NUR 630 WEEK 5: Outcome and Process Measures

NUR 630 WEEK 5: Outcome and Process Measures

Assessment Description

In a 1,250-1,350-word paper, consider the outcome and process measures that can be used for CQI. Include the following in your essay:

1. At least two process measures that can be used for CQI.
2. At least one outcome measure that can be used for CQI.
3. A description of why each measure was chosen.
4. An explanation of how data would be collected for each (how each will be measured).
5. An explanation of how success would be determined.
6. One or two data-driven, cost-effective solutions to this challenge.

Use a minimum of five peer-reviewed scholarly references as evidence.

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Sample Research Paper : Outcome and Process Measures

Health care organizations set different goals as they strive to achieve internal and external performance benchmarks. Among many targets, health care facilities prioritize the quality of care and develop different mechanisms to provide top-quality services. Aase et al. (2021) conceptualized care quality as the degree to which health care services achieve the desired outcomes. Improving care quality helps health care facilities to provide reliable, cost-effective, and sustainable services. To achieve the set goals, health care facilities should measure care quality and improve it using evidence-based strategies. The purpose of this paper is to describe the process and outcome measures for continuous quality improvement (CQI), rationale, data collection, and how to determine success.

Process Measures for CQI

 

Health care facilities engage in different activities to improve patients’ and populations’ health. Process measures represent health care providers’ initiatives to maintain or improve health (Akmaz et al., 2021). The initiatives could primarily focus on patients, healthy people, or both. Process measures can also be described as the actionable items that offer feedback about the required quality improvement activities for improving patient outcomes (Akmaz et al., 2021). One of the process measures that can be used for CQI is the percentage of people being screened for cancer in a health care facility monthly. The other suitable process measure is the percentage of people receiving education for lifestyle diseases. Such diseases include obesity, diabetes, and hypertension. Education can focus on healthy eating, sedentary lifestyles, and risky behaviors.

Outcome Measures for CQI

Outcome measures indicate the result of an activity. They are the effects of processes used in improving the care quality. According to Kampstra et al. (2018), outcome measures reflect the effects of health care services and related interventions on the patients’ health status. Such health care services and interventions include improved hand hygiene, adopting case management for patients with chronic conditions, and remote patient care for COVID-19 patients. An effective outcome measure for CQI is the rate of falls in an emergency department (ED) after adopting the fall Tailoring Interventions for Patient Safety (TIPS) toolkit.

A Description of Why Each Measure was Chosen

CQI involves providers’ relentless efforts to ensure that the care quality matches patient needs. Health care organizations committed to quality improvement evaluate performance gaps regularly and develop mechanisms to enhance care quality. Typical activities include improving the care environment, embracing current technologies to reduce waiting time, remote care, and training health care professionals to enable them to provide care that meets current demands. The measures were chosen since they present problem areas affecting patient care adversely. Addressing each problem through a quality improvement initiative offers an excellent opportunity for care quality improvement in a health care setting. The measures also allow health care providers to promote patient-centered and data-driven practices.

Health care organizations should intensify efforts to reduce hospital visits, health complications, and injuries, among other issues challenging health care. The primary reason for choosing the percentage of people undergoing cancer screening per month is to determine an organization’s efforts to minimize cancer’s menace and engage in preventive health. As a quality improvement intervention, cancer screening reduces the number of people developing the disease and cancer-related deaths (Meza et al., 2021)). The Centers for Disease Control and Prevention (CDC) reported that cancer is the leading cause of death after heart disease in the United States, and 602,350 cancer deaths occurred in 2020 (CDC, 2022). The high number of infections and costly drugs make cancer management challenging, necessitating early interventions. As a result, screening should be intensified as time advances.

