This blog post is a writing assignment for HIMT 2200: Performance Improvement, part of the Health Information Management Technology (HI13) Associate of Applied Science Degree program at Georgia Northwestern Technical College.
The Institute of Medicine (IOM) created one of the most prominent quality assessment frameworks. The IOM framework contains six healthcare domains, and each measure or indicator can address at least one category. The six domains are safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity (AHRQ, 2018).
A hospital provides safe care if it does not harm patients while providing services intended to treat them. Most measures address safety (AHRQ, 2018). An example of a measure indicating safety is the cleanliness of the hospital environment, which measures the frequency of cleaning a patient’s room and bathroom. Keeping the hospital environment clean will help prevent hospital-acquired infections (AHRQ, n.d.).
A hospital provides effective care if its care is proven scientifically beneficial to those it treats. It also does not treat patients who are not likely to improve and abstains from misuse and underuse. Most measures address effectiveness (AHRQ, 2018). An example of a measuare indicating effectiveness is the readmission rate for any procedure or a hospital-wide readmission rate for all causes. If many patients return after a procedure, the measure indicates that the treatment was inadequate or did not benefit the patient (AHRQ, n.d.).
A hospital provides patient-centered care if care providers respond to patients and respect them according to their individual needs, values, and preferences. The care providers also make clinical decisions and provide treatment based on these needs, values, and preferences (AHRQ, 2018). An example of a measure indicating patient-centeredness is the overall patient rating for the facility. Such a measure indicates how satisfied a patient is overall with the care received during their time in the hospital (AHRQ, n.d.).
A hospital provides timely care if the facility has procedures to actively lower or maintain adequate wait times and delays (AHRQ, 2018). An example of a measure indicating timeliness is the average time a patient waits for treatment in the emergency room. Another example is how long patients remain in the emergency room for a room after a doctor decides to admit them. These measures indicate how long a patient might wait for treatment. A long wait for emergency care jeopardizes patients’ lives and safety (AHRQ, n.d.).
A hospital’s care is efficient if it does not waste anything, including supplies, equipment, energy, and ideas (AHRQ, 2018). An example of a measure indicating efficiency is the percentage of newborn deliveries scheduled early, but the early delivery is not medically necessary. Planning an early delivery provides services that are not needed and wastes time and resources that other patients might need (AHRQ, n.d.).
A hospital’s care is equitable if its care to different patients does not vary in quality due to differences in ethnicity, gender, or socioeconomic status (AHRQ, 2018). Equity can also indicate the capacity of a facility to provide quality services. One example of a measure indicating equity is the number of beds a facility has or the types of services it offers. Another example is staffing ratios like the nurse-to-patient ratio. Such numbers and ratios might indicate if staff is equally dispersed or fair to patients in particular areas based on their population and demographics (AHRQ, 2016).
References
AHRQ. (2016, Mar.). Examples of Hospital Quality Measures for Consumers. https://www.ahrq.gov/talkingquality/measures/setting/hospitals/examples.html
AHRQ. (n.d.). MONAHRQ Measures List. https://www.ahrq.gov/downloads/monahrq/documentation/MONAHRQ_7_Measures_List.xlsx
AHRQ. (2018, Nov.). Six Domains of Health Care Quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html
Spath, P. L., & Kelly, D. L. (2017). Applying Quality Management in Healthcare: A Systems Approach. (4th ed.). Chicago, IL: Health Administration Press.
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