Health Care Quality Measures (Nursing)

00:00 Welcome back, everyone.

00:02 In order to ensure a health care organization is operating in a manner consistent with providing optimal outcomes, the organization must use quality measures.

00:12 Quality measurement in health care is the process of using data to evaluate the performance of health plans and health care providers against recognized quality standards.

00:23 Use of quality measures prevents the overuse, underuse, and misuse of health care services.

00:29 It identifies what works in health care and what doesn't to drive improvement.

00:34 It holds health insurance plans and health care providers accountable for providing high quality care.

00:40 It measures and addresses disparities in how care is delivered and in health outcomes.

00:45 And finally, it helps consumers make informed choices about their care.

00:49 Now there are different types of quality measures.

00:51 There are structure measures, process measures, outcomes measures, and patient experience measures.

00:59 Let's go into each one.

01:01 Structure measures evaluate the infrastructure of health care settings, such as hospitals or doctors offices, and whether those health care settings are able to deliver care.

01:11 Structure measures include: staffing of facilities, capabilities of the staff, policy environment in which the care is being delivered, an availability of resources within an institution.

01:25 Examples of structural measures include: Does a hospital have a hand hygiene protocol in place? Does a physician's office use computerized order entry prescriptions? Process measures are used to determine the extent to which providers consistently give patients specific services that are consistent with recommended guidelines for care.

01:47 Process measures are linked to procedures or treatments that are known to improve health status or prevent future complications or health conditions.

01:57 Examples of process measures include: Are nurse practitioners routinely examining the feet of diabetic patients to check for wounds? Are physicians prescribing the appropriate drugs to their diabetic patients? Outcome measures evaluate patient's health as a result of the care they've received.

02:15 Outcome measures look at the effects, either intended or unintended, that care has had on a patient's health, health status, and function.

02:24 It also assesses whether or not the goals of care have been accomplished.

02:29 Some examples of outcome measures: What was the amputation rate for patients with diabetes? What percentage of cancer patients went into remission? What was the quality of pain relief for patients who had knee surgery? Patient experience measures provide feedback on patients' experiences of their care, including the interpersonal aspects of care.

02:50 But these measures assess many other aspects of care ranging from the clarity and accessibility of information that doctors provide, to whether doctors tell patients about test results and how quickly patients are able to get appointments for urgently needed care.

03:06 Some examples of patient experience measures include: How long did patients have to wait before being seen? Did a physician give easy-to-understand information to his patients that address their health questions or concerns? Did someone from the provider's office follow up regarding the results of a blood test, X-ray, or other lab work? So who develops quality measures? First, government agencies, such as the Center for Medicare and Medicaid Services, also the Agency for Healthcare Research and Quality.

03:37 Also, private nonprofits, such as Joint Commission on Accreditation of Health Care Organizations and National Committee for Quality Assurance.

03:45 And finally, for-profit companies, such as Healthgrades or the U.S. News & World Report.

03:51 Where did data on health care quality come from? Some common sources of the data that are currently used to track quality measures include: administrative data, disease registries, medical records, and qualitative data.

04:06 So how do we use quality measures? Currently, the most common uses of quality measurements include: public reporting, provider incentive programs, accreditation and/or certification of providers and health plans.

04:21 Remember, the process of developing meaningful quality measures and putting them into use is ongoing and will be refined over time.

04:30 But as we collect and evaluate more data on quality, we'll be closer to ensuring that every patient gets the right care at the right time the first time.

04:39 So when thinking about everything we've covered today, I'd like for you to consider this question.

04:43 What are five ways quality measures help improve health care? It prevents the overuse, underuse, and misuse of health care services.

04:58 It identifies what works in health care and what doesn't to drive improvement.

05:03 It holds health insurance plans and health care providers accountable for providing high quality care.

05:09 It measures and addresses disparities in how care is delivered and in health outcomes.

05:14 And it helps consumers make informed choices about their care.

05:18 I hope you've enjoyed today's video on Quality Measures.

05:20 Thanks so much for watching.