Major Factors that Led to the Enactment of Clinical Establishment Act

Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow.

The structure involves the infrastructure that is needed to deliver medical care such as medical equipment, staff, information system, workplace, culture and physical structure (Lighter, 2011). The process involves the essential procedures and steps to provide healthcare services to customers and this include finance, service utilization, compliance and customer satisfaction with care (Lighter, 2011). The outcome measures assess the process effectiveness, which includes two types: business and clinical outcomes (Lighter, 2011). Examples of business outcomes are insurance billings return and customer satisfaction with food services (Lighter, 2011). Clinical outcome measures are specific to the clinical condition being measured which should meet the usual healthcare needs and goals of the patients’ population where it is used (Lighter,

Quality is the efficiency and effectiveness of what happens, do they monitor and what are their standards (Boex, 2015). The health care

In the reading I noted that The Institute of Medicine(IOM), found that patients were not satisfied with the quality of care that they received (Joel, 2013) I feel that the healthcare services for a patient should be that not only of a good quality but it should be cost effective, and make improvements for better outcomes with their overall health We have many organizations out there like NQF, NCQA, and TJC to help us with achieving this goal and maintaining a better quality of health with our patients and their needs.

Health care organizations, particularly hospitals, currently face numerous legal issues, several of which will be examined in this paper. The first issue to be examined is medical malpractice and the tort system.

The healthcare provider needs to implement processes which are in line with the norms of the healthcare industry and simultaneously need to ensure that the patients are provided with proper care. The process implemented should be instrumental in satisfying the patient's and avail them the benefits of proper care. Such as health care quality measurement for children is the process of using a scientifically sound tool to assess the extent to which children are receiving quality health care in any of the IOM quality domains. Another quality measurement aspect is patient experience which is an outcome of the quality of infrastructure and processes followed by the healthcare provider. The healthcare provider is rated on the types of facilities provided to the patients and the service that they have been rendered. It plays a major role in the success of a healthcare provider. All the above factors are determined keeping in mind the organizational values, mission and vision of the organization. Without sufficing the needs of these three factors, the purpose of providing quality service and structure is

The next theory describes the principle of Utilization as well as the idea of Utilization review, which “refers to the consumption of health care services and the extent to which health care services are used”. There are specific, crude and institution-specific utilization measurements that can help the hospital management to find out whether specific services and programs should be added or eliminated to deliver the necessary medical care in their communities. Some of the Measures include, “access to primary care services, utilization of primary care services, utilization of targeted and specific services, average daily census, occupancy rate, and average length of stay” (Shi, L. & Singh, D., 2015, p. 60). “Utilization review is the process of evaluating the appropriateness of utilization before the care is actually delivered”, the length of stay necessary in a hospital and the review of utilization after service have been delivered, including

There are different factors that determinate the services that are rendered by different health care services. The competition in the health care industries has tremendously increased, and thus the government authorities have regularized the rules that govern the health care industry. Physicians play an important role in determining the medical expenses for different patients. Such individuals act as a health care consultants sand play a key role in controlling the quality of the services that are provided to the patients. As per the amended rules, the physicians are entrusted with the task of controlling the expenses related to medical care and also making way to utilize the services in the best possible manner. Doctors usually provide services based on fees and there is a proper arrangement between the health are centers and the doctors.

The definition of quality in the health care system can be puzzling since it can have different meanings to various people. However, the Institute of Medicine has helped out by bringing together a solid standardized representation of the word quality in our system. "Initially, the IOM defined quality as the “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” This led to a definition of quality that appeared to be listings of quality indicators, which are expressions of the standards.”(Mitchell 2008) Some implications of these standards have to deal with quality performance, focus of the delivery of health care services,

The service of good healthcare is essential to the society due to two major causes; reprieve from diseases and improved healthcare facilities for humans (Bowers & Kiefe, 2002). Nonetheless, the healthcare system has been undergoing some extreme difficulties from the very beginning of the 1990s. Speedy progress towards a technique of controlled healthcare and incorporated delivery systems has led the healthcare suppliers to identify the existence of a contest and competitive surge. It's possible to only subsist in this competitive environment when the healthcare provided is beyond the customer's demands and expectations (Lee, Delene, Bunda & Kim, 2000). To be able to provide economical healthcare to the clients, the hospitals have to study the major facets of service quality (Li, 1997).

Health care systems around the world are struggling with rising costs and unequal quality of care and many solutions like error reduction, enforcing practice guidelines and implementation of Electronic Medical Records were tried without much effect (Porter & Lee, 2013). The primary goal of any Country’s health care system is to provide high quality and cost effective care, which produces quality patient outcomes for all.

However, they failed to provide universal access of care, the resources was not used efficiently, or even accomplish price for the amount of cash spent. Researcher had proven that, there were significant lapses in safety and in each year as many as 98,000 Americans mortality was due to medical errors. It was argued that only fifty five percent of patients received recommended care (Anne et al. 2006). On the other hand United Stated does have examples of high performance on efficiency of care and quality.

In medicine, quality is considered to be one of the most important factors. In fact, many countries in the world share the same feeling (Storey, 2013). In the United States (US), about a trillion dollars are spent to ensure the quality of healthcare. However, ironically, this has not made US one among the healthiest nations in the world (Donald Berndt, John Fisher, Alan Hevner, & Studnicki, 2001). When analysing healthcare issues and their solutions, it should always start with accurate and timely information.

Essentially, every country’s health care providers are categorized into either public or private. This particular article enlists six categories of health care providers including multinational and national for-profit corporations; formal individual private providers; informal for-profit providers; public hospitals, health centers, and clinics; not-for-profit providers; and public-private partnerships. There is a considerable ideological debate around whether low-and-middle-income countries should strengthen public vs. private healthcare services. And often, there is a preconceived idea and assertion relating to health care providers which states that the private sector delivery of healthcare is more efficient, accountable and sustainable than public sector delivery. This article questions the validity of the above hypothesis on the basis of a comprehensive review of 102 studies, by evaluating available data on public and private sector performance across the key domains of health systems competencies. These competencies are organized into six World Health Organization health system themes in terms of: accessibility and responsiveness; quality; patient outcomes; accountability, transparency, and regulation; fairness and

In the present scenario achieving effective and efficient health care services is an acute issue that needs an immediate attention. In developing countries this problem is mostly common as the government alone is not fully capable in undertaking different challenges to meet the heath needs of fast growing populations. There was a need to develop an