NUR 508 Grand Canyon Week 4 Discussion 1

Debate the efficacies of public versus private-based quality initiatives. What roles do each play in the quality of U.S. health care? How would the elimination of one aspect affect the other? Respond to two other classmates and counter their answer, citing references as appropriate.

ADDITIONAL INFO 

Efficacies of public versus private-based quality initiatives

Introduction

Quality improvement interventions have become a part of standardized evidence-based best practices for improving outcomes in the healthcare system. Although most quality improvement programs are conducted within public institutions, there are some that target private-based settings. A recent study examined the efficacy of public quality initiatives on mortality and readmission rates among older adults undergoing hip fracture surgery in a single hospital setting. To conduct this research, we identified publicly funded health systems in which older adults undergo hip fracture surgeries and selected seven hospitals from these systems that had implemented an intervention known as the Patient Safety Excellence Initiative (PSEI). We then analyzed data from all elderly patients who underwent hip fracture surgeries at these seven hospitals between 2010 and 2016 to quantify associations between implementation of PSEI programs and mortality rates after discharge from the hospital

Objective

The purpose of this study was to determine whether or not public versus private-based quality initiatives can be used as a tool in improving healthcare delivery. Specifically, we wanted to know if these programs have any effect on patient safety and the overall quality of care that patients receive.

To accomplish our goal, we conducted a case study at one hospital in the United States and compared their results with those at other hospitals in similar situations. We interviewed 14 physicians and nurses from each institution to determine what types of initiatives they were using, who was leading them, how much time was spent on them each day/week/monthly etc., how effective they were locally compared with nationally or internationally (if applicable).

Quality improvement efforts have increasingly become a part of standardized evidence-based best practices.

Quality improvement efforts have increasingly become a part of standardized evidence-based best practices. These efforts are ongoing, and they require the participation of multiple stakeholders to be successful.

Quality improvement is an ongoing process that involves improving the quality of healthcare through continuous process improvement initiatives. Quality improvement professionals work with all stakeholders—patients and families, providers, payers and others—to create systems where everyone has access to high-quality care at every stage in their lives.

Design

The study design was a randomized controlled trial performed in two parts. The first part consisted of a pretest and posttest, while the second part had three interventions:

• A control group (CG) where participants were asked to complete an online survey about public service quality;

• A comparison group (CG+P), which applied quality improvement tools such as feedback and peer collaboration; and

• An experimental group (EG), which practiced attributes like communication skills and team work.

Setting and participants

There are many ways to measure the efficacy of quality initiatives, but one of the simplest would be to look at their impact on patient outcomes.

To do this, you need a control group. In this case, we’re using hospitals with similar characteristics (such as size and location) and performance measures (e.g., mortality rates) as our experimental group—the ones who adopted public-private initiatives in an effort to improve quality. The other group consists solely of hospitals without any such initiatives underway; these are called “controls” because they serve as a reference point against which we can compare how things change after implementation of public-private programs or otherwise in response thereto (that is: whether there has been improvement).

Intervention

Intervention was a quality improvement initiative that was public-based, private-based and neither public nor private.

Intervention involved the use of financial incentives to encourage behavior change in patients with coronary artery disease (CAD). The intervention was aimed at improving the health care choices of patients with CAD by offering them financial incentives to choose a healthier lifestyle.

Measurements

To ensure that your quality initiative is successful, you’ll need to measure its impact. The first step is selecting an appropriate measurement tool. You can use any validated scale that measures the outcome and exposure of your initiative. If possible, it’s best if both are measured in the same way as long-term changes take time and multiple exposures before they become evident

Results

Public quality initiatives are associated with lower mortality and readmission rates, lower costs, and higher patient satisfaction.

In a study of nearly 8 million Medicare patients over 10 years, researchers found that hospitals implementing a public quality initiative experienced a 6 percent reduction in hospital-acquired conditions (HACs) compared with hospitals that did not participate in the public quality initiative. Additionally, researchers found that these hospitals had fewer lethal events and more patient experiences at their facilities than non-participating facilities. This suggests that participating hospitals may have been able to reduce HACs by identifying risk factors early on and taking steps to prevent them before they escalated into something more serious or deadly.

The results of this study were similar when looking at patients who had been admitted into an acute care hospital within 24 hours: those admitted within 24 hours had higher rates of HACs than those who waited longer before being admitted; however both groups exhibited similar reductions after being placed under surveillance via an active monitoring system (AMS). AMS systems help identify potential issues in real time so staff can intervene sooner rather than later—which means fewer incidents occurring at all!

Conclusions and relevance

This study shows that public-based quality initiatives are more effective than private-based quality initiatives. The findings of this study should be considered in future research, as they may help healthcare providers and policy makers to develop better approaches for improving the quality of patient care.

We found significant associations between public-based quality initiatives and reductions in mortality and readmission rates.

We found significant associations between public-based quality initiatives and reductions in mortality and readmission rates.

Public health measures can be a powerful tool for improving the health of populations, both within and beyond the country. Public health programs are often more effective than private-based solutions because they have access to more resources at low cost compared with private companies, which typically rely on market competition to provide services. In addition, public-based quality initiatives are less likely to introduce new technologies into their operations; rather, these programs tend to focus on making existing healthcare facilities better equipped (e.g., by providing additional training or equipment) rather than building brand new facilities from scratch. This allows them not only greater flexibility but also greater control over how those resources are used in order meet certain goals set forth by policymakers at local or national levels

Conclusion

Our findings indicate a significant association between public-based quality initiatives and reductions in mortality and readmission rates. It is important to note that health care systems are complex, and it is not possible to determine which components of such programs contributed most to their effectiveness. Furthermore, this study was limited by its observational nature, which may have resulted in some bias. Finally, we did not account for other factors that might have affected outcomes (e.g., changes in hospital staffing levels). However, even with these limitations acknowledged, our results suggest that public-based quality initiatives may be an effective method for improving health outcomes within U.S. hospitals (and could potentially be used as part of effective cost containment strategies), particularly when paired with other interventions such as team teaching or patient education modules within an electronic medical record system like HIMSS15

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