N502 Module 7 discussion

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Aspen University *

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MISC

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Health Science

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Oct 30, 2023

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docx

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Uploaded by ButterflyRoses

Module 7 Discussion: Structure measures influence process measures, which in turn influence outcome measures, according to the Donabedian model for quality of care. These are the foundation of what is required for an effective suite of measures. Structure considers the provider's qualities, such as patient-to-staff ratios and hours of operation. The process evaluates how the system functions to achieve specific results. For example, the length of time a patient waits for exams, handwashing, standards of care, event documentation, and patient communication. The impact of the results of improvement on the patient is assessed by outcomes. For example, shorter hospital stays, fewer hospital acquired infections, and a better patient experience. An outcome evaluation determines whether a program met its objectives. A process evaluation explains how and why something works. A process evaluation describes the services, activities, policies, and procedures of a program. Outcomes are "what matters" to patients and represent the most important components of care, notably the resulting health of individuals treated. These measurements frequently reflect the most significant financial implications, allowing for a more easy estimate of avoided costs and increased value. According to Donabedian, outcome measurements continue to be the 'ultimate validators' of the effectiveness and quality of healthcare, although they can be difficult to define and have time lags. Process metrics are crucial in quality improvement because they describe if clinical care was "properly applied" or if we were "doing what we said we should do." They make a crucial link between behavioral changes and results from the standpoint of improvement. While the Donabedian model remains a fundamental paradigm in health services research, other researchers have identified potential limits and, in some circumstances, proposed model adjustments. Some have regarded the sequential development from structure to process to outcome as an overly linear paradigm with limited utility for comprehending how the three domains influence and interact with one another. The model has also been chastised for neglecting to incorporate antecedent variables (e.g., patient traits, environmental factors), which are critical precursors to assessing quality of care. According to Coyle and Battles, these aspects are critical to completely understanding the true success of new tactics or changes within the care process. Patient factors, according to Coyle and Battles, include genetics, socio-demographics, health practices, beliefs and attitudes, and preferences. Cultural, social, political, personal, and physical features of patients, as well as aspects relating to the health profession itself, are examples of environmental influences. References: Coyle YM, Battles JB. Using antecedents of medical care to develop valid quality of care measures. Int J Qual Health Care. 1999 Feb;11(1):5-12. doi: 10.1093/intqhc/11.1.5. PMID: 10411284. Donabedian A. (2005). Evaluating the quality of medical care. 1966. The Milbank quarterly , 83 (4), 691– 729. https://doi.org/10.1111/j.1468-0009.2005.00397.x Young, K. M., & Kroth, P. J. (2017). Sultz & Young’s Health Care USA . Jones & Bartlett Learning.

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