Discuss the following:
1. I enjoyed reading your post and I completely agree with your points. I would like to comment on one of your points regarding controlling the quality of care by using independent contractors. There are benefits to this initiatives, but there could be disadvantages too. The benefit of using teams of experts that you did not hire saves the organization costs associated with keeping full time employees, and patients are seen in a timely manner (In some cases). Many years ago, some departsments in a HMO that I work for had access problem such as patients having to wait 3-4 weeks when they need to see a specialist within the organization. No patient with ear infection or difficulty swallowing wants to wait for 3 three weeks to be seen.
We were sending patients outside for urgent MRIs, CT scans, as well as to different specialists even though the company has capabilities to perform some of these functions in house. Apart from the rising costs this created, the level of patients dissatisfaction went through the roof as some patients get to their appointments and were told that referrals that were to be autofaxed to the outside vendors were never received. Some patients were sent away (no referral, no service). Our Utilization Management department was bombarded with approving these external referrals. We have improved, regrouped, and expanded. State of the art facilities were built and still continue to be built, More physicians, nurses, and support staff were hired, and our patient satifaction rate has grown greatly. For example, we used to send our deaf patients to John's Hopkins Hospital for cochlear implants which cost way over hundred thousand dollars, but that's done in house now
2. Quality of care is a very sensitive subject for every party involved in the healthcare system. They all have different perspectives, each looking at healthcare from a different lens. Patients see quality of care in the results of their treatment and whether their treatment was effective immediately. It can also be measured by how the provider thinks, If a provider were to say that a patient would heal in 2 weeks, the patient would check for the dulling of pain around 2 weeks after the visit. Providers, on the other hand, see quality of care as the credentials that they need to get in order to renew and keep their license to practice.
Quality has its place in the healthcare system, with its positives and negatives. The positives are that it creates an air of steady improvement within competing facilities, and that it encompasses the entire scope of the patient's feelings and their care, such as the friendliness of staff to the patient, and number of services provided. The negatives are that the rating system could list quality as bad for a number of reasons that culminate in the spirit of customer service, and that constant high quality for providers means that their licenses are constantly being improved with items that fit the demanding regulations of the healthcare industry.
Licensed Independent Practitioners are those who independently practice their craft, yet are often grouped together with hospitals. This strips them of their title and identity, and destroys their position. It does damage to their reputation as an individual. However, they tend to be very educated on a few subjects, and are able to provide live training to interns and new employees through field work.
3. To measure quality of care, the World Health Organization defined quality as steps taken for best outcomes (who.int). It states that the care provided to patients and communities must be measured by six basic concepts of quality. Care should be effective based on the patient’s need, efficient without wasting of resources, accessible to patients in a timely manner, acceptable to patient, safe without injury or risks to patients, and equitable with no discrimination to age, gender, appearance, social or economic background (who.int).
The quality of care can be viewed differently from the perspectives of patients and physicians. From a provider’s point of view, I believe quality of care is using knowledge gained through education, experience, and good bedside manner to care for patients regardless of who the patient is. However, from patients’ view, quality may be measure based on prior experience, expectations, and interactions with the healthcare team starting from the first phone call to the department. A patient that perceive kindness and empathy from his/her nurse and physician may rate the whole experience as good quality of care, while kindness and empathy alone may not cut it with another patient. Quality may be based on how well prepared the physician was, his years of experience on the job, familiarity with the type of illness/disease that patient have, bedside manner, tests carried out, how quickly he returned phone calls, and how soon the patient got better or cured after treatment.
Quality can be viewed as a strength and a weakness in the U.S. health care system. Technology, invention, education, and the overall health care system is amazing when it works. For example, a patient who finds a lump in one breast, starts by seeing her primary care physician, and after a bunch of tests and treatments by many health care workers, ends up with a successful recovery of breast cancer would see the strength in health care. While the bureaucracy of the system may highlight the weaknesses of the U.S. health care system.
The benefits of working with licensed independent practitioners include experience in all aspects of the business and being a manager is the highest position after the physicians. Drawbacks include inability for higher career path as the position of a manager is the highest. Reporting to physicians that may not have business education or experience.
References:
World Health Organization. (2016). Quality of Care which is located at below url:
https://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf?ua=1