Healthcare is an imperative issue for the community, both economically and socially. It is a fundamental aspect for the well-being and prosperity of society. As such, effective health should not only be perceived based on the nonexistence of ailments but also as a preventative measure. However, healthcare is affected by various factors including novel technology, advancements in medication, and expectations of the society. Therefore, there is a need to put into place policies and performance strategies that will ensure that the services delivered to the clients are of high quality. That is, organizations should implement measures that guarantee that the services provided will deliver positive outcomes and not aggravate the problems. As mentioned in chapter 9, the concept of performance-driven planning is of great significance in guaranteeing quality in medical care. As mentioned, the current challenges in the healthcare setup can determine the success and failure of the organization. Therefore, it is important for the management to implement structures that can override such challenges.
Healthcare organizations have developed and implemented numerous models purposed to intellectualize quality in healthcare. The intention is to ascertain that the level of quality offered is beyond a reasonable doubt. For example, in one of the models proposed by Avedis Donabedian, the focus of the framework is to enhance the access and experience of the patients in healthcare. The model emphasizes three key aspects that determine the level of medical services offered to the patient. The first element that Avedis emphasizes is accessibility. According to Avedis, patients should be able to access healthcare services without encountering any form of barriers. The other aspect is the structure, which according to Avedis should entail the characteristics and attributes that the healthcare organization should exhibit. Moreover, the structure should also take into account the potentials of the hospital personnel. The staff should be competent, licensed, and with relevant credentials and conversant with the current technology. The last aspect that plays a pivotal role in ensuring the delivery of quality services is the process. In this respect, the process entails the practices that have put in place to ensure the effective delivery of care services. It is necessary for a healthcare facility to establish or rather implement protocols that serve as guidance in the provision of care.
The other fundamental aspect as explained by Britton (2015) is reimbursement whose purpose is to ensure that the organization operates seamlessly. Although healthcare organizations are usually classified as not-for-profit, they require revenue to run various activities including the acquisition of prescriptions and other indispensable expenses, such as salaries and wages for the hospital personnel. Reimbursement for healthcare has deployed several payment frameworks with different levels of efficiency. Irrespective of whether the frameworks utilized by the healthcare are applied singularly or in combination with others, it is important for them to offer reimbursement based on quantity, intricacy, and quality of care offered. The Medicare Program is one of the reimbursement agencies that have proven effective throughout. However, in most cases, only a small proportion of hospitals are capable of providing quality care to patients despite having the best reimbursement mechanisms, effective protocols, and competent personnel among other core aspects. In such cases, the electronic medical record (EMR) comes in handy to monitor the care services, patient responsiveness, and operations of the healthcare facility. As explained by Britton (2015) the EMR has the potential of improving the accuracy and efficiency of reimbursement systems, as well as promote the quality of medical care.
Britton, J.R. (2015). Healthcare Reimbursement and Quality Improvement: Integration Using the Electronic Medical Record. Int J Health Policy Manag4 (8), 549–551
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