Access, Cost, and Quality
Introduction
Driven by a disturbing decrease in the nu
Access, Cost, and Quality
Introduction
Driven by a disturbing decrease in the number and availability of primary care physicians, long wait times in emergency rooms for nonemergent care, and the public demand for immediate access to medical care, the urgent care industry has experiences considerable growth during the last two decades. The Urgent Care Center Accreditation (UCCA) program sets quality standards, measures performance, and provides consultations. However, implementation of the ambulatory care measures at urgent care centers is challenging because urgent care is, by definition, episodic and most measures focus on providing longitudinal care to a panel of patients.
In this LearnScape, the Chief Executive Officer of a healthcare system wants to improve patient care survey results in their urgent care facilities. The perceived quality of services is the lowest rated area in the survey. As a Change and Process Management consultant, the student will work with the Director of Quality Improvement of the healthcare system to analyze the current structure, process, and outcomes of the urgent care facilities.
In healthcare, there is a great deal of focus placed on access, cost, and quality and for good reason. While these are three distinct concepts, they are also interrelated. When expanding access to health services, we see a corresponding increase in healthcare expenditures. This phenomenon can be explained by the fact that people will access health services when made available, which in turns drives up operating costs. Increasing access can have a positive impact on quality if the proper structures and processes are in place to ensure consistent outcomes. Improving quality can have an inverse relationship with costs. As structure, process, and outcomes improve, the costs associated with care delivery (direct and indirect) tend to lower. Having appropriate and timely access to healthcare services can improve quality and potentially lower costs, especially when the focus is on population health management. In healthcare organizations, as is the case in many other industries, there are a number of quality management models (e.g., SPO of medical care, TQM, TQL, Lean, Six Sigma, CQI, PDCA, PDSA) being utilized to identify process inefficiencies, and then effect necessary changes that drive down costs, decrease variability in outcomes, and make it easier to forecast revenues. This LearnScape will address the importance of strengthening access, cost, and quality within health care. More specifically, topics such as leveraging information systems to improve quality; examining of staffing patterns on health outcomes; legal and regulatory requirements associated with the privacy and security of private health information; the impact of cost, communication, correctness, and care outcomes on quality; avoidable medical errors; strategies to boost access and quality; and more. The focus on quality management isn’t a passing phase, but rather an important component in the long-term success of the healthcare industry. As the industry becomes more data dependent, analytics will play an increasing role in guiding management decision-making intended to improve access and quality while controlling costs.
Unit Learning Outcomes
ULO #1: Examine issues pertaining to structure, process, and outcomes that are compromising quality medical care. (CLO 1, 2, 3, 4, 5, 6, and 7)
ULO #2: Compare and contrast various models of quality management/quality improvement that are commonly used within the healthcare industry. (CLO 7)
ULO #3: Point out the relationships that exist between access, cost, and quality in health care. (CLO 3 and 7)
ULO #4: Consider the nature, scope, and dimensions of quality in formulating recommendations for strengthening process outcomes. (CLO 7)
Directions
LearnScapes Scenario
Initial Posting
Peer Responses
LearnScapes Scenario
(Initial Posting). Students are to complete the LearnScape for Health Care Delivery: Episode 3: Customer Satisfaction (Scenario).
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Customer Satisfaction
Prepare your initial discussion posting consisting of two parts:
Part 1 – Based on the information provided in the scenario and on an outside review of the relevant literature, prepare a formal recommendation, to the Director of the Bright Road’s urgent care facilities, which includes suggestions on how to improve access and quality while managing costs within facilities. The recommendation needs to be well supported, logically presented, and thoroughly vetted.
Part 2 – Propose an innovative process approach to get rid of the urgent care waiting room and discuss how removing waiting room can reduce costs, increase access, and improve quality of care.
Due Dates
Online Students: The initial response is due by Wednesday at 11:59 p.m. (CT). Respond to a minimum of two peers’ initial postings. The peer responses are due by 11:59 p.m. (CT), on Sunday.