Quality Measurement Through Point of Care Discussion Question
Description
explore the many point-of-care tools available to assist with data acquisition, analysis, and decision-making and to research how these tools can assist with quality measurement.
For the first part of this assignment, research three quality measurement point-of-care tools used in the health care environment. On the “Quality Measurement Point-of-Care Tools” chart, identify each tool and analyze its ability to assist with data acquisition, analysis, and decision making in health care. Include references for any sources used to complete the chart.
For the second part of this assignment, use the information gathered from the chart to write a 500-750-word paper that answers the following questions:
Explain how your chosen point-of-care tools contribute to quality of service through data acquisition, analysis, and decision making.
Discuss the impact that these point-of-care tools can have on quality standards.
- Discuss the impact of quality standards on organizational operations.
Policies to improve population health have often focused exclusively on the expansion of access to basic health services, to the neglect of quality of care. Efforts to increase the demand for priority interventions have implicitly assumed that the care available is of sufficient quality or that, with the expansion of coverage, quality will naturally improve.1 However, such assumptions may be incorrect. There is growing recognition that people may be acting in a perfectly rational way when they avoid using health services of poor quality and that poor quality of care can be a barrier to universal health coverage independent of access.
The aim of many strategies to improve health-care quality has been to ensure that essential inputs – e.g. technology, operational facilities, pharmaceutical supplies and trained health workers – are in place.3 Many such strategies have focused on the supply side and been designed to support the provision of services according to clinical guidelines.4 The acknowledgement that quality improvement approaches should be applied within patient-centred models of care is relatively recent.5
In this paper we seek to unpack complexities around quality of care and identify strategies for improving the measurement of such quality. An understanding of these issues could inform pragmatic strategies for the analysis and measurement of quality of care. We draw on research conducted in a variety of low- and middle-income countries and identify areas of inherent complexity that require further in-depth research. In doing so, we reflect on what is meant by quality of care and how perceptions and understanding of quality of care influence health systems and effect the measurement of quality.
We have identified and structured our discussion around six conceptual and measurement challenges. First is the recognition that, even though they may not reflect actual quality, perceptions of the quality of care are an important driver of care utilization. Second, a patient’s experience of quality must be conceptualized as occurring over time. Third, responsiveness to the patient is a key attribute of quality. Fourth, so-called upstream factors – e.g. management at facility and higher levels – are likely to be important for quality. Fifth, quality can be considered as a social construct co-produced by different actors. Finally, there are substantial measurement challenges that require the adaptation and improvement of current approaches.
The classic framework on quality of care developed by Donabedian makes the distinction between structure, process and outcomes.6 More recently, the Institute of Medicine in the United States of America (USA) has unpacked the concept further and suggested that efforts to improve care quality should be focused around six aims: effectiveness, efficiency, equity, patient-centredness, safety and timeliness. We do not seek to propose a new framework for understanding quality. Rather, we highlight some key issues that deserve more consideration in debates about enhancing the accessibility and quality of care. Building on our experiences of doing empirical research in low- and middle-income countries, we present several insights that are complementary to existing, comprehensive frameworks of quality of care and may be absent from current debates.
Enhancing Quality and Safety Scoring Guide
| Criteria | Non-performance | Basic | Proficient | Distinguished |
|---|---|---|---|---|
| Explain factors leading to a specific patient-safety risk focusing on medication administration. | Does not identify factors leading to a specific patient-safety risk focusing on medication administration. | Identifies factors leading to a specific patient-safety risk focusing on medication administration. | Explains factors leading to a specific patient-safety risk focusing on medication administration. | Explains factors leading to a specific patient-safety risk focusing on medication administration. Makes reference to specific data, evidence, or standards to illustrate the safety risk. |
| Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs. | Does not identify evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs. | Identifies evidence-based and best-practice solutions to improve patient safety focusing on medication administration and/or discusses reducing costs but not both. | Explains evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs. | Explains evidence-based and best practice solutions to improve patient safety focusing on medication administration and reducing costs. Makes explicit reference to scholarly or professional resources to support explanation. |
| Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs. | Does not identify how nurses can help coordinate care to increase patient safety with medication administration and reduce costs. | Identifies how nurses can help coordinate care to increase patient safety with medication administration and/or how to reduce costs but not both. | Explains how nurses can help coordinate care to increase patient safety with medication administration and reduce costs. | Explains how nurses can help coordinate care to increase patient safety with medication administration and reduce costs, providing specific examples related to a patient safety risk. |
| Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration. | Does not identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration. | Identifies stakeholders, but their relevance to collaboration with nurses or their ability to drive quality and safety enhancements with medication administration is unclear. | Identifies stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration. | Identifies stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration, noting the relevance and potential importance of the stakeholders. |
| Organize content so ideas flow logically with smooth transitions; contains few errors in grammar or punctuation, word choice, and spelling. | Does not organize content for ideas. Lacks logical flow and smooth transitions. | Organizes content with some logical flow and smooth transitions. Contains errors in grammar or punctuation, word choice, and spelling. | Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar or punctuation, word choice, and spelling. | Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar or punctuation, word choice, and free of spelling errors. |
| Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. | Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. | Applies APA formatting to in-text citations, headings and references incorrectly or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes or paraphrasing. | Applies APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. | Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly. |
