Compare and contrast various outcomes assessment tools – their reliability and validity – used in healthcare quality assessment

The purpose of measurement is to gather information, particularly as it is related to quality

management in a healthcare organization. For the healthcare administrator who must measure quality in their facility, the cycle of measurement, assessment, and improvement is crucial. Conducting this cycle allows a determination of why the traditional healthcare model at a hospital is succeeding or failing, and thus change can be structured and the Lean Sigma roadmap can be implemented.

The Lean Sigma roadmap allows improvement to occur at the healthcare organization by using business improvement methodologies that employ Six Sigma. Six Sigma is an excellent method to drive much higher reliability in a process by increasing accuracy and decreasing defects.

For example, to improve the functioning and profitability of the skin cancer institute of a major university hospital system, hiring the best trained and experienced professional staff, purchasing and utilizing the most advanced diagnostic and treatment procedures and machinery, instituting the most advanced IT programs and documentation systems are all essential when applying the measurement cycle and pursing Six Sigma. Higher reliability, increased accuracy, and decreased defects lead to improved revenues by increasing the number of patients served, minimizing malpractice issues and diagnostic/treatment mistakes, and improving patient outcomes.

Upon completion of this assignment, you should be able to:

• Compare and contrast various outcomes assessment tools – their reliability and validity – used in healthcare quality assessment.
• Understand measurement in quality management in a healthcare organization.
• Evaluate performance and assessment of quality management.

Resources

• Textbook: Introduction to Healthcare Quality Management
• Textbook: Lean Sigma – Rebuilding Capacity in Healthcare
• Report: Combined Assessment Program Review of the New Mexico VA Health Care System, Albuquerque, New Mexico
• Video: Comparing Health Care Quality: A Road Map to Better Care

Background Information

Healthcare organizations measure many aspects of performance, such as medical needs of the community, revenues, profitability, numbers and types of patients treated, malpractice issues, and demographics. Some of these are mandated by external regulatory, licensing, and accreditation groups. Some of these external groups include HITECH, CLIA, HEDIS, NCQA, AHRQ, and others.

To affect performance improvement at a hospital, quality measurements must be undertaken. Quality measurement criteria include metrics, performance, customer service, and other structure/process/outcome performance measures. To build and utilize an effective quality measurement system, a data collection program must be designed to be reliable, be capable of adequate sampling, have inter-rater reliability, and use evidence-based performance measures.

Useful quality measurement must use performance goals that are quantifiable. These goals employ opinion, criteria, and performance comparisons so that the healthcare administrator can identify strengths and weaknesses in the healthcare organization and affect meaningful change. Once the strengths and weaknesses are identified, change models can be employed, Lean Sigma instituted, and a program direction used to reach Six Sigma goals. Measuring and evaluating performance allows opportunities to be identified, particularly in the United States where healthcare is retail and for-profit, and revenue growth, cost reduction, and cash enhancement are maximized.