcare effectiveness? First, when doctors increase the clinical quality of care, they increase safety because the interaction between patients and providers will yield high health outcomes (Hanefeldet al., 2017, p. 370). Second, doctors’ perceived quality can improve care safety because the concept emphasizes adherence to clinical guideline’s gold standards of quality. Third, doctorscan view quality as a process and understand how to enhance the safety of care (371). Fourth, increasing doctors’ responsiveness in facilities increases care safety since they will show improved respect, privacy, confidentiality, and appointment bookings(372). Lastly, the governance and management of doctors’ practices at the facility, subnational, and national levels will ensure high-quality care and the safety of patients. 

Evaluation of the Tools and Best Results

​Patient Satisfaction and Experience

​The tool can be used for attaining the best healthcare results and person-centeredness in many ways. According to Larson et al. (2019), policy implementors and makers use the tool to hold stakeholders and healthcare systems accountable to the people they serve and also evaluate and measure quality improvement efforts in the sector (568). For instance, the tool has been applied in East Africa to inform targeted interventions towards improving maternal health by quantifying types of disrespectful care during childbirth (Larson et al., 2019, p. 568). In this regard, the region uses the tool to improve support for women during childbirth and labor from their preferred companions like friends, sisters, or partners. Accordingly, the tool evaluates the success of critical policies and targets areas in need of quality improvement. 

​Patient experience is used in testing and validating medical procedures. For instance, the tool can test and validate the use of blood pressure in diagnosing hypertension. Notably, different facilities use varied scales and measures to determine health outcomes and the tool standardizes the procedures (Larson et al., 2019, p. 569). However, researchers caution that stakeholders should assess the measures depending on cultural contexts, geographical factors, or the type of care (569). Besides, caregivers must investigate how specific measures perform across different demographics and settings to determine patient satisfaction or experience. 

​Safety of Care

​The Safety of Care tool can be used to enhance hospitals’ effectiveness as a social construct. The tool can increase care safety by assessing the quality of care in middle-income and low-income nations (Hanefeld et al., 2017). Notably, individual-level assessments may use tools like standardized patients, role-playing vignettes, extraction of medical records, in-depth and exit interviews, and clinical observations (Hanefeld et al., 2017, p. 373). Doctors can also use the tools to assess the technical quality and patients’ experiences as well (373). However, the authors note that doctors must examine family and community values before conducting a comprehensive investigation of the patients’ and the general public’s perception of care.

​However, the Care Safety tool poses an array of challenges. For instance, a detailed and comprehensive assessment of the quality of care cannot be achieved if caregivers do not give attention to manifestations of quality like responsiveness, cultural appropriateness, and acceptability (Hanefeld et al., 2017, p. 374). Experts also note that strategies to improve care safety and quality will not be effective if patients’ and communities’ perceptions of care quality do not improve.Despite the challenges, the authors affirm that caregivers should assess how patients’ quality perceptions are rooted in their societal, family, and community expectations values, and norms to increase the effectiveness of quality measurement. 

​In summation, most US healthcare organizations use quality measurement tools like patient experience and safety of care to improve service delivery for specific reasons. For instance, caregivers use the Patient Satisfaction and Experience tool to enhance the person-centeredness of a facility. Besides hospitals use the Safety of Care tool to prevent instances of neglect of care and also expanding access to basic health. Moreover, an evaluation of the two quality assessment tools indicates challenges and the circumstances for the tool’s best use. For example, the Patient Experience tool tests and validates medical procedures, but researchers warn that factors like the culture of patients must be considered. Similarly, the Safety Care tool is widely used as a social construct, but again caregivers must assess and examine the patient’s family and community values for the effectiveness of the tool.

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References

Doyle, J., Graves, J., & Gruber, J. (2017). Evaluating Measures of Hospital Quality (pp. 2-23). Cambridge, MA: National Bureau of Economic Research.

Hanefeld, J., Powell-Jackson, T., & Balabanova, D. (2017). Understanding and measuring quality of care: dealing with complexity. Bulletin of the World Health Organization, 95(5), 368-374. https://doi.org/10.2471/blt.16.179309

Larson, E., Sharma, J., Bohren, M., & Tunçalp, Ö. (2019). When the patient is the expert: measuring patient experience and satisfaction with care. Bulletin of The World Health Organization, 97(8), 563-569. https://doi.org/10.2471/blt.18.225201

Riebling, N., Norouzzadeh, S., Reeder, G., Mouradian, C., Hillier, A., Cowan, R., & Doerfler, M. (2018). Quantifying patient satisfaction with process metrics using a weighted bundle approach. BMJ Open Quality. Retrieved 19 April 2021, from https://bmjopenquality.bmj.com/content/8/1/e000458.