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The Complicated World of Health Care Quality

March 18, 2014

By Jim Judson, Director of Quality

Over the last forty years, there has been much discussion on the definition related to the quality of health care. There have been multiple attempts by various governing bodies to define quality succinctly.  Many healthcare quality and safety experts utilize the definition developed by the Agency for Research and Healthcare Quality (AHRQ), a federal agency of the Department of Human and Health Services.  AHRQ defines quality as “doing the right thing, at the right time, for the right person, and having the best possible result.

 Even with the above definition of healthcare quality, the concept is much more complicated than it appears.  Each member of the healthcare team, including the patient, has a different perception of quality.  If you asked a physician, a nurse, a patient or a quality healthcare professional what he or she would define as “good quality health care”, the answers might vary and may include “assuring I am providing care that is safe and effective”, “the staff being friendly” or “achieving care that is three standard deviations above the expected mean.”. Whether it is in a hospital or at a vacation resort, the definition of quality is always based on an individual’s perception.

 So with such individuality, what can a healthcare organization do?  What may be quality care and services to one recipient may not meet the definition of another consumer.  It is virtually impossible to meet everyone’s expectation of quality when the expectations are so diverse. Although members of the healthcare team do try to meet those expectations, providers often project our own definitions of quality onto others. 

 Healthcare organizations can demonstrate quality to all those who are part of the care and services provided.  This includes patients, residents, clients, direct and indirect care providers, vendors and regulatory agencies.  Healthcare organizations need to have quantifiable measures to demonstrate the quality of care to those we serve.  Currently every affiliate of Masonicare has quantifiable quality measures that they have defined and track.  Some of these indicators are mandated by the Center for Medicare/Medicaid Services (CMS) in order to receive federal funds and are publically reported on CMS websites to assist the public in making decisions as to where to seek their care.  Other Masonicare indicators are unique quality issues identified by each affiliate. Current quality indicators include levels of client’s satisfaction, appropriate use of medications, rates of readmission and transfer, adherence to evidence based medical practices and tracking patient outcomes.  When any quality indicator does not meet the affiliate’s expectations, corrective actions should be taken to improve the results.   Even if expectations are met, plans should be in place to sustain or improve compliance.

 It is important to provide quality care to those we serve.  Providing care that is patient-centered, safe and effective is a continuous process.  The frequent monitoring of quality indicators and associated measures allows us to be sure we are on target and allows us the opportunity to improve when the target is missed.  The mission of Masonicare is to enhance the quality of life thru an exceptional continuum of person-centered care.  To assure that we live up to this mission takes commitment to our work, to the population we serve and to each other.  We do this, to paraphrase the Agency for Healthcare Research and Quality, because “it is the right thing to do” for our future and present patients, resident and clients and to quantify that Masonicare provides the highest caliber of quality care and services.