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In recent times, due to cultural shifts, implementation of new policies, augmentation in the cost of care and technological advancements, hospitals are inclined towards providing patient centered care. Along with considering health related issues, most of the hospitals are considering other factors like social factors, financial factors and demographics for improving efficiency, quality and safety of healthcare services. Hospitals are upgrading themselves in terms of integrating big data and shifting form the fee-for-service to the fee-for-outcome model. Quality improvement programmes should be implemented in the hospitals like values based purchasing programme, hospital readmission reduction programme, and hospital acquired conditions reduction programme. In values based purchasing programme, incentive would be offered to the hospitals for providing healthcare services with improved quality. Other factors considered under the values based purchasing are proximity of clinical procedures followed and patient’s experiences and feedback during stay in the hospitals. Value based purchase was established under the The Affordable Care Act of 2010. In value based purchasing programme, should be evaluated on each measure and improvements need to be assessed in each measure form the baseline values. Hospital readmission reduction programme should be implemented to reduce overall workload and financial burden on the healthcare organization. Hospital should establish a benchmark for the number of readmnissions. Hospital readmission reduction programme would be helpful in improving the transparency in the hospital care, for selecting top hospital by the patients and for providing benchmark for improving quality of the hospital. Centre for Medicare and Medicaid services fixed penalty for the hospitals with the increasing number of hospital readmissions. Patient Protection and Affordable Care Act (ACA) promoted the Hospital-Acquired Condition (HAC) Reduction Program. This HCA programme was established to reduce hospital acquired conditions. According to this programme, payments to the worst performing hospitals based on hospital acquired conditions were stopped (Rosenbaum, 2011).
Tort law deals with the actions against the medical malpractice and medical negligence. These actions can be taken against physician and other healthcare professionals for violating standard protocols of the medical processes. However, in medical service there is scarcity of standard protocols. In such scenario, physician or healthcare professional who is defending the case may argue that there is no written standard protocol for medical practice. In healthcare sector, patients are generally helpless and at most of the instances at mercy of others. Almost all the healthcare facilities comprises of mentally and physically weak patients. Even though, healthcare facilities are meant for providing wellbeing and safety to patients, sometimes criminal conduct may happen in the healthcare facility. Law enforcement agencies adopted zero-tolerance policies for healthcare fraud, patient abuse and other crimes in the healthcare facility. Consent for the medical and surgical procedures is based on the principle of patient autonomy and basic human rights. Nobody has rights to force patient to act or make decisions in a particular direction. However, physician can act as a catalyst in the patient’s decision making. Other than routine physical examination, there should be consent taken from patient for other medical procedures. Medical procedures performed without permission or consent is considered as battery (Sadeghi et al., 2012).
Efficiency and quality can be improved in healthcare organization by reducing cost. Recruitment of highly skilled and efficient healthcare professionals would be helpful in reducing number of employees. It ultimately leads to reduction in healthcare cost. Hospitals should spend less money on the high cost drugs and prefer cost efficient drugs. Hospitals can reduce their medical expenses by using telepath. Along with reducing cost telepath can also be useful in engaging more number of patients, bridging gap in the care, expanding revenue resources and making patients more continent. Telepath can reduce cost of the hospitals by reducing readmission cost, improving staff utilization and preventing outreach. Hospitals can reduce cost of expenditure of hospitals by outsourcing information technology and housekeeping. Hospitals can recruit travel or agency staff during the seasonal increase in the patients. Hospitals can implement proper strategy for the segregation of the hazardous and non-hazardous wastes. Most of the wastes from the hospitals would be form the operating rooms and labor-delivery rooms. Hazardous and infectious wastes can again produce diseases in patients and staff members. It would lead to extra financial burden on the hospitals (Sadeghi et al., 2012).
Advantages of single payer healthcare system include improved accessibility and efficiency. In single payer healthcare system, people in the poor and lower middle class can get benefit of healthcare services despite of healthcare insurance. There would be very less financial burden in single payer healthcare system. Single payer healthcare system incorporates economy on the larger scale which consists of large number of people covered under insurance. In this system, insurance processes are based on the average prices and these prices are less fluctuating in large proportion of population. Requirement of bureaucracy is very less in a single payer healthcare system; hence this system is more efficient. It would lead to cost saving because expenditure on the bureaucracy is less as compared to the private insurance. Medicare is good example of cost saving because it spends approximately 2-3 % overhead costs, which is comparatively less as compared to private insurance. However, few analyst argued that manpower requirement in the single payer healthcare would be similar to private insurance companies because lot of government administrative support required for single payer healthcare. On the other hand, private companies need to bear this administrative burden on their own. Benefits of free market healthcare include decreasing price over time, innovation, availability of healthcare, quality of healthcare, freedom and customer choice. It is a general perception that prices would fall in free market healthcare however it has been observed that reality is different. Prices didn’t fall in free market because in insurance models there is elimination of competition due to socialized economies. In free market, there are lot of innovations occurring in medical technologies and new drugs. There is qualitative and quantitative improvement in treatment in free market due to increase in supply of doctors, hospitals, and other healthcare providers. Free market improved quality of healthcare services by imparting medical training and upgrading medical technology. In free market healthcare, choice of availing medical insurance is completely depends on patient. Free market healthcare system completely depends on the income of the individual.
