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Quality measures
in healthcare

Author: Mark Stone

The healthcare industry is making a noticeable push toward better quality healthcare and improvements to aged systems and out-of-date methods.

Hospitals of all sizes are working on improving quality measures in healthcare—striving for more cost-efficient, optimized, sustainable and reliable care. These quality measures span a range of categories and are important for numerous reasons.

What are quality measures in healthcare?

According to CMS, Quality measures are standards for measuring the performance of healthcare providers in providing care for patients and populations.  For hospitals, the incentives to prioritize quality measures are significant. For example, preventing avoidable readmissions has the potential to profoundly improve both the quality of life for patients and the financial well-being of health care systems.  Quality measures in healthcare involve taking established quality standards from governments and non-government organizations, and assessing hospitals in a diverse set of criteria based on those standards.  With the right tools and solutions, healthcare institutions can significantly improve their performance across all areas.  

What are the different types of quality measures in healthcare?

According to the Agency for Healthcare Research and Quality (AHRQ), hospitals measure quality across three main categories: structure, process and outcome.

1. Structure

Structural measures assess the hospital's ability to do its job and provide basic services and care. Capacity, current systems, staff quality and patient-to-staff ratio are all examples of quality measures in healthcare in this category. For instance, does the hospital use electronic records or still rely on paper records? The structure is the foundation and framework for everything the hospital does.

2. Process

Process measures refer to the actions hospitals take to improve care quality. Some processes that hospitals measure include the scope and effectiveness of preventative care, the quality of care for existing patients and the ability to meet standards of practice.

While structure refers to the tools and resources available to hospitals, process is all about how well they use those resources to do the best job possible.

3. Outcome

Finally, outcome measures assess the effectiveness of structure and process. Essentially, these demonstrate the impact of the hospital's patient interventions and the extent to which patients' health improved. To measure outcome, metrics can include surgical mortality, patient readmission, the frequency and severity of surgical complications and the likelihood of patients acquiring new infections while in the hospital.

Examples of quality measures in healthcare

It is critical for hospitals to pay attention to quality measures and take proactive steps to assess their performance in these three aforementioned areas.

Key potential advantages of deploying quality measures in healthcare include:

  • Keeping patients safe and ensuring everyone receives the optimal level of care and the best possible chance of a successful outcome
  • Holding healthcare providers and insurers to higher standards, quickly identifying any areas of concern and preventing issues from going unnoticed
  • Driving improvement by locating problem areas and providing clear direction on where and how to make positive changes
  • Seeing the bigger picture, gaining visibility into inequalities and differences between various healthcare providers in different parts of the country
  • Using budgets more efficiently by identifying and eliminating unnecessary processes and avoiding expensive mistakes

These examples of quality measures in healthcare can also help avoid waste of medical equipment supplies, time and energy, and can help medical institutions to achieve greater efficiency, reduce healthcare costs and ensure high-quality patient outcomes.

How technology—and Verizon—can help improve quality in healthcare

Verizon helped one company keep up with a 200% boost in business and to be ready for new Affordable Care Act mandates while successfully scaling their organization.  Examples of improved quality measures in healthcare included how they helped to implement streamlined customer communications with a Virtual Contact Center (VCC), automatically adjusted call routing to agents across locations and integrated click-to-chat and email solutions.  As a result, the company significantly expedited customer service and reduced wait times as capacity increased. Additionally, the company increased the ability to control costs by using existing PBX equipment and implementing IP for inbound calls. Agents productivity increased with an automatic call routing solution.

By leveraging technology strategically, hospitals can provide higher quality care as they grow in size and in patient numbers.

Learn more here about how Verizon can drive better patient experience at the digital front door to support quality care outcomes.