HCA 610 Quality Measurement Through Point of Care Discussion Essay

 Explore the many point-of-care tools available to assist with data acquisition, analysis, and decision-making and to research how these tools can assist with quality measurement.

For the first part of this assignment, research three quality measurement point-of-care tools used in the health care environment. On the “Quality Measurement Point-of-Care Tools” chart, identify each tool and analyze its ability to assist with data acquisition, analysis, and decision making in health care. Include references for any sources used to complete the chart.

For the second part of this assignment, use the information gathered from the chart to write a 500-750-word paper that answers the following questions:

Explain how your chosen point-of-care tools contribute to quality of service through data acquisition, analysis, and decision making.

Discuss the impact that these point-of-care tools can have on quality standards.

1. Discuss the impact of quality standards on organizational operations. Reflect on your thoughts related to point-of-care tools and decision making.

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Policies to improve population health have often focused exclusively on the expansion of access to basic health services, to the neglect of quality of care. Efforts to increase the demand for priority interventions have implicitly assumed that the care available is of sufficient quality or that, with the expansion of coverage, quality will naturally improve.1 However, such assumptions may be incorrect. There is growing recognition that people may be acting in a perfectly rational way when they avoid using health services of poor quality and that poor quality of care can be a barrier to universal health coverage independent of access.

The aim of many strategies to improve health-care quality has been to ensure that essential inputs – e.g. technology, operational facilities, pharmaceutical supplies and trained health workers – are in place.3 Many such strategies have focused on the supply side and been designed to support the provision of services according to clinical guidelines.4 The acknowledgement that quality improvement approaches should be applied within patient-centred models of care is relatively recent.5

In this paper we seek to unpack complexities around quality of care and identify strategies for improving the measurement of such quality. An understanding of these issues could inform pragmatic strategies for the analysis and measurement of quality of care. We draw on research conducted in a variety of low- and middle-income countries and identify areas of inherent complexity that require further in-depth research. In doing so, we reflect on what is meant by quality of care and how perceptions and understanding of quality of care influence health systems and effect the measurement of quality.

We have identified and structured our discussion around six conceptual and measurement challenges. First is the recognition that, even though they may not reflect actual quality, perceptions of the quality of care are an important driver of care utilization. Second, a patient’s experience of quality must be conceptualized as occurring over time. Third, responsiveness to the patient is a key attribute of quality. Fourth, so-called upstream factors – e.g. management at facility and higher levels – are likely to be important for quality. Fifth, quality can be considered as a social construct co-produced by different actors. Finally, there are substantial measurement challenges that require the adaptation and improvement of current approaches.

The classic framework on quality of care developed by Donabedian makes the distinction between structure, process and outcomes.6 More recently, the Institute of Medicine in the United States of America (USA) has unpacked the concept further and suggested that efforts to improve care quality should be focused around six aims: effectiveness, efficiency, equity, patient-centredness, safety and timeliness. We do not seek to propose a new framework for understanding quality. Rather, we highlight some key issues that deserve more consideration in debates about enhancing the accessibility and quality of care. Building on our experiences of doing empirical research in low- and middle-income countries, we present several insights that are complementary to existing, comprehensive frameworks of quality of care and may be absent from current debates.