PROVIDE A RESPONSE AND REMARKS TO THIS STUDENTS DISCUSSION POST BELOW, BASED ON YOUR UNDERSTANDING:
One of the primary arguments for a QA Program is that there is a concern for ensuring that health services are both cost-effective and responsive to public needs. However, other health care professionals believe that QA Programs are necessary to protect patients while under care in a health facility.
Which of the two statements above do you believe is the most important for patients?
Depending on the perspective of the individual, I believe that both statements are important for a patient. I state this due to the reason of one definition of QA that is provided by Dlugacz (2017), which states:
“Quality assurance (QA) is focused on ensuring that the product – in this case, the delivery of health care services – is meeting expectations through the identification of problems or defects in the system, developing solutions, and monitoring the effectiveness of the solutions.”
Healthcare must be responsive to the needs of the public, and when possible cost effective. In addition, it must meet the expectations of the patients, and the most important expectation in my mind is that the care received must be safe. Nothing should trump safety when delivering or administering healthcare to patients. As such QA programs are necessary since ultimately, they help protect patients in the provision of healthcare since they promote patient safety. However, that does not override the fact that QA overlaps into the realm of providing cost-effective care. Continuous quality improvement (CQI) initiatives in my mind are part of QA. They promote efficiency in the delivery of healthcare, especially when problems or defects are apparent. This again is driven by the perception and expectations of the patients. However, as eluded to, I would state that the second statement in regards to QA programs are needed to protect patients in the delivery of health care is more important as it refers to patient safety in my mind.
What can we do to assure that both quality care and cost-effective programs are in place?
The pursuit of quality in healthcare is difficult, especially since it is difficult to define. In general, patients, providers, and payers define quality differently which leads to different expectations and evaluations of quality (Shi & Singh, 2017). The Institute of Medicine defines healthcare quality as: “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” However, this definition fails to include the roles that access to care and the cost of care have on the quality of healthcare.
The primary issue that affects quality is the limited consensus of standards of care. Both patients and healthcare providers are ill-equipped to promote the best and most cost-effective treatments without reliable information that enables comparison of healthcare quality and outcomes (Ginsburg, et al., 2012). One of the primary reason for this is a lack of emphasis on disease prevention, health promotion, and access to primary healthcare. If more consensus is developed regarding standards of care, it would improve quality as well as promote cost efficiencies. However, these standards must also include the patient perception of quality and not just the payer and providers perceptio
Expert Answer
The first statement is generic in nature and may be interpreted as providing effective service before, during and after admission into a health care facility. So Statement 1 is more important. Statement 2 is just concerned with the health care while in the facility.
- Cost-effectiveness is not possibility based, it should be there, always. Definitely the service should meet the expectation of the patients. Healthcare ought to be safe, even before a patient is subjected to that. It is a mandatory condition. Continuous improvement is indeed a part of QA, and it helps improve benefit, safety and reduce cost. QA is not driven by perception, it is driven by need and expectation.
- Quality can be defined in a service based environment as easily as that can be done in a product based environment. (Read SERVQUAL). All these definitions by patient, provider and payers can be grouped and a common definition of quality improvement can be made. Health care organizations does that. It is objective in nature and can be ascertained with absolute certainty. The lack of perception is very correctly defined. Just not the consensus, the health care board should define certain standards and ensure that the quality of service is up to the mark.