Difference between revisions of "Healthcare quality process measures"

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An applicable example would be an emergency room guideline that requires a tetanus vaccine for patients seen that have been injured by a nail or screw.  If in the month of June, 10 patients visited the emergency room after being hurt by a nail and 7 received the vaccine, then the percentage of patients in accordance with the guideline would be 70%. This information should be kept in the electronic medical record (EMR).  If the patient is seen again within 10 years, he/she should not be given the vaccine.  However, if the patient is seen again after 10 years, regardless of the reason, an alert in the EHR should prompt the provider to administer the vaccine.   
 
An applicable example would be an emergency room guideline that requires a tetanus vaccine for patients seen that have been injured by a nail or screw.  If in the month of June, 10 patients visited the emergency room after being hurt by a nail and 7 received the vaccine, then the percentage of patients in accordance with the guideline would be 70%. This information should be kept in the electronic medical record (EMR).  If the patient is seen again within 10 years, he/she should not be given the vaccine.  However, if the patient is seen again after 10 years, regardless of the reason, an alert in the EHR should prompt the provider to administer the vaccine.   
Possible reasons why the Accordance of guideline was not met include tetatus vaccination within 10 years, allergy to vaccination, or patient refusal.
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Possible reasons why the Accordance of guideline was not 100% in the above example include: tetatus vaccination within 10 years, allergy to vaccination, or patient refusal.
  
  
 
== '''Advantages''' ==
 
== '''Advantages''' ==
  
1. Can be used to provide feedback for quality improvement initiatives.  It also provides information that is actionable, what is being done well or what needs improvement.  It gives the ability to accurately reflect the care that clinicians are providing.  
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#.Can be used to provide feedback for quality improvement initiatives.  It also provides information that is actionable, what is being done well or what needs improvement.  It gives the ability to accurately reflect the care that clinicians are providing.  
2. Minimal risk adjustment for patients illness.  A process measure requires defining a population that is eligible to receive the process.  For example, patient population to receive aspirin upon admittance to ER for chest pain.
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#.Minimal risk adjustment for patients illness.  A process measure requires defining a population that is eligible to receive the process.  For example, patient population to receive aspirin upon admittance to ER for chest pain.
3. Data collection can be done when clinical process is occurring.  This eliminates the need for additional tracking of patients for data collection.
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#.Data collection can be done when clinical process is occurring.  This eliminates the need for additional tracking of patients for data collection.
  
  

Revision as of 16:25, 27 July 2013

Healthcare quality process measures are often used to recommend guidelines for clinical practice based on scientific evidence or consensus. Quality measures are defined as metrics, indicators, or ratings which provide information in regards to the quality of care that patients are receiving in a particular setting. A process measure is a type of quality measure that assess a health service provided to or on behalf of a patient.

Standardization of Process Measures

Evidence based research is used to create guidelines for healthcare. Once guidelines are developed, standardization of process measures can be achieved. The following formula is one way to explain this:

      Number of Patients Who Receive Care/Number of Patients Eligible to Receive Care=y
      y multiplied by 100=Percentage of Patients Who are in Accordance with the Guideline 

This would allow a quality assessment comparison of what was actually done to what should have been done. Once the results of process measures have been determined, the reasons why that measure was performed or not performed can be evaluated further. Process measures can be tracked as part of the electronic medical record. Thus making results and alerts easily accessible to providers.

An applicable example would be an emergency room guideline that requires a tetanus vaccine for patients seen that have been injured by a nail or screw. If in the month of June, 10 patients visited the emergency room after being hurt by a nail and 7 received the vaccine, then the percentage of patients in accordance with the guideline would be 70%. This information should be kept in the electronic medical record (EMR). If the patient is seen again within 10 years, he/she should not be given the vaccine. However, if the patient is seen again after 10 years, regardless of the reason, an alert in the EHR should prompt the provider to administer the vaccine.

Possible reasons why the Accordance of guideline was not 100% in the above example include: tetatus vaccination within 10 years, allergy to vaccination, or patient refusal.


Advantages

  1. .Can be used to provide feedback for quality improvement initiatives. It also provides information that is actionable, what is being done well or what needs improvement. It gives the ability to accurately reflect the care that clinicians are providing.
  2. .Minimal risk adjustment for patients illness. A process measure requires defining a population that is eligible to receive the process. For example, patient population to receive aspirin upon admittance to ER for chest pain.
  3. .Data collection can be done when clinical process is occurring. This eliminates the need for additional tracking of patients for data collection.


Disadvantages

1. May be difficult to specify population eligible for a process. There may be many exclusions ??? indications. 2. Not as valued to patients and non-clinicians. Patients believe providers responsibility to perform appropriate care and are only concerned about outcome.


Relationship b/n Process Measures and Outcome Measures

Process measures assess weather specific healthcare services are provided to an individual who needs them based on their conditions and place of tx????. Outcome measures assess how patients actually fair during and after their tx??. Outcome measures attempt to gauge the comprehensive result of multiple healthcare services (or processes) provided to and individual.


Donabedian

?? Proposed that we measure quality of healthcare by observing its structure, process, outcomes…