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Qi Plan Part 1

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QI Plan Part I- Consumerism
HCS/588
October 17, 2011

QI Plan Part I- Consumerism
Healthcare organizations have a responsibility to its consumers and various stakeholders to ensure only the highest quality care is delivered. Quality measures such as performance measurement and quality improvement processes play a critical role in helping organizations achieve quality outcomes. This paper will contrast performance measurement and quality improvement processes. In addition, this paper will discuss a healthcare organization, Gulf Coast Medical Center, its mission and QI goals, and the role of the consumer and stakeholders in the QI process.
Performance Measurement vs. Quality Improvement Processes Performance measures are an important element of the overall quality management of an organization. “Performance measures quantitatively tell us something important about our products, services, and the processes that produce them” (Oak Ridge Institute for Science and Education, n.d.). In the healthcare industry, performance measures are a tool used to help understand, manage, and improve what healthcare organizations do. Performance measures are composed of units of measure; a number to tell how much, a unit to give the number a meaning of what, each tying in to the overall target number. In contrast, quality improvement (QI) focuses on bridging the gap between current levels of quality and expected levels of quality. “QI uses quality management tools and principles to understand and address systems deficiencies and improve or re-design efficient and effective healthcare processes” (Bornstein, n.d., p. 9). QI processes are varied but most use a four-step method to (1) identify the problem or what to improve, (2) analyze the factors of the problem, (3) develop a plan to address the problem, and (4) evaluate the effectiveness of the interventions.
Chosen Organization: Gulf Coast Medical Center Gulf Coast Medical Center (GCMC) is a 176-bed regional referral center that is nationally ranked for the quality of healthcare provided to its patients. Specialties include emergency services (adult/pediatric), general medical and surgical, robotic surgery, bariatric surgery, intensive care units (adult, neonatal, pediatric), outpatient, and diagnostic services. Gulf Coast Medical Center’s mission states “above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high-quality, cost-effective healthcare in the communities we serve” (Gulf Coast Medical Center, 2011, Mission and Vision).
GCMC's QI Goals
GCMC is dedicated to four key quality measures: surgical care improvement project (SCIP), heart failure, pneumonia, and heart attack/chest pain. GCMC ranks higher than any local hospital in the area and consistently ranks higher than state and national averages. GCMC also has unit specific QI processes such as reducing the occurrence of Ventilator Associated Pneumonia (VAP) in the ICU and NICU, reducing falls in the pediatric population through the Humpty Dumpty program, and elimination of central line associated blood stream infections (CLA-BSI) through its AIM for Zero initiative.
Role of the Consumer
Healthcare consumers such as the patient, family, and friends play a critical role in GCMC’s QI process. According to Hibbard (2008) healthcare consumers can impact quality improvement through informed choice (market share), hospital’s concerns regarding public image (reputation), and feedback received by hospitals about their own performance can motivate improvements (feedback). Upon admission, all patients of GCMC receive a booklet outlining ways for the patient and significant others to become active participants in his or her healthcare. This includes guidelines for ensuring staff is following proper hand hygiene, pain is well-controlled, medications and discharge instructions are thoroughly explained. GCMC’s Patient Care Handbook is aimed at reducing infection rates, decreasing medication errors especially with the introduction of a new medication, and increasing customer satisfaction as it relates to pain management and post-discharge care.
External Quality Indicators Elements such as pain management, nurse communication, environmental cleanliness, medication and discharge education are a sample of questions asked as part of the HCAHPS survey. The purpose of The Hospital Consumer Assessment of Healthcare Providers and Systems, commonly referred to as HCAHPS, is “to uniformly measure and publicly report patients’ perspectives on their inpatient care” (Centers for Medicare & Medicaid Services, 2011, Quality Assurance Guidelines, p. 13). HCAHPS scores are an example of an external quality indicator available to consumers of GCMC. Survey results are posted at www.hospitalcompare.gov and the consumer has the ability to compare up to three hospitals in his or her area to help make an informed decision on which healthcare organization is the best choice. Another quality indicator used by consumers of GCMC is through the facility’s accreditation. GCMC is accredited by The Joint Commission. “Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards” (The Joint Commission, 2011, About Us). GCMC has received The Joint Commission’s Gold Seal of Approval for its hospital service and advanced certification as a Primary Stroke Center. GCMC also received the 2010 Top Performer on Key Quality Measures in heart failure, pneumonia, and surgical care. Consumers of GCMC can be confident the care they receive is of the highest quality, Another external quality indicator often used by consumers of GCMC is the word-of-mouth recommendation received by family and friends. The Agency for Healthcare Research and Quality (2000) “found that the public is more likely to rely on recommendations of friends, family and health professionals they know than on standardized quality indicators” (para. 2). Considering the lower socioeconomic and educational levels of the area’s population, which limits internet access, word-of-mouth recommendations probably have the most influence as an external quality indicator. Stakeholder feedback is also an important component of GCMC’s QI process. In order for any healthcare quality improvement process to be successful, the organization must have buy-in from all stakeholders. Stakeholder feedback is an important measure of buy-in. Feedback form external stakeholders as with patient satisfaction surveys provide insight into an organization’s strengths and weaknesses as well as the value of the services offered and not offered at the facility. “Hospitals that compete for paying customers have strong commercial reasons for obtaining consumer feedback about satisfaction with their products and services and acting on those results” (Draper, Cohen, & Buchan, 2001, p. 463).
Conclusion
In today’s competitive healthcare environment, healthcare organizations are under pressure to reduce costs and improve the quality of care delivered to its patients. Healthcare organizations utilize performance measurement and QI processes to help facilitate this. Healthcare consumers also play a role in a healthcare organization’s QI process. External quality indicators are available to the healthcare consumer to provide information on the level of quality a healthcare organization provides in comparison to others. Stakeholder feedback is also a key component of the QI process.

References
Agency for Healthcare Research and Quality. (2000). Americans as Health Care Consumers. Retrieved from http://www.ahrq.gov/qual/kffhigh00.htm
Bornstein, T. (n.d.). Quality improvement and performance improvement: Different means to the same end? Retrieved from http://www.reproline.jhu.edu/english/6read/6pi/pi_qi/pdf/qiandpi.pdf
Centers for Medicare and Medicaid Services. (2011, March). Quality Assurance Guidelines. Retrieved from http://www.hcahpsonline.org/files/HCAHPS%20Quality%20Assurance%20Guidelines%20V6.0%20March%202011.pdf
Draper, M., Cohen, P., & Buchan, H. (2001). Seeking consumer views: What use are results of hospital patient satisfaction surveys. International Journal for Quality Healthcare, 6(13), 463-468. doi:10.1093/intqhc/13.6.463
Gulf Coast Medical Center. (2011). about us. Retrieved from http://gcmc-pc.com/about/mission-and-vision.dot
Hibbard, J. H. (2008). What is the consumer role in improving quality? Retrieved from http://www.delmarvafoundation.org/events
Oak Ridge Institute for Science and Research. (n.d.). Performance Measurement Process. Retrieved from http://www.orau.gov/pbm/handbook/1-1.pdf
The Joint Commission. (2011). About The Joint Commission. Retrieved from http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx

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