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The Measurement of Healthcare Quality

What is quality? The dictionary defines quality as “a peculiar and essential characteristic; an inherent feature; or a degree of excellence.” For many charged with leading quality in healthcare, quality is often measured as a success in certification, a successful audit, or decreasing rejections. Instead, quality should be measured by what is experienced directly by the customer, the “value added” of what was received, and/or the perception of provider that was involved in the interaction, as both are customers of the healthcare institution.

When measured through the perspective of the customer, quality becomes the foundation of customer satisfaction and promotes safety and effectiveness. This form of measurement must be incorporated at the point of concept development, and nurtured throughout the design and development process. Once transferred into use, the quality built in has to be evident enough for the customer to experience it.  It is in that experience where true quality can be measured; and its byproduct, customer satisfaction, can be determined. For facilities that are certified by an auditing body, customer satisfaction is a key element that is measured and discussed, as it is often an organizational goal. A satisfied customer becomes a provider’s best advocate for new opportunities.

The problem is that “satisfaction” is a perception. It is hard to measure because it cannot be defined in engineering terms. As a result, customer satisfaction has to be measured indirectly by customer feedback and experience. Customer satisfaction as a perception of quality supports an iterative process of trial, testing, and feedback on performance and features. As a result, the product is continually evaluated and quality can be enhanced, with a goal of producing more satisfied customers.

The challenge of quality improvement in patient care

This discussion is particularly timely, since this is National Healthcare Quality Week (October 22-October 26, 2018) and defining quality is one of the overarching themes. Quality is the patient’s (customer) perception of the services they received. For patients under care, that is getting the information needed so when providers ask for informed consent, the patient feels confident in both the provider and the information when the form is provided. Another name for this process is active engagement with the patient.

Active engagement with patients is associated with improved outcomes. As this cycle is repeated with patients, they become more confident. As a result, the quality perception increases, continuing to enhance levels of customer satisfaction from both the perceived value the patient receives and the perceived benefits the hospital institution receives, therefore enhancing quality of care for all.

This discussion comes at a time when healthcare institutions are constantly challenged to find ways to improve quality of care, while at the same time reducing cost and increasing revenue. One key indicator of this trend: the 2018 Healthcare Financial Management survey confirmed that hospital construction remained relatively flat similar to 2017, with a slight increase in renovations and infrastructure. Hospitals are focusing primarily on renovation versus new construction, outpatient vs. inpatient projects, and those in line with population health.

This focus means that hospitals have to do more with less, while at the same time dealing with a decentralizing patient population. This makes communication, records and staff access to the information critical for three reasons: (1) staff is more dispersed and held at minimum levels; (2) centralized records are accessed by many contributors and have to be accurate and current; and (3) communication with the database and other staff has to be seamless.

The Accreditation Council for Graduate Medical Education reported that in 2012, 85 percent of medical providers had a smartphone and were using apps. While nursing reports a decreased amount of time spent on trying to contact the physician, they also report no change in response time for urgent issues.

Without question, quick and effective communication is top of mind in healthcare. The Joint Commission on Accreditation of Healthcare Organizations describes communication error as the cause of 60 to 70 percent of preventable hospital deaths. John Hopkins found medical error to be the third leading cause of death in the US. Improvement in this statistic will not only enhance quality of care but also save lives.

How technology can assist in communication for quality of care

With all of the potential sources of communication that can come directly to smartphones, this flow of information can overload an individual. Studies have found that physicians find smartphones more efficient than pagers, but noted a perceived increase in interruptions and weakened inter-professional relationships.

Automation that allows information to be securely collected from disparate sources, and provides the opportunity for providers to select tiles or options from a menu on their mobile devices, can provide seamless communication of current patient information. This minimizes interruptions and fosters better patient care.

Consolidation of the platforms, combined with secure messaging that allows both words and images to be exchanged to demonstrate the case questions, can lead to more informed communication and consultation, optimal staff utilization, and ultimately better medical decisions and consensus. As it can reach providers wherever they may be, it fosters a care team approach – now a common method of staff organization in healthcare. Over 75 percent of the American Hospital Association’s Hospital and Health Networks report that they offer secure messaging.

Technologies that can communicate with a variety of software instrumentation and software platforms can provide a seamless integration on a mobile handset to improve patient care by making all of the technology available for decision-making.  Such tools contribute to effective teamwork, which is recognized globally as essential to construct a more effective patient-centered healthcare delivery system. This moves automated communication to a seamless approach, keeping all of the available data organized in line with hospital best management practices. The result is better utilization of staff and the promotion of both efficiency in rendering of care and cost savings.

Written by
Lillie Thomas
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