HealthCare Partners' Quality Improvement
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Quality improvement has always been a priority in the healthcare industry. The industry cares for the health and lives of patients, and this can only be done through a continued commitment to quality. In an attempt to foment quality improvement within the industry, organizations have started to pursue a new model, one that aims at elevating the coverage and quality of service, while at the same decreasing costs. HealthCare Partners is a pioneer in the implementation of this new model. The organization has already initiated its efforts to transform into an Accountable Care Organizations (ACO). ACOs were conceived “as a new delivery model to encourage clinicians, hospitals, and other health care organizations” (The Commonwealth Fund, 2012, p. 1). HealthCare Partners intends to promote higher quality management and care of patients. The organization wishes to improve the quality of its clinical systems strategy, its inpatient services, and its disease management strategies. Improving these three areas is a challenge for the doctors and managers at HealthCare Partners. This is a challenge shared by the sector in its entirety; national policy requires that health care services improve the quality of service, economy, and coverage (Department of Health & Human Services, 2010, p. 4). However, through the use of specific data collection methods, vital data related to the organization’s efficiency (including communications, inventories, and technological infrastructure) and quality of service (including customer satisfaction, physical infrastructure capabilities, and screening score percentages), HealthCare Partners appears to be successful in the implementation of the ACO model.
A successful ACO manages to identify those areas, in which quality improvements are required. This entails collecting specific information relevant to each of the areas that need improvement. HealthCare Partners, in improving the quality of its clinical systems strategy, needs to develop health information technology (HIT) that allows it to identify the risk factor associated with the health of each patient, as well as the capabilities (physical and medical) of each care provider. This information is paramount for the organization. It would allow the patient to be matched to the care provider he or she needs.
Secondly, in order to improve its inpatient services, information regarding each care provider’s physical capacity, the costs associated with the services offered, and the screening score percentages would be most important. Offering the best care for patients does not necessarily mean offering the most expensive one, but the most efficient one. This information would enable HealthCare Providers to know exactly which providers offer which services. Patients would receive the best care in an expedient manner; the organization would also save time (and money).
Thirdly, in improving the quality of its disease management strategies, it would be necessary to know what the screening score percentages are. It would also be necessary to know what prevention campaigns have been undertaken, as well as how effective these have been. Knowing what the most prevalent diseases are, the organization could identify patients facing greater risks. This would allow it to focus its efforts on educating the public on preventing such diseases (if possible) and procuring the best possible treatment for the patients.
In order to procure the information that would be required to ascertain the quality in each of the aforementioned areas and, subsequently, monitor potential quality improvements, there are three methods that HealthCare Providers has used: interviews; focus groups and surveys. The first two methods (interviews and focus groups) are qualitative methods. This means that they obtain insights about what a person thinks or feels on a particular subject. The third proposed method, surveys, is a quantitative method. This method is generally used to quantify data and make exact measurements (National Gang Center, n.d.).
Information was collected through in-person and telephone interviews with a diverse group of stakeholders. The site visit included focus groups with physicians and administrative staff. HealthCare Partners routinely fields surveys of patient experience in all six regional business units, with a goal to have 100 completed surveys per primary care physician each year (The Commonwealth Fund, 2012, p. 3).
In HealthCare Partner’s case, the qualitative methods described above would help the organization get a good idea of how patients perceive the care they receive. The same applies for the input that physicians might have about the conditions, in which they treat patients and any suggestions for additional or improved services. Through these findings, the organization could make adjustments to provide a higher quality service (one that is more adequate in the minds of patients). The quantitative method presented would also be helpful for the organization to get exact figures regarding the number of health care providers, the services offered, the providers’ inpatient capabilities, inventories, etc. Surveys would also assist insomuch as they make it possible to quantify customer satisfaction, thus allowing management to make decisions based on the proportion of patients satisfied with the proportion of those unsatisfied.
Combining qualitative and quantitative tools/methods for procuring information, HealthCare Partners would be able to make an initial assessment of the quality of service in the targeted areas. The continued use of these methods would ultimately allow the organization to make comparative analyses of each area’s improvement. Of course, these methods would have to be complemented with tools. Tools would be required to tabulate the data and present it to all stakeholders (physicians and managers). Physicians need to have information regarding service capability/availability, inventories, and patient screening score percentages in order to provide a better service.
Through the methods delineated above they would be able to do all of this, and managers would know what diseases/conditions to focus on in order to foment prevention. Tools that would enhance the organization’s capabilities might include the Provider Information Portal (PIP), the Clinical Dashboard, and the Predictive Modeling System (The Commonwealth Fund, 2012, p. 7). These tools, apart from enhancing the clinical systems strategy, would enhance the inpatient services and the disease management strategies as well. The Predictive Modeling System, for instance, would allow physicians and managers alike to predict which patients have greater risk factors and are therefore more costly. Once identified, disease management strategies could be formulated to target those patients in order to improve quality, decrease screening score percentages, and decrease costs. The same applies for the Provider Information Portal (PIP). This tool allows “physicians to monitor their performance on predetermined care coordination and quality metrics” (The Commonwealth Fund, 2012, p. 7). It also allows managers to determine what physicians in which areas need to improve the quality of the services offered.
HealthCare Partners is a pioneer in the implementation of the ACO model. The organization attempts to increase the quality of healthcare services (as well as the coverage), while at the same time decreasing operational costs. In order to be able to do this, the organization identified three areas in which quality improvements were required. Data is also a requisite for the ACO model to succeed. Data enables organizations to develop strategies to be more efficient, but when collecting data, it is important to know what data is relevant (and what methods allow for relevant data to be procured). Given that HealthCare Partners offers health care, both qualitative and quantitative data is required. It is necessary to have precise data on costs, number of patients/physicians, and screening score percentages, but it is equally necessary to have qualitative information regarding patient satisfaction. High quality health care is more than curing a disease/condition. Health care is also about offering comfort to patients (looking after both their physical and mental health). In the health care industry, the objective is to provide universal treatment of the highest quality (and at the most affordable cost). This objective will take time to fulfill, but HealthCare Patient’s ACO experience hints that it is possible.