Essay Sample on Quality Measures in Patient Care and Reimbursement

Technology plays a critical role in the modern-day's dynamic health systems. As a result, the role and prominence of nurse informaticists have been on the rise in recent years (Kumari, 2019). The major elements of nurse informatics include advanced systems, healthcare promotion, internet, and network. Implementation of these elements is critical in the improvement of patient care as well as reimbursement, especially as health organizations seek to comply with various regulations such as the Affordable Care Act (ACA). To ensure that quality is achieved across these spheres, various national and state quality measures have been established. The measures can be broadly divided into structure, process, and outcome measures (AHRQ, 2015). The structural measures seek to enhance the capacity, systems, as well as the processes of the healthcare providers to improve the quality of care. Process measures outline what a healthcare provider needs to do to maintain and improve the health of the patients. Finally, the outcome measures mirror the impact of the intervention. Though outcome measures may look like the gold standard of quality, the outcome is a result of many factors, some of which are beyond the control of the healthcare providers. The measures can also further be divided into inpatient quality indicators, patient safety indicators, pediatric quality indicators, among others. This paper seeks to examine the quality measures at John Hopkins Hospital and recommend possible improvements.

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Inpatient quality indicators The hospital inpatient quality reporting program is meant to help collect quality data to enhance transparency and quality of care. The hospital has different programs meant to enhance inpatient quality. For instance, the blood clot prevention program seeks to prevent development of deep vein blood clots among inpatients (Johns Hopkins Medicine, 2020).

Patient safety indicators The 2020 National Safety Goals outlines programs that must be implemented to ensure the safety of the patients. The programs include ambulatory health care, behavioral health care, nursing care, among others (The Joint Commission, 2020). Johns Hopkins Hospital gives a critical focus on patient safety. Various programs have been developed and implemented to eliminate preventable harm, as well as optimize patient outcomes, while reducing healthcare costs. For instance, the hospital has various measures to prevent hospital-acquired infections and reduce readmission rates.

Pediatric quality indicators Helps identify any potential safety and quality issues specific to the pediatric population. John Hopkins has several in-house programs meant to enhance the quality of care given to pediatric population. For instance, the hospital screens all hospitalized inpatients for seasonal flu vaccine, and vaccination carried out before discharge. This helps prevent infections.

While the hospital has largely done well regarding adherence to the national and state standards, more can still be done to enhance the quality of care given to patients. This is particularly important in the light of changing health environment both locally and internationally. To respond to these changes, the hospital must embrace technology more. The nurse informaticists must also be given more autonomy since data will be the solution to most of the future challenges. More investment in informatics, therefore, is inevitable. Moreover, to ensure that the hospitals receive the recommended care, the hospital must get into more collaborations with other institutions. The partnerships and collaborations should be aimed at improving the quality of the workforce, identify barriers to improvement, as well as develop solutions to the various challenges. The collaborations will also help in the sharing of best practices by the members to improve internal processes.

References

AHRQ. (2015). Types of Health Care Quality Measures. Retrieved from Agency for Healthcare Research and Quality: https://www.ahrq.gov/talkingquality/measures/types.html

Johns Hopkins Medicine. (2020). Patient Safety and Quality. Retrieved from Jihns Hopkins Medicine: https://www.hopkinsmedicine.org/patient_safety/core_measures.html

Kumari, R. (2019). The Impact of Informatics on Nursing Education and Promoting Quality of Health Care. International Journal of Advances in Nursing Management, 7(3), 285-288. Retrieved from http://www.indianjournals.com/ijor.aspx?target=ijor:ijanm&volume=7&issue=3&article=027

The Joint Commission. (2020). National Patient Safety Goals. Retrieved from The Joint Commission: https://www.jointcommission.org/standards/national-patient-safety-goals/