In 2001, the National Academy of Medicine (NAM), formerly the Institute of Medicine (IoM), reported serious quality gaps in the U.S. health system, identified the six dimensions of quality in healthcare

by | Sep 6, 2021 | Uncategorized | 0 comments

Please read the scenario below, and then answer the questions that follow in a 3-page analysis. The questions will guide your analysis of the situation, but they will need to be presented as part of your assessment of risk as a healthcare manager.
Scenario:
In 2001, the National Academy of Medicine (NAM), formerly the Institute of Medicine (IoM), reported serious quality gaps in the U.S. health system, identified the six dimensions of quality in healthcare, and identified the need to apply new technology safely to improve the quality of health services. Since this report—and in the face of high healthcare costs, an aging population, and the need to apply scientific and systematic approaches to improve the quality and safety of healthcare—the U.S. healthcare system is experiencing tremendous changes. Safety, quality of care, and healthcare consumer satisfaction are at the forefront of healthcare organizations’ goals.
The triple objectives of healthcare improvement in the country are as follows:
To improve experience of care
To reduce per capita cost
To improve population health outcomes
Healthcare organizations are implementing quality improvement programs to achieve these objectives. Funding and regulatory agencies are initiating standards and providing financial incentives to facilitate the achievement of these objectives, too. For instance, the Agency for Healthcare Research and Quality (AHRQ) supports health services research to promote quality of care and evidence-based decision making. The National Quality Forum (NQF) improves the quality of care by setting national priorities and goals for performance improvement, supports education, and creates outreach programs.
As part of a broader quality strategy to the delivery of health services, the Centers for Medicare and Medicaid Services (CMS) introduced the pay-for-performance program, or value-based healthcare. Many see this approach as transformational. The program reimburses health organizations based on the quality (value) of care, cost, and outcomes of service rather than the volume or the number of patients. The following are included in CMS’s approach:
Hospital Value-Based Purchasing (VBP) Program
Hospital Readmissions Reduction Program (HRRP)
Hospital-Acquired Condition (HAC) Reduction Program
For each program, CMS compares performance data annually from individual hospitals with national data, and payment rates are adjusted as incentive for better performance.
As a healthcare manager, you will lead your team to establish standards and use technologies to provide safe, effective, and high-quality patient care. However, it is necessary to identify the key stakeholders in the healthcare organization—patients, care providers, and payers—and to understand their interests and perception of quality. In addition to performance and professional standards, stakeholder expectations are important.
Please address the following questions in your response:
What is quality improvement synonymous with?
What is one of the steps in process improvement?
What does technology support to enhance quality improvement?
What function do the CMS value-based programs and quality metrics perform?
What factors are part of the CMS value-based programs?
What do the CMS quality metrics include?
What are the eight measurements for the patient- and caregiver-centered experience?
How is the value-based approach affecting health organizations?
What legislation supports the value-based program?

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