Measuring Hospital Enterprise in Light of National Quality Strategy

Health Care -- Quality in Healthcare Enterprise

The metrics used to determine quality in my medical enterprise are: the Clinical Process of Care Measures; and the Patient Experience of Care Dimensions, embodying facets in which an acute care hospital accumulates points according to achievement and/or improvement, ultimately providing Medicare payment incentives for quality of care rather than merely quantity of care. The Patient Experience of Care Dimensions consist of eight facets measured according to a HCAHPS questionnaire administered voluntarily to a sampling of patients discharged home. Both metrics also align with and flow from the hospital enterprise's mission and vision core values of Caring, Safety, Excellence and Integrity. They also align organically with the National Quality Strategy priorities.

B. Body

Metrics Used To Determine Quality In Medical Enterprise

The metrics used to determine quality in my medical enterprise are: the Clinical Process of Care Measures; and the Patient Experience of Care Dimensions (Szablowski, 2014). The Clinical Process of Care Measures are based on incentivized quality of care in which hospitals are rewarded for high quality of care rather than merely quantity of care. These measures consist of twelve performance measures prescribed by NQS and explicitly chosen for the valuation of Medicare payments. Acute care hospitals are given points for achievement relative to all hospitals and improvement relative to the hospital's own baseline of performance. Higher score due to achievement and/or improvement result in higher the financial incentives. The Patient Experience of Care Dimensions include eight care dimensions. Patient experience is gauged via a questionnaire entitled the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). A random sampling of discharged patients is voluntarily questioned by phone or letter regarding their experience of care in those eight dimensions. Here, hospitals also receive appropriate scores for achievement and improvement, with the higher score being used for estimating Medicare payments (Szablowski, 2014).

Both the measures of Clinical Process of Care Measure; and the Patient Experience of Care Dimensions are leading indicators, as they predict financial outcomes for adherence to achievement/improvement standards. The quality goals of high quality care and high patient experience of care measures consciously align with mission and vision because they actually spring from core values of Caring, Safety, Excellence and Integrity. Caring means that we do the kind thing, serving and treating each other kindly and compassionately. Safety means that we do the safe thing, protecting our patients and their families from harm. Excellence means that we do the best thing, applying advanced best practices by continually improving, excelling, innovating and serving professionally. Integrity means we do the right thing, acting ethically and responsibly in all we do.

2. Quality And Or Performance Improvement Initiatives Having the Most Impact on Health Care Enterprise.

Two specific initiatives that align with the National Quality Strategy are: in the Clinical Process of Care Measure, for Heart Failure, issuing and thoroughly explaining comprehensive discharge instructions; and in the Patient Experience of Care Dimensions, promoting excellence in Nursing communication by enhanced communication from the administration to the nurse, from the nurse to and among all staff and from the nursing staff to the patients (Szablowski, 2014). The Discharge Instructions for Heart Failure, which is one of the twelve specific Clinical Process of Care Measures, aligns with the National Quality Strategy: ensuring that the patient and his/her family is an engaged partner in the patient's care; sponsoring effective communication and care coordination; and sponsoring the most effective prevention and treatment the principal causes of death, commencing with cardiovascular disease (National Quality Strategy, 2016; National Quality Strategy, 2015)). The highly effective Nurse Communication dimension of Patient Experience of Care Dimensions aligns with the National Quality Strategy in several aspects, as well: improving care safety by reducing harm in care delivery; ensuring that the patient and his/her family is an engaged partner in the patient's care; sponsoring effective communication and care coordination; and sponsoring the most effective prevention and treatment the principal causes of death (National Quality Strategy, 2016; National Quality Strategy, 2015).

3. Conclusion

The metrics used to determine quality in my medical enterprise are: the Clinical Process of Care Measures; and the Patient Experience of Care Dimensions. The Clinical Process of Care Measures embody 12 facets in which an acute care hospital accumulates points according to achievement and/or improvement, ultimately providing Medicare payment incentives for quality of care rather than merely quantity of care. The Patient Experience of Care Dimensions consist of eight facets measured according to a HCAHPS questionnaire administered voluntarily to a sampling of patients discharged home. In Patient Experience of Care Dimensions points for achievement/improvement are also tallied according to quality of care, the highest score being applied to Medicare payment incentives. Both metrics are leading indicators, predicting financial outcomes for adherence to achievement/improvement standards. Both metrics also align with and flow from the hospital enterprise's mission and vision core values of Caring, Safety, Excellence and Integrity.