Provide a more expansive view of the nature of health and wellness

Provide a more expansive view of the nature of health and wellness
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Healthcare Quality at the Organization

Healthcare Quality at the Organization

Healthcare Quality at the Organization and Microsystem Level
Systems Thinking

“…A view of reality that emphasizes the relationships and interactions of each part of the system to all the other parts” (McLaughlin & Olson 2012, 23).

McLaughlin, D.B., & J.R. Olson. 2012. Healthcare Operations Management, 2nd ed. Chicago, Health Administration Press.

A systems thinking approach to quality management

The interconnected system model

The three core process model

The Baldrige performance excellence program framework

Socioecological framework

Interconnected system level

Divided into four levels:

Environment level

Organization level: is a critical level of change in the health care system because it can provide an overall climate and culture for change.

Microsystem level

Patient level

Three core process model

Clinical, Medical, and Technical process: are critical process because they are the main reason why clients seek health care assistance.

Operational or patient flow process (registering patient, scheduling): enable clients to gain access.

Administrative process (decision making, communication, resource allocation, and performance evaluation)

The improvement in any one of these process has the potential to increase the value of the service provided.

Three Core Process Model

Outcomes

Clinical outcomes

Cost

Satisfaction

Functional status

Clinical/Medical/Technical Processes

Operational/Patient & Client Flow Processes

Administrative Decision-Making Processes

Administrative Decision-Making Processes

Source: Kelly, D. L. 2017. Applying Quality Management in Healthcare, 4th Edition. Chicago: Health Administration Press.
Baldrige Performance Excellence Program Framework (BPEP)

The model describes essential elements of organizational effectiveness

The model shows the importance of alignment in the organization

www.nist.gov/baldrige

Source: www.baldrige.gov.
Socioecological Framework

A transdisciplinary systems perspective on promoting health and wellness that uses and reflects theory from multiple fields; medicine, public health, behavior and social science.

Emphasis on multilevel and recognition of the complexity of human environment

Provide a more expansive view of the nature of health and wellness

Help to understand interventions designed to improve the quality and safety of services.

Maybe used to better understand smoking behavior and drinking

Socioecological Framework: Determinants, Interventions, Evaluation

https://www.cdc.gov/cancer/crccp/sem.htm
Systems Models: Lessons for Managers

Interconnected System Model
Three Core Process Model
Baldrige Performance Excellence Program Framework
Socioecological Framework
Places the patient at the center of healthcare delivery Fosters feed back mechanisms that reinforce or balance system performance Encourages awareness of linkages between major elements affecting patient care Illustrates the wave effect of changes in the environment
Encourages concurrent improvement of inter-dependent processes Aligns processes around patient/client/customer needs Values all provider/ employee groups Views administrative role as a process not a function
Shows how the components of organizational effectiveness are related Recognizes the context in which the organization operates Promotes alignment of all organizational activities, including performance measurement Illustrates essential links in the system
Broadens and expands the manager’s view Addresses community and policy influences on health outcomes Illustrates the interrelationships among multiple levels involved in improving health outcomes Encourages interrelated, multilevel interventions
Source: Kelly, D. L. 2006. Applying Quality Management in Healthcare, 2nd Edition. Chicago: Health Administration Press. Reprinted with permission.

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Where do data on health care quality come from?

Administrative data

Medical records

Qualitative data

Disease registries

Data availability and validity are key elements to consider when selecting appropriate quality and resource use measures.

How are quality measures used?

Public reporting: CMS provides quality performance data for hospitals in the Medicare program on its Hospital Compare website, also, data for the Medicare program on nursing homes, home health agencies, and Medicare Advantage plans.

Provider incentive programs: For example, rather than paying providers for the volume of care they deliver, payers can link all or part of a payment to the quality of care that is delivered. (ACOs) use quality measurement as a critical method of allocating payments to participating providers.

Accreditation and certification: ACA requires all qualified health plans to be accredited.

Insert your name and surname in the space provided above, as well as in the file name. Save the file as: First name Surname Assignment 4 – e.g. Lilly Smith Assignment 4. NB: Please ensure that you use the name that appears in your student profile on the Online Campus.
Discussion Questions

Identify 1-2 activities a manager in St. David’s HealthCare did to advance organizational excellence in each of the following Baldrige framework categories:

Strategy

Customer

Workforce

Operations
Summary

Quality measurements can be grouped into four categories: 1. clinical quality including process and outcomes, 2. financial performance, 3. patient, physician, staff satisfaction, 4. functional status.

System models help managers identify the elements and connections between those elements in their organizations and the environments in which they functions.

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