Healthcare: Measuring Quality

Many hospitals and healthcare facilities are pursuing process improvement initiatives to streamline operations and improve the effectiveness of services provided. Some of these initiatives involve applying Lean thinking and other process improvement techniques to reduce waste and non-value adding activity, thereby increasing efficiency and quality.

A key question for healthcare providers is, how should the quality of healthcare services be measured? There are basically three ways.

The first way uses measures of structure to describe input use. Measuring the number of full-time equivalent nurses per hospital bed is an example of a structural measure.

A second way of measuring healthcare quality is to use process measures. Process measures include wait times, medication errors, and the like.

The final way to measure healthcare quality is to use outcome measures. Outcome measures assess the effects of care provided. They include such things as the frequency of hospital-acquired infections, the frequency of surgeries on wrong body parts, etc.

While outcome measures are often used to gauge the quality of hospital services, these measures often have limitations. The data needed to compile such measures is often lacking and, more importantly, adverse outcomes often arise for reasons other than poor quality care. For example, cancer patients vary in their disease staging, and comparing survival outcomes across facilities must take into account these differences. In addition, outcomes measured at a specific point in time may be attributable to factors other than care quality. For example, the mortality rates of heart attack patients following admission to a hospital is not only dependent on the quality of care, but also upon the patient’s condition upon admission and events that may occur following discharge.

The bottom line is that healthcare managers need to carefully consider how they will measure healthcare quality. Because healthcare quality is complex and multi-dimensional. it may be impractical to adequately measure every relevant aspect of quality.


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