Examples of single player healthcare system :1) Canada Health Act is a single payer healthcare system and it proved beneficial due to its administrative simplicity. 2) Medicare in US is a single player healthcare system and in this everyone has insurance plan under one healthcare plan. 3) National Health Insurance (NHI) of Taiwan provided health insurance to each and every individual of the country (Krahn, 2011).
Examples of free market healthcare system: 1) Surgery Center of Oklahoma can save upto 90 % of the conventional hospital costs. 2) Direct primary care services (DPCS) proved useful in reducing hospital cost by approximately 20 %, 3) Catastrophic care is a type of self insurance in which employees can be incentivized to decrease cost without compromising quality of care.
Health professional education, implementation of information technology and prevention of medical errors are the common law quality initiatives, which found in the 21st century health organization. Health professional is of prime importance for improving quality of health. Acquiring and implementation of the healthcare core competencies can be achieved by acquiring required knowledge and skills. Performance and efficiency of health care organizations can be decided based on the adaption of modern technologies. Modern technologies like information technology for electronic health record would be useful in evaluating performance of the healthcare organization. Medical errors can occur due to improper education of healthcare professionals and insufficient information technology. Poor communication and inadequate information can lead to medical error. Electronic health care records are helpful in promoting safety to patients, improving efficiency of medical processes and maintaining quality of health care organization. It would be helpful in providing healthcare services to right patients at the right time. Medical errors have major financial burden to healthcare organization and these medical errors can be prevented (Aase and Schibevaag, 2016; Lueddeke, 2015).
Quality of healthcare services in an organization can be improved by establishing policies, values and standards. These standards can lead to the establishment of medical culture in the healthcare organization. Doctors and nurses should take more responsibility for carrying medical processes in an efficient way. Improvement in the quality of healthcare services would be helpful in gaining more trust of patients, reducing morbidity and mortality and reducing complications. Establishment of quality in healthcare organizations also would be helpful identifying failures of healthcare providers and taking corrective action against them. Quality healthcare services are also useful in improving morale, productivity, efficiency and team performance of healthcare professionals. Quality services are useful in improving patient’s and family member’s satisfaction. Quality of healthcare services can be improved by improving communication between patients and healthcare professionals (Earp et al., 2008).
Quality officer should be accountable for all the goals related to quality of an organization. Quality officer should work in collaboration with all the stakeholders and all the departments of the hospital. Quality officer should spend significant amount of time in improving healthcare services. Priority setting and planning strategies should be main focus of the quality officer for improving quality and reducing risks. Quality officer should set norms for the organization quality improvement culture. Main goal of this quality improvement culture should be clinical excellence and patient safety. Quality officer should analyze all the data related to the quality and present this data to the management and board. Quality officer should implement incident reporting tool to make amendments in the policies and procedures and provide training and education for improvement in the quality. There should be implementation of performance monitoring system for the employees. In the studies, it was observed that implementation of performance monitoring system proved beneficial in reducing patient discomfort and mortality (Roussel, 2011). Examples: 1) Quality office advised medical advisory committee (MAC) to identify venous thromboembolism (VTE) as a quality improvement initiative. As a result of this initiative, there was improvement in the VTE care, 67 % reduction in the catheter induced urinary tract infection and unnecessary use of catheters. 2) Quality officer recommended medicine education to the patient and patient’s family members. As a result, there was increase in the medicine consumption and reduction in hospital readmissions. 3) Quality officer implemented fall prevention strategy for the elderly patients in the hospital. This leads to the remarkable reduction in the falls of elderly patients in the hospital.
Aase, K., and Schibevaag, L. (2016). Researching Patient Safety and Quality in Healthcare: A Nordic Perspective. CRC Press.
Earp, A. L., French, E. A., and Gilkey, M. B. (2008). Patient Advocacy for Health Care Quality: Strategies for Achieving Patient Centred Care. Jones & Bartlett Publishers.
Krahn, H. P. (2016). The Single Payer Healthcare System - Faults and Fixes. Friesen Press.
Lueddeke, G. (2015). Global Population Health and Well- Being in the 21st Century: Toward New Paradigms, Policy, and Practice. Springer Publishing Company
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Reports, 126(1), 130–135.
Roussel, L. (2011). Management and Leadership for Nurse Administrators. Jones & Bartlett Publishers.
Sadeghi, S., Barzi, A., and Mikhail, O. (2012). Integrating Quality and Strategy in Health Care Organizations. Jones & Bartlett Publishers.
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