Refer back to the structure-process-outcome (S-P-O) model discussed in Week 1. In addition, refer to the text reading pertaining to the quality management system (QMS) a

  The concept of 'Quality', as defined by the S-P-O model, states the three prime features, which include the structure, the process, and the outcomes. The component 'structure' defines the system or resources that are required by the healthcare units for the treatment of patients. It also includes the fulfillment of the needs of the department by providing the tools and other appliances that would be beneficial in treating and caring the patients more appropriately. In addition, the second component, i.e. 'the process', refers to the way the equipment and other resources have been used in the treatment of patients. The structure of the healthcare departments is designed to ensure the availability of resources for the patients, whereas the process of the S-P-O model ensures that patients are treated well by utilization of the resources. Moreover, the outcomes define how well the patient is treated. The effects of the treatment on the patient will depict the whole system of the healthcare department. The S-P-O model states that a well-defined and organized structure of the department leads towards a well-organized process, and this process leads towards the desired and positive outcomes. Therefore, all the components of quality are dependent on each other to treat a patient more effectively.

        A well-organized and well-defined structure is important in creating an effective and efficient process. The structure includes the allocation of the resources that would be beneficial and effectively used in the process of treating the patients. For healthcare professionals, using the (Structure Process Outcome) S-P-O model is one of the most effective methods. It enables people to assess the caliber of services given efficiently. The S-P-O paradigm requires evidence-based medicine as one of its key components. By utilizing the evidence, it improves the result. The model's applied strategies are closely related to the patient's state of health. It is a method focused on people. Its success is predicated on how a certain process turns out. Employing this strategy may require financial sacrifices from medical facilities. By implementing the ideas that the model suggests, the same institutions can also save a considerable amount of money. A lot of people struggle to pay for quality medical treatment. The concept guarantees fair treatment for all involved parties. The strategy works well because it suggests receiving quality medical treatment regardless of a person's financial situation. Additionally, the paradigm promotes individual accountability.

        Generally speaking, the objective of EBM has been to raise quality by standardizing medical care. In fact, clinical guidelines, protocols, or best practices have been the usual means by which EBM has been applied; these methods serve to standardize rather than individualize patient care. However, efforts have lately been made to include personal preferences and conditions in EBM decision protocols. A medical practice that uses evidence-based medicine (EBM) should ideally enable the integration of individual clinical experience with the best available data from population-based research, according to some pioneers in the field. It has five several advantages stated below:

1. It gives clinicians access to the objective experience of numerous researchers using recognized scientific standards.

2. It increases provider efficacy and efficiency

3. It reduces the use of ineffective clinical practices

4. It promises to improve patient and clinician education about clinical practices by providing publicly available, consensus-based information about treatment options

5. It offers a scientific foundation for the development of health care policy.

For example, the clinicians at Johns Hopkins Hospital rely heavily on the computerized dashboards. These gadgets are a dependable source of pertinent personal data that aids in giving  patients better healthcare services. S-P-O-based information technology enable physicians to make timely, well-informed decisions. 

References:

Moore, L., Lavoie, A., Bourgeois, G., & Lapointe, J. (2015). Donabedian’s structure-process-outcome quality of care model: Validation in an integrated trauma system.  Journal of Trauma and Acute Care Surgery,  78(6), 1168. https://doi.org/10.1097/TA.00000000h00000663

Romana, H.-W. (2006). Is Evidence-Based Medicine Patient-Centered, and Is Patient-Centered Care Evidence-Based?  Health Services Research,  41(1), 1–8. https://doi.org/10.1111/j.1475-6773.2006.00504.x

Analayze and evaluate how quality is defined, measured, and reported with regards to the S-P-O model.

A framework that is created and also compiled based solely on the work of Avedis Donabedian that measures the quality of healthcare is called an S-P-O model.  Through structure, process, and outcome, an S-P-O model can compare and assess healthcare facilities and their quality of healthcare.

