Process of Care
Introduction
Process care measures are the evidence-based practices which represents the health care system’s effort to systemize the improvement of giving process care to the patients (Burton, n.d.). These practices are often guided by using evidence-based clinical guidelines and these may also vary in strength. Performance involved in much process care may fail to have a measurement of 100 percent and this may not be entirely because of the failure to act in accordance to the guidelines. Some patients may experience contradictions to the treatment and not all of these contradictions are reflected as exclusions in the process care measure. These measures show how many of the patients who received treatment and showed positive results from it. This also includes other treatments for serious medical conditions and surgical procedures. It is also a measure of how a hospital quickly responds to certain medical emergencies and how well they provide preventive health care services (Medicare.gov, n.d.).
Process of care measures have been used to compare the performance between medical providers and also to give a guide in value-based purchasing performance. In many situations, process of care measures provided a number of advantages over outcome measures as they may be easier and less costly to conduct (National Quality Measures Clearinghouse, 2015). Process of care measures can be used in the quality assessment of a health care system but there are still some disadvantages in terms of aggregating it into a single measure of quality. The process is also subject to many sample selection problems and data reporting process (Lieberthal, 2008, p. 999). The next part of the paper will focus on the looking into process of care of Mount Sinai Hospital in New York City and comparing it to two of its competing hospitals which are close to its location.
Mount Sinai Hospital New York City
Mount Sinai Hospital was founded in 1852 and it has been known for being internationally acclaimed when it comes to clinical care. It is among the top hospitals in the country including in several specialties including geriatrics, cardiology and heart surgery and gastroenterology (The Mount Sinai Hospital, n.d.). When it comes to emergency care, hospitals need to respond quickly may it be a timely heart attack or broken bones. Compared to New York-Presbyterian Hospital and Carepoint Health-Hoboken University Medical Center, despite being the farthest of the three in the city center, Mount Sinai provided the fastest response to timely health attacks for their outpatients but is the slowest to provide pain medications to patients in the emergency area with broken bones ("Medicare Hospital Comparison," n.d.).
For surgical care, hospitals can reduce the risk of infection after surgery by providing the recommended antibiotics and stopping it at the right time after surgery. Process of care can also be measured on how they maintained the blood glucose levels and removing catheters at a timely manner. Carepoint Health-Hoboken University Medical Center and Mount Sinai hospital has a 100 percent rating when it comes to giving antibiotics at the right time while New York-Presbyterian Hospital garnered 99 percent. Compared to the two hospitals, Mount Sinai also garnered a higher percentage when it comes to stopping preventive antibiotics at the right time. For preventive care, Mount Sinai and New York-Presbyterian Hospital scored higher in giving influenza shots to patients and health care workers compared to Carepoint Health-Hoboken University Medical Center who only seem to focus on giving preventive care to patients rather than also giving influenza shots to their health care workers as well ("Medicare Hospital Comparison," n.d.).
Analysis and Conclusion
Process of care measurements just like what has been done in the comparison above has been the topic of debate as it is being compared to outcomes of care. Within the categories of process of care and outcomes of care, there are specific advantages and disadvantages which can be applied to the processes like risk adjustment and mortality rates. The advantages of process measures are that it can be used to provide feedback for quality improvement initiatives of the organization. This is considering that there are many factors that can affect patient outcomes. Process of care measures can help health care providers identify if they have exactly followed the guidelines in patient care or not. This can provide actionable means in addressing quality issues inside the organization (Rubin, 2001, p. 470).
There are also issues in publicly reporting these data. Many experts believe that these data can help the consumers the information about the performance of a certain hospital. This can allow comparison of costs, quality and patient satisfaction when it comes to service. Many advocated believe that publicly reporting these data can help the consumers make informed choices when choosing the right facility for their needs. However, many clinicians believe that there are issues in obtaining or gathering these data as it may not be as accurate as it seems. Aside from that, public data can also affect a hospital’s performance as it could lead to the potential for unintended consequences which might result for the medical providers to manipulate their score card. For example, they would decline patients with serious illnesses which could negatively impact their ratings. These are some of the issues concerning public reports of the ratings in quality of care of hospitals (James, 2012, p. 3). With that, surveys and public ratings should be studied intently and provide more accurate information of how the hospital operates and manages its patients.
References
Burton, T. (n.d.). Why Process Measures Are Often More Important Than Outcome Measures in Healthcare. Retrieved March 20, 2016,
James, J. (2012). Health Policy Brief: Public Reporting on Quality and Costs. Health Affairs, 1-5.
Lieberthal, R. D. (2008). Hospital Quality: A PRIDIT Approach. Health Services Research,43(3), 988-1005. doi:10.1111/j.1475-6773.2007.00821.x
Medicare Hospital Comparison. (n.d.). Retrieved from https://www.medicare.gov/hospitalcompare/compare.html#cmprTab=2&cmprID=330101%2C330024%2C310040&cmprDist=5.4%2C7.4%2C3.0&dist=25&loc=NEW%20YORK%2C%20NY&lat=40.7143528&lng=-74.0059731
Medicare.gov. (n.d.). Timely and Effective Care Measures. Retrieved from https://www.medicare.gov/hospitalcompare/Data/Measures.html
The Mount Sinai Hospital. (n.d.). Who We Are. Retrieved from http://www.mountsinai.org/about-us/who-we-are
National Quality Measures Clearinghouse. (2015, June 18). Selecting Process Measures for Clinical Quality Measurement. Retrieved from https://www.qualitymeasures.ahrq.gov/tutorial/ProcessMeasure.aspx
Rubin, H. R. (2001). The advantages and disadvantages of process-based measures of health care quality. International Journal for Quality in Health Care, 13(6), 469-474. doi:10.1093/intqhc/13.6.469
