Question

Health care delivery and the organizations that provide it, manage it, and reimburse for it are growing at an explosive rate. As part of this trend, the growth in the allied health job sector is expected to grow significantly, with job growth projections in the 40% plus range for the period 2012-2022 (according to the U.S. Bureau of Labor Statistics, 2012).

Expansive growth is a response to current and predicted need for services, and while encouraging, sustained, and rapid growth will inevitably impact safety, risk management, and quality provision on scales not yet seen by health care organizations.

In an essay of 1,250-1,500 words, provide your assessment, with recommendations, of how the United States, as a country, can best manage quality assurance in the health care workplace going into the future. Questions to consider include:

How best can the United States, as a country, manage this growth in the allied health sector? Provide examples.

What steps might the United States take, from the global down to organizational level, to maintain high standards to provide outstanding care-based services?

What steps might the United States take, from the global down to organizational level, to provide exceptional employment opportunities in in-demand allied health fields?

Answer 1

Quality assurance in health care

Quality assurance (QA) refers to all the requirements and goals for a service or activity. It is a process-oriented approach in which the key aspect is the systematic measurement. The systematic measurement includes the monitoring processes, with a feedback loop for error prevention.

In health care, the QA refers to the activities and programs intended to achieve improvement in the quality of care in a medical setting. The process involves assessing or evaluating quality, identifying problems or issues with care delivery and designing quality improvement activities to overcome them and follow-up monitoring to ensure the focused process. The QA in healthcare can help the health care facility to meet other goals such as the patient-centred medical model, achieving meaningful use of health IT, enhancing clinical quality, raising patient and staff satisfaction and gaining quality recognition like accreditation. The improvements in quality care are demonstrated as saved lives, prevented illnesses and reduced costs.

The concepts of quality improvement in medical practice have its route in the Hippocrates’ school it self. Ever since his ancient work, the medical world has gone through a series of changes and every change had significant impact efficiency and outcome of care. All the aim in health care aims to achieve an identical goal: the highest quality of care for each patient, in consideration with societal aspects such as cost control, and accessibility of care, out of sight. The continuous rapid technical developments enhance the aim.

Present scenario:

The quality of care was hard to describe, measure, or report until the publication of the report ‘To err is human: building a safer health system’ in 1999 by Institute of Medicine’s (IOM).

The QA becomes the top priority for health care providers after the publication of the report.

The healthcare indicators like mortality and morbidity ratios were used as a measurement tool for QA. In the US, a set of quality indicators to assess the quality of care delivered to Medicare beneficiaries were developed by the Health Care Financing Administration (HCFA).

The quality indicators played a key role to complete the field of health care research.

The safety and customer or patient-centeredness is the key to QA in health care services. The patient-centered approach ensures the safety of the patient in all aspects. The possible threats for patient safety can be recognized early to prevent the accident. Healthcare services or agencies are considered as system to improve its functionality. The system approach explains that the care consists of connected processes that influence each other and the ultimate patient outcome.

In order to attain the goal continuous quality assurance is essential. Continuous monitoring of the system enables to assess the errors at the beginning and redirect to the better outcome.

The levels of quality aspects:

• The structural level
• The indicators that are associated with processes of care (represents the interaction between the health care providers and the health care users or patients).
• The clinical outcomes directly associated with the patient’s health status or patient satisfaction.

A sustainable QA program

The implementing a QA program is a long-term process along with the establishment of the right culture and awareness of the proposed change, followed by search for background information, followed by acceptance of the change and adoption in practice. It needs the appropriate attitude.

The Joint Commission on Accreditation of Healthcare Organizations

In US The Joint Commission on Accreditation of Healthcare Organizations began in 1951, and their programs have expanded into a long list of different types of medical institutions, from psychiatric hospitals to drug treatment facilities to hospices to laboratories.

NCQA : it is designed as a Means of Managed Care Oversight

A Unified System of Quality Measures

In US there are many other quality assurance systems, like the World Health Organization,other countries and even those of individual states. The Affordable Health Care Act of 2011 stated more extensive plans: standardizing quality measures across the health care field and the federal Agency for Health Care Research and Quality also, offers voluntary "Quality Indicators" .

The Future of Quality Assurance

To ensure QA the organizations have to renew accreditation every few years. The healthcare industry has reformed to improve QA measures. The development programmes of allies health professions are on of its effort to do so. The term "Allied Health Professions" is sometimes used as a subcategory of health professions and they perform diagnostic procedures, provide therapeutic services, and patient care as part of a caregiving team.

The Allied Health professionals include nurses, respiratory therapists, radiation therapists, occupational therapists, physical therapists, technologists of various types, dental hygienists and other professionals who do not independently diagnose and prescribe treatment, but perform diagnostic procedures, therapeutic services and provide care as requested by doctors practising in the particular area.

In recent years new professions have emerged like the Nurse Practitioners in some states, who are independent primary care providers who may diagnose and write prescriptions. The governmental regulations vary from state to state and changes over time in response to new demands on our healthcare system. Therefore the list of those professions loosely categorized as "Allied Health Professions" may change over time and from state to stat.

THE federal government establishes new guidelines and programs to improve the utilization of Allied Health professionals.The QA service is regularly appraised by the sector regulatory bodies. The effective training of allied health professional eventually helps in improving the QA.

PRogrammes: The annual documents to monitor the nation’s progress toward improved healthcare quality

1. The programmes for collecting and publishing patient experience data in

United States like the Centers for Medicare and Medicaid Services (CMS) and the Agency for

Healthcare Research and Quality (AHRQ) routinely collect data on patient experience from

service providers recently enacted under Patient Protection and Affordable Care Act 2010.

2. The Consumer Assessment of Healthcare Providers and Systems survey (CAHPS), developed at Harvard University based on Picker principles of patient centred care. The National CAHPS Benchmarking Database (also referred to as the CAHPS Database) is the national repository for data from CAHPS surveys which holds 11 years of data and is one of the key resources for the AHRQ’s National Healthcare Quality Report and National Healthcare

Disparities Report.

3.Patient experience surveys that focus on specific diseases

4. ‘Hospital Compare’ the web-based tool sets out patients with certain medical conditions or surgical procedures, using data from the Hospital Outcomes of Care Measures, CAHPS and H-CAHPS

surveys.

5. Physician Compare site, under the newly enacted Patient Protection and Affordable Care Act 2010.

The improvement of employment conditions like incentives, career growth opportunities, annual leaves, convenient working hours also is effective in establishing a good employment environment in the healthcare industry.