Healthcare Delivery Systems

4.2 Quality of Care
Healthcare Delivery Systems
BOOK INFORMATION
Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.).
Burlington, MA: Jones & Bartlett Learning.
ISBN: 9781284074635
To assess your ability to:
• Evaluate the elements and procedures for assuring quality in healthcare services; evaluate the
impact of technology on quality of care.
• Describe how healthcare services are accessed and delivered in the United States.
Overview:
In this assignment, you will address questions regarding quality of care based on the required and
recommended readings and support your answers with scholarly research.
Action Items- IMPORTANT
1. Complete the Week 4 Readings prior to working on this assignment. Document your thoughts as
you read.
2. Conduct research to address the following questions. Use the resources at the Nationwide
Library to obtain at least three relevant, scholarly sources.
o Adverse events are defined as an outcome measure. What are adverse events? What do
they tell us about the quality of care?
o What is the relationship between patient satisfaction and the quality of care? Identify and
describe the elements that go into making an effective program to measure quality in a
healthcare organization.
3. Write a three- to four-page paper, in which you address each of the items you researched.
Incorporate your notes from the readings as well.
o You must incorporate research into your paper from at least three relevant, scholarly
resources.
o Follow all applicable APA Guidelines regarding in-text citations, list of cited references,
and document formatting for this paper. Failure to properly cite and reference sources
constitutes plagiarism.
o The title page and reference list are not included in the page count for this paper.

Week 4 Readings
Learning Outcomes
Upon successful completion of this week, the student will be able to:
• Describe how healthcare services are accessed and delivered in the United States.
• Describe structural Design of Healthcare Organizations.
• Evaluate the elements and processes for quality of healthcare services as well as the impact of
technology on quality of patient care.
Required Readings
Read the following chapters in your textbook, Understanding the U.S. Health Services System:
• Chapter 5 from Shi and Singh textbook (( Medical Technology ))
• Chapter 12 from Shi and Singh textbook (( Cost, Access, and Quality ))
Introduction
This week will review and addresses the three analytic dimensions of the U.S. healthcare system: access
to care, costs and expenditures of care, and quality of care. Quality has been the most difficult of the
dimensions to measure, and outcome measures (as opposed to structural and process measures) are
particularly difficult to construct and appropriately measure.
The United States is the leader in biotechnology development. Technology is one of the major drivers of
health services expenditures. What is the likelihood that the United States will be able to retain this
technology imperative? How many technological resources should be used at the end of life? We have yet
to grapple with these kinds of questions, but technology is also the driving force behind improving patient
outcomes and the quality of care.
Key Points:
Quality
When discussing quality, one has to consider quality assessment, quality improvement, and quality
assurance.
Electronic Health Records
Solid data are essential to the measurement of quality. Electronic health records provide a new basis for
measuring individuals’ quality of care as well as population-level quality of care. The electronic health
record’s adoption status is an important point to consider.
Measuring outcomes of care
By measuring outcomes of care as opposed to just structural and process measures, researchers can better
evaluate the differences that specific treatments and interventions make in providing care.
Quality of care initiatives
A review of major quality of care initiatives (beginning on page 456) may help to understand some of the
terms.
Regulate quality of care
Efforts to regulate quality of care have met with mixed success. Medicare continues its initiatives to
regulate quality to provide a basis for expenditure control.
The intent of regulations
It is not always easy to distinguish whether the intent of regulations is to control quality of care or to
control the costs of care.
Technology
In “Biomedical Research, Health Services Technology, and Technology Assessment,” the discussion
focuses on technology. With the future of the economy still uncertain, and in view of the discussions
about a national health insurance plan, will Congress, and thus the public, be able to continue to support
NIH? What are the implications for the U.S. retaining its leadership in the development of new
technology if the support remains the same or declines? For researchers? For the health of the American
population?
HIE & IT: Changing the Cost-Quality Curve
Robert Connely, SVP, Medicity, talks about what’s ahead for health information exchanges, analytics, the
potential to change the cost-quality curve and more.
Development costs
Private drug companies are responsible for the research that leads to new products, and other private
companies are responsible for the development and proposal of new devices. It is interesting to consider
the costs of developing new drugs, obtaining FDA approval, and protecting patents in developing new
technologies.
Technology Assessment
Not all technologies are assessed, or, if assessed, not always in a timely manner. What does this
lack/delay portend for healthcare expenditures? For ineffective care? For the eradication of ineffective
care? For patients that could benefit from new drugs but can’t because of delays in approvals or costs not
covered by insurance?
Bring Your Own Mobile Devices
Friday, November 02, 2012
Two hospital chief information officers and a software development executive discuss the trend of bringyour-own-mobile devices in medical settings and the gravitation toward Apple’s iOS-based systems.
Featuring panelists Dimitri Volkmann, VP, Good Technology; David Kempson, CIO, Maricopa
Integrated Health System; and Humberto Quintanar, CIO, Antelope Valley Hospital.