Social Insurance Quality Measures Research Paper

Medical professional should select quality measures for reporting such as commonly treated conditions, the types of care that are frequently delivered, the settings in which care is given, quality improvement goals and other quality reporting options that are available or being considered. A couple of options available are Physician Quality Reporting System and Value Based Purchasing. Both

Quality management is essential to the success of the quality improvement of the health care industry. “Management uses management and planning tools to organize the decision making process and create a hierarchy when faced with competing priorities “( Ransom, et al., 2008). Quality measures should have these goals: effective, safe, efficient, patient-centered, equitable, and timely care (Quality Measures, Center for Medicare & Medicaid Services, 2011).

According to the Centers for Medicare & Medicaid Services (CMS), care measures are quality benchmarks that are based on care standards, industry guidelines and practice scopes. Care measures based on statistical evidence and scientific data.

Claxton, Cox, Gonzales, Kamal, and Levitt (2015) explains measuring the effectiveness and quality of care provided for the patients were unclear. Therefore, quality measures were developed by organizations, such as healthcare providers, the federal government, and accredited organizations. Thereby, focusing on measuring specific areas of care and performance

When dealing with healthcare organizations such as hospitals; evaluating the quality of care is essential. This will help to know what needs to be done to improve the quality of healthcare. There are a few different measures

Develop a plan for the center by using clinical quality measures, or CQMs, which are tools to help track and measure the quality of health care serviced that are provided by eligible professionals, eligible hospitals that are within the health care system. These would be measures to use data that is associated with providers that are able to provide high quality care or relate to long term goals for health care. The measures would be the many aspects of patient care including:

For instance, in nursing homes, the quality measures come from resident assessment data that is routinely collected. Those measures are then combined to form a quality benchmark and standards program. For instance, short stay measures include:

quality assurance is a system for evaluating the performance, the quality if the services they provide i.e. what chamberlayne provie for their service users. Many quality assurance procedures would be set by the central government. Standards, governance, and quality control are all essential in any care setting like the NHS of any health service.

In any continuous quality improvement effort, measurement is the key element (Sollecito, & Johnson, 2013). “Measurement and statistical analysis are used to assess the impact of an improvement effort” (Sollecito & Johnson, 2013). To Measure the impact of the program, the hospital utilized a departmental quality improvement assessment with a scoring matrix for self-assessment (McLaughlin, et. al., 2012). The scoring matrix consisted of five category ratings which each department head had to complete. Univer4sal Charting and Resource Utilization were also used for measurement (McLaughlin, et. al., 2012).

The purpose of this paper is to discuss the methods used by a local health care facility, Southwest General Hospital, to evaluate and monitor healthcare quality data. Quality measurement in health care is the process of using data to evaluate the performance of health care providers against recognized quality standards (FamiliesUSA, 2014). The measuring of quality plays a vital role in the creating, maintaining, and managing of the data that this healthcare facility aims in focusing on quality of health care.

Using these measures, a hospital can understand where they stand among other hospitals in terms of providing quality care. This can help them to improve quality of care and also understand competitive advantage. The hospitals can find out whether they have the desired percentage and then compare its position with respect to other hospitals or hospital state average and national average (hospital). A lower percentage can help them to do a root cause analysis and help them in improving their percentage by adopting to strategies that will benefit them. An above average and good percentage will encourage and motivate them to achieve stability. The comparison is made not only on the basis of medical condition but also on wide range of categories like complications, Readmissions and deaths, payment and value of care etc. This

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.

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).

Quality Measures otherwise called CQM 's are an instrument for evaluating perceptions, medications, procedures, encounters, as well as results of patient consideration. At the end of the day, CQM 's survey "the extent to which a supplier capability securely conveys clinical administrations that are proper for the patient in an ideal time period which is a prerequisite as a component of significant use necessities for the Medicare and Medicaid Electronic Health Record motivating force programs. According to Medicare.gov, (n.d.), quality measures demonstrate how frequently patients who are hospitalized for specific conditions experience difficult issues not long after they are released.

Quality is not always that simple to measure. The five dimensions of quality as stated in the text, such as reliability, responsiveness, assurance, empathy, and tangibles are good fit for Memorial Hospital (Vonderembse & White, 2013). The factor included in quality assessment of Memorial Hospital depends on delivering exceptional care, i.e. effective, timely, safe, courteous, and convenient. Hospitals use quality measure to assess whether hospitals are using the right treatments and procedures when patients are in the hospital. Memorial Hospital has concentrated on offering high-quality general health care in the areas such as laboratory and X-ray facilities, an emergency room, an intensive care unit, a cardiac care unit, and a psychiatric ward.