The role that the health care worker have in determining quality care is very important in not only a hospital setting but in any health care setting. A physician may make assessments and diagnosis, but the nurse, physician’s assistant, or other health care worker is the one who is able to closely monitor and observe treatments given, as well as note the patient’s response to changes in medicines, therapy routines, and dietary restrictions. A healthcare worker’s duty is to allow a patient to have quality care and to be able to live.
Measuring the quality of hospital care is a thorny business. Health care is complex, and links between clinical practice and patient outcomes are often tenuous and distant. These types of challenges have not prevented the pursuit of simple indicators that identify the good and the bad hospitals. The measurements should identify hospitals where more patients die than would be expected on the basis of their cases, the hospital with fewer deaths than expected are the good hospitals.
Most hospitals now report process measures as a requirement for full Medicare payments, these measurements are based on compliance with well established processes of care. The two companies that do these measurements are Hospital Quality Alliance (HQA) and Joint Commission on Accreditation of Healthcare Organizations (JACHO. ) Since 2004, nearly all acute care hospitals have participated in one of these two measurement companies.
Hospital Quality Alliance and Joint Commission on Accreditation of Healthcare Organizations are a public-private partnership that encourages collection and reporting of data on quality of care. The Centers for Medicare and Medicaid Services (CMS) now links participation in these programs to yearly Medicare payments increases, providing a financial incentive for hospitals that report data. One way that hospital performance measures might lead to improvements in health care quality is if patients and referring physicians use them to choose higher-quality hospitals.
Another way that performance measures could lead to improved quality is if providers use them to improve their practices and adhere more closely to the standards of care. JCAHO responds to a voluntary request by the healthcare provider, uses established measures and indicators to evaluate quality of care, interprets the results of this evaluation process and uses this information to deny or approve the accreditation of the organization.
JCAHO acts as a third party in this capacity, using healthcare professionals as site surveyors to evaluate the provision of healthcare in a particular set of circumstances. For example, a home-health care provider delivers care in a different setting than where the patient records are housed. This evaluation of care is via standards developed by a scientifically based research method that includes: a complete review of the literature, involvement in the process by subject experts, consideration of patient needs as reflected by public opinion and a consensus of what care is optimally achievable.