New initiatives for quality management in healthcare are costly and time-consuming to implement. With large financial investments in upgrading operations and attending to patient care, it is an imperative that the numbers support the efforts. The decision-makers within an organization will be held accountable for mismanagement and patient outcomes. Measurement is a critical component in quality management
QUALITY AND PATIENT SAFETY MEASURES
As the US healthcare system continues to grow, more patients face the possible challenges and impact of poor quality healthcare and outdated safety practices. At a well-known conference on healthcare quality and patient safety, Dr. Kelly McGrath identified how more patients die annually from hospital-acquired infections (HAIs) than people in auto accidents. This disturbing fact requires immediate insight into how the state of US healthcare needs to change. However, healthcare entities and organizations must take a few moments to understand what quality and safety measures are, how they impact the financial state of healthcare, how clinical analytics can identify key weaknesses in the healthcare system, and how the Centers For Medicaid and Medicare Services (CMS) is taking action to improve quality and patient safety measures..
Data Impacts Decision-making
The proof is in the data. Dr. William Deming brought quality improvement processes to the forefront about 75 years ago. His concepts helped modern businesses tackle ever-changing conditions. According to Deming, “In God we trust…and all others must bring data.” Data will provide the push to move physicians and healthcare organizations into using processes that are quantifiable and offer real value. According to a survey from McKinsey, 84 percent of physicians surveyed were willing to change as long as a reasonable course an argument could be made that change was necessary. Real-time data will guide future improvements for physicians and result in the ability to make vital decisions that impact a healthy bottom line and better patient care.
Why Should We Measure?
The implementation of a system of measurement allows clinicians and healthcare organization to better serve patients. According to Science of Improvement: Establishing Measures from the Institute for Healthcare Improvement, measurement for learning and process Improvement allows providers to:
- Use new knowledge within daily practice
- Learn from sequential, observable tests
- Stable biases within each test performed
- Gather the necessary data used for learning and completing another cycle
- “Small tests of significant changes” allow for a faster rate of improvement
Oftentimes, there is so much data that it becomes overwhelming. Pertinent data needs to be given to practitioners at the right time and place. The information needs to answer their questions succinctly. Small-scale tests can allow providers the information necessary to control for biases and correct prior to large-scale implementation. Data for improvement in quality management in healthcare should be derived from outcome measures, process measures and balancing measures.
The quest for quality improvement in healthcare is nothing new. Chester County Hospital and Health System president and CEO H.L. Perry Pepper said:
“The funny part about it is that process improvement has been in healthcare forever and we got away from it. When Pepper began in the 70s, his department “went from department to department with a clipboard and looked at the process. We didn’t have computers, but we were smart enough to know that they were basically industrial engineers.”
Improvements are still made from data from keen observation. With the right data, trends can be identified, better protocols can be implemented and waste can be reduced. Data can help physicians identify and manage diseases collectively in a cohesive joint effort. Some examples from the National Strategy for Quality Improvement in Health Care: 2014 Annual Report to Congress include:
- Data was used at the state and federal level to focus on preventing healthcare-associated infections. The U.S. Department of Health and Human Services’ National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination and the Centers for Medicare & Medicaid Services, the Partnership for Patients® initiative and Hospital Networks and Federal and State agencies have made a substantial impact on central line-associated bloodstream infections. Data has been instrumental in the improvement of safety in healthcare settings with a 9 percent decrease in harm experienced by patients in hospitals in 2012 compared to 2010. These improvements are estimated to have prevented 15,000 deaths in 2011 and 2012 and decreased 56,000 patient harms. Patient outcomes can improve and mortality rates decrease with data-centered quality management initiatives.
- Data was used collectively to better serve individuals affected with diabetes. Nearly 1.4 million New Yorkers are diabetic with 4.5 million more considered prediabetic. The New York State Health Foundation’s (NYSHealth) ‘Reversing the Trend Diabetes’ campaign, with the assistance of over 3,000 physicians and statewide associations have helped improve diabetic care for over 600,000 people. 8,000 people have been informed of their status. From 2007 to 2011, the campaign showed that New Yorkers with diabetes and controlled cholesterol increased from 41 to 47 percent and those with controlled blood pressure increased from 61 to 66 percent.
Measurements for quality improvement in healthcare have been successful in improving patient outcomes and the in safer delivery of medical care. Consider the possibilities when all physicians make the leap to using data to improve their practice’s ability to deliver the best of medical care.