Health Services Research And Evaluation Methods

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

By measuring nursing sensitive indicators hospital wide and collecting this information, quality patient care in hospitals can be advanced due to the administrators knowing which areas of practice nurses need to improve. All organizations, including hospitals have institutional cultures, these cultures can potentially have a positive or negative effect on desired outcomes. In the case of hospitals this would be the quality of patient care. If the institutional culture of nurses in the hospital promotes negligence in care, lack of respect for patient autonomy, or poor prioritization, the nursing sensitive indicators should reveal it as for example: negligent care would lead to higher rates of falls and complications acquired during the patient stay.

Keywords: The Joint Commission, Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, The American Nurses Association, Hospital Inpatient Quality Reporting,

In this assignment I will be comparing the different types of research methodologies for health and social care.

Multiple studies demonstrate a relationship between lower patient-to-nurse ratios and improved patient outcomes (Garrett, 2008; Penoyer, 2010; Unruh, 2008). Patient outcomes addressed in the various studies included falls, infections, length of stay, mortality, patient safety, patient satisfaction, postoperative complications, pressure ulcers, quality of care and unplanned extubation with reintubation. A 2004 report from the Agency for Healthcare Research and Quality (AHRQ) stated that adverse events can increase the cost of a total treatment by 84%, length of stay by 5.1 to 5.4 days and probability of death by 4.67% to 5.5% (Garrett, 2008).

According to a report by the Institute of Medicine in (IOM) 2008, “the hallmarks of quality care are illustrated by a thorough understanding of existing disparities and the implementation strategies will lead to improvements in patient safety, treatment effectiveness, efficiency, and equity” (Gertner, et al, 2012).

Today, many Americans are affected by health care decisions made without their prior knowledge. More than likely most Americans are unsure how those decisions are decided and who is responsible for making those decisions that ultimately affect how health care is administered. The Department of Health and Human Services (HHS) is the United States government’s principle agency for protecting the health of all Americans and for providing essential human services, especially to those who are unable to help themselves. HHS administrators over two hundred programs and it accounts for almost forty percent of all United States federal government spending. HHS mission is to keep Americans safe and healthy through effective health and human service programs. The department has five strategic goals: strengthen health care, advance scientific knowledge and innovation, advance the health, safety, and well-being of the American people, increase efficacy, transparency, and accountability of HHS programs and strengthen the Nation’s health and human service infrastructure and workforce (Department of Health and Human Services, (n.d.).

Majid,S.Foo,S.Luyt,B.Ahang,X.Theng,YL.Chang,YK.Mokhtar,IA.(2011) Adopting and evidence-based practice in clinical decision making: nurses’ perceptions, knowledge , and barriers. Journal of the Medical Library Association 99(3) PP229-236.

Over the past decades, various studies world-wide have been conducted on the connection of nursing quality indicators and their outcomes. The

Ashton, C., Kuykendall, David H., Johnson, Michael M. (1999). An Empirical Assessment of the Validity of Explicit and Implicit Process-of-Care Criteria for Quality Assessment. 27(8). 798-808.

In health and social care research tends to accept the methods of social science research because the projects often involve investigating people’s feelings, observations and attitudes, which do not lend themselves to investigation by scientific methodology.

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

Outcome measurements are used to evaluate the health status of patients following the care he/she has received in a given hospital. The measurements look at both the intended and unintended effects such care might have had on the health status of patients and general function. They also help evaluate the level to which a hospital is achieving its goals as they relate to the care being provided to a patients. Outcome measurements usually include traditional measures such as mortality, morbidity, and issues that are related to quality of life. They incorporate patient satisfaction reports related to the healthcare services they have received. These measures are important to patients looking for a hospital as he/she may seek the opinion of persons who have previously received medical care in a given hospital (Jha &Epstein, 2010).

Quality indicators enable the health care system to identify inferior care in both process or outcome and structure while enhancing quality improvement in health care (De Vos et. al, 2009, p.1).

Because our group admits and follows low mortality risk DRGs, the quality indicator that I have identified as most pertinent to my current position falls under the umbrella of the patient safety indicators that were identified by AHRQ. The specific patient safety indicator that measures most of what I do on a daily basis is the Death Rate in Low-Mortality Diagnosis Related Groups (DRGs). The website is as follows: