Public policies, licensure, and accreditation standards for health care professionals and organizations

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Measures of Quality

 Health care quality is a nationally recognized topic that is addressed through public policies, licensure, and accreditation standards for health care professionals and organizations. Throughout history, numerous organizations have been involved in developing health care quality and safety initiatives.
 

The Joint Commission and Centers for Medicare and Medicaid Services (CMS) developed quality and safety indicators for various health care systems. These indicators seek to establish accountability for health care organizations through a reporting system, which is available to the public. For this Discussion, explore various accrediting organizations and specific measures that pertain to quality. In your research on accrediting organizations, consider how these quality measures affect quality outcomes, support ethical principles, and influence the delivery of clinical services.
 

To prepare:

  • Select one specific quality indicator      from the Week 2 Discussion and compare it with those outlined in this      week’s Learning Resources (In week 2 discussion, I spoke about nosocomial      infections and pain management as quality indicators).
  • Review the accrediting body standards      that pertain to your organization focusing on those standards that require      your organization to define its quality management program.
  • Consider regulatory requirements at      the state or national level that affect quality outcomes in your      organization.
  • Ask yourself: How do the Centers for      Medicare and Medicaid Services (CMS) restricted reimbursements affect      quality management or improvement efforts at my organization? How do these      standards and regulations influence or support ethical principles and      influence patient care and nursing practice?

By tomorrow Wednesday 12/13/17, write a minimum of 550 words in APA format with at least 3 references from the list below that addresses the level one & two headings as numbered and lettered below:

post a cohesive scholarly response that addresses the following:

1) Choose any measurement and explain the extent to which your chosen measure is affected by CMS driven incentives and disincentives. 

2) From a systems perspective, discuss how this measure affects:

a. Quality outcomes 

b. Supports ethical principles 

c. Influences patient care and nursing practice.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 5: “Data Collection”

Chapter 6: “Statistical Tools for QI”

Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefitted financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251.

Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting.

Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406.

This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable.

Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/

Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF).

Required Media

Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.