The “S” part of the model is the structure part.  It “gives consumers a sense of health care provider’s capacity, systems, and process to provide high-quality care” ( Types of Health Care Quality Measures, n.d.). Basically, it provides the factors of healthcare.  When the structure part of the model is factored in, it gives the aspects of healthcare that pertain to things like the ratio-to-patients or even when the healthcare facility uses its digital medical records.  The structure part of the S-P-O model is very beneficial in determining whether healthcare is good.

The next part of the model is the “P” part which stands for process.  The process of the S-P-O model is where the actions become part of healthcare.  The process part measures “what a provider does to maintain or improve health, either for healthy people or for the diagnosed with a health care condition” ( Types of Health Care Quality Measures, n.d.).  Part of the process is collecting percentages of patients taking preventive measures by getting flu immunizations or a mammogram to prevent breast cancer.  Another example of a process could be the percentage of patients that have already been diagnosed with such diabetes and get their blood sugar tested regularly so they may keep it controlled. So, the process part of the model can become very educational and keep patients informed about the medical care they could expect for the outcome of their health.

The “O” part of the model is the outcome part.  The outcome measures “the impact of the healthcare service or intervention on the health status of patients” ( Types of Health Care Quality Measures, n.d.).  When it comes to the outcome, it provides the effects of the health care provided.  Therefore, the outcome can be the percentages of mortality rates from previous surgeries, the adverse effects from drugs, the percentage of availability of appointments, etc.

What structural characteristics of the S-P-O model do you think are necessary in creating an effective and efficient process? Why?

First off, the structural characteristics are of the model itself where it begins with structure and ends with outcome.  The structures were the physical as well as the healthcare facilities characteristics within the healthcare field.  As soon as the structure is figured out they move on to the next, which is the process.  The process is where it can focus on the care given to the patient such as giving them treatments or diagnosing them. The last step would be where the outcomes come in.  The outcome can range from the patient dying from a complication of surgery to putting a patient on a no-sugar diet so that they may lower their A1-C for their diabetes.  Another major structural characteristic is making sure there is enough staff to cover patients like doctors, physician assistants, nurses, office aids, etc.

Does evidence-based medicine play a role in the S-P-O model and quality outcomes of care?  Justify using examples.

I would say most definitely simply because evidence-based medicine plays such a huge role in the S-P-O model. Let’s say that a patient went in for really high blood sugar and was diagnosed with Type 2 Diabetes.  For the patient to lower their blood sugar, they definitely need to get it under control.  To do so, they need insulin, which is a medicine used to lower blood sugar.  If they do not use it, they could possibly die. If we were to conduct surveys and interviews with our patients, we could establish that approximately 61% of patients who come in their doors do in fact have either Type 1 or Type 2 diabetes.  So, to keep insulin in stock and prove that insulin does help lower blood sugar levels, it can then base the evidence that it does indeed work and so therefore keeping insulin on hand is a good thing.

References

Centers for Medicare & Medicaid. (2018). Measure management & you. In  Centers for Medicare & Medicaid.  Retrieved from   https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Downloads/Structural-Measures.pdf

How to improve: Model for improvement: Establishing measures. (n.d.). Institute for Healthcare Improvement. Retrieved from  https://www.ihi.org/resources/how-to-improve/model-for-improvement-establishing-measures#:~:text=The%20three%20types%20of%20measures,%2C%20process%2C%20and%20balancing%20measures.

Measure Development Theory | The Measures Management System. (2022, December 1). Retrieved from  https://mmshub.cms.gov/about-quality/quality-at-CMS/theory

Types of health care quality measures. (n.d.). Agency for Healthcare Research and Quality. Retrieved from  https://www.ahrq.gov/talkingquality/measures/types.html

Types of measures | The Measures Management System. (2023, October 1). Retrieved from  https://mmshub.cms.gov/about-quality/new-to-measures/types

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