By Matt Stone QHCusa 2010
Our first step to address medical errors starts with Quality Improvement (QI) initiatives currently set in place to pinpoint barriers through Performance Evaluation and Desired Outcomes.
As a foundation of healthcare, patient and provider relationship, we must understand health care is built upon a dynamic trio of Quality, Access and Cost ….
Although there are ongoing concerns with performance improvements within health care, we need a better understanding of political differences which fuel debate about health standards and quality. Buchbinder (2007) describes quality care as bases for desired outcomes and should be consistent with health care professionals by leading their staff to quality outcomes (Buchbinder & Shanks, 2007).
There are various consortiums acting as political and patient advocates to ensure quality care:
The Joint Commission on Accreditation of Healthcare Organization, also known as The Joint Commission JCAHO, in support, is our watch dog supporting quality care. “JCAHO mission is to preside over a growing, national, comparative performance measurement database that can inform internal health care organization of quality improvement activities, external accountability, pay for performance programs and advance research, more important, is recognized as an international leader with a long proven ability to identify, test and specify. www.jointcommission.org/PerformanceMeasurement/PerformanceMeasurement/default.htm
Our second patient/consumer advocate,
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) also known as Privacy and Security Rules, “which protects the privacy of individually identifiable health information; Our HIPAA Security Rule is charged with setting national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety” ( http://www.hhs.gov/ocr/privacy/)
As a foundation, Administrator’s leadership competencies are a hierarchy of organizational success under three domains, Technical skills, Interpersonal skills, Conceptual skills, says, Sultz & Young (2006), in how health standards reflect quality and public opinion. Key challenges for administrators are how to identify best practices through an appropriate evaluation process while maximizing performance and quality improvement, together, standardization and influencing positive relationships among staff and stakeholders breeds a culture of safety (Sultz & Young, 2006).
Competency levels are paramount to determine best practices of standards and ongoing support of interpersonal relationships among staff and how relationships do influence standards. For instance, Competencies of conceptual skills and decision making through an understanding of health policy and change, and thus, introducing change through standards first, will create staff retention through contribution of ideas and confidence.
This presumption is through communication to minimize inconsistencies and barriers in support of an organizational feedback loop which exists among mid-level and senior management, intern will aid in implementing strategic goals and quality care protocols and standardization, such as, identifying interpersonal conflict resolution and decision making through organizational behaviors leading to performance improvements (JACHO, 2008).
Moving along in addressing our three domains as a foundation leads us to a culture of safety, not only within an organization, but throughout our continuum of care, respectfully.
Technical skills through research have developed significant opportunities to identify quality standards in today’s healthcare organizations. Hospital administrators in support of JACHO accredited hospitals have progressed in implementing improvement standards compared to those that are not accredited by JACHO (Hosford, 2008). JACHO ongoing support of patient safety measures contributes in how Health Care Organization (HCO) meet their strategic goals of quality performance, an evaluation of process improvements, desirable outcomes and quality care standards (Hosford, 2008).
Interpersonal skills, Together, JACHO, patient centered care and staff leadership plays a dynamic role in effort to improve health care when diverse populations are in play. Leadership skills are about how to master interpersonal conflicts among staff while adapting to ongoing changes of standardization. As a consequence, staying abreast of cultural avoidance of change generally depends on abilities to communicate values of performance improvements (Hosford, 2008).
Conceptual skills through decision competencies should be a foci point to support best practices. Administrators should consider ongoing pilot testing of performance improvement measures and should be considered “to reduce risk behaviors and not only where risks occurred” (JACHO, 2008). Root cause analysis by JACHO is an aid or tool to address ongoing standards and where improvements can be implemented through evaluation for credibility. More important, is used by JACHO to aid with researching standardization and consistencies, thus, evaluate quality outcomes supporting staff with an opportunity to be involved through a research process which brings together cultural differences who struggle with avoiding change.
I encourage consumers of healthcare to browse through The Joint Commission Standards, at http://www.jointcommission.org/Standards/ specifically our National Patient Safety Goals
Point an click to read each Core Measure Set:
- SCIP Core Measure Set
Heart Failure Core Measure Set
Acute Myocardial Infarction Core Measure Set
Pneumonia Core Measure Set
Perinatal Care Core Measure Set
Pregnancy Core Measure Set
ORYX Risk Adjustment Guide*
Risk Factor ICD-9 Code Specifications through 9-30-2008 discharges*
Risk Factor ICD-9 Code Specifications 10-1-2008 discharges and forward
Hospital Outpatient Department Quality Measures
Children's Asthma Care
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