The other process measure is the percentage of people that a health care facility assists with education for lifestyle diseases. Like cancer screening, the evaluation of education programs can be conducted monthly to assess a facility’s efforts in preventing lifestyle diseases. In the current health practice, lifestyle diseases increase patient visits to health care facilities, which increases workload and disease management costs. A high workload causes burnout among health care professionals. The CDC (2022) reported that medical cost associated with diagnosed diabetes and obesity is $327 billion and $173 billion annually. As quality improvement initiatives, health education programs in health care facilities and communities can help people make more informed decisions regarding food choices, physical activity, stress, alcoholism, and other lifestyle elements.

Regarding outcome measures, the emergency department should record the least falls possible. Health care facilities use the TIPS toolkit to reduce inpatient falls and fall-related injuries through a patient-centered, engaging process (Dykes et al., 2020; Duckworth et al., 2019). Evaluating the change in the rates of patient falls after adopting the toolkit can effectively indicate whether the toolkit achieved the desired outcomes. In the current practice, patient falls increase injuries and readmissions and are a common cause of traumatic brain injuries (CDC, 2021). Reducing patient leads to a significant decline in fall-related problems and overall health costs. Assessing the reduction in falls can indicate the effectiveness of the TIPS toolkit as a quality improvement intervention or whether a different quality improvement program is required in the ED.

 

Data Collection for Each Measure

Data helps health care providers to make accurate decisions. As a result, it is crucial to collect plenty of quantitative and qualitative data for each measure. Regarding process measures, the percentage of patients being screened for cancer can be obtained from a care facility’s medical records. Monthly data can be processed and analyzed to determine the facility’s intensification of cancer prevention efforts over a particular period. The percentage of people receiving health education for lifestyle diseases can also be recorded in medical records. A comparative analysis of monthly performance against the national benchmark can effectively indicate whether the current interventions are a success or improvements are necessary. Regarding the outcomes of the fall prevention TIPS toolkit, the most effective way to collect data is to record daily patient falls before and after adopting the fall prevention toolkit.

Determining Success

Success would be effectively determined by tracking improvements over time. A comparative analysis of data over a particular period can accurately demonstrate whether there is a significant change in care quality. A suitable example of the process measures is a numerical comparison of the percentage of patients screened for cancer or receiving education for lifestyle diseases at the beginning and the end of the year. Here, the assumption is that screening and educating more people would lead to healthy choices and adoption of preventive health measures and reduce possible infections and the number of patients visiting a health care facility. A quantitative analysis of the outcomes data can effectively determine success for outcome measures. For instance, a statistically significant reduction in the number of falls after adopting the fall prevention TIPS toolkit would accurately indicate a successful intervention.

 

Data-Driven, Cost-Effective Solutions

CQI is challenging, particularly where health care organizations lack resources, effective leadership, or a progressive culture. Data collection, measurement, and analysis are also common challenges hampering quality improvement. One of the possible solutions is to select a health care team to be primarily involved in quality improvement. The team would collect and analyze data continuously to ensure that areas requiring improvement are explicit. Doing so will guide organizations in committing resources to process and outcome measures where change is critical. The other solution is integrating technology or a data expert in data collection. It would be a perfect way of enhancing accuracy so that organizations’ staff and leaders can make accurate decisions.

Conclusion

Quality care should be a right for every patient. Due to the inevitable gaps between the offered and desired care quality, health care organizations should be continuously involved in care improvement initiatives. As discussed in this paper, process and outcome measures for CQI represent the priority areas with far-reaching consequences on patients’ health. Process measures involve what an organization does to achieve excellent health outcomes, while outcome measures involve the effects of interventions. In each case, providers should collect accurate and adequate data for them to make informed decisions.

 

 

References

Aase, I., Ree, E., Johannessen, T., Strømme, T., Ullebust, B., Holen-Rabbersvik, E., … & Wiig, S. (2021). Talking about quality: How ‘quality’is conceptualized in nursing homes and homecare. BMC Health Services Research, 21(1), 1-12. https://doi.org/10.1186/s12913-021-06104-0

Akmaz, B., Zipfel, N., Bal, R. A., Rensing, B. J., Daeter, E. J., & van der Nat, P. B. (2019). Developing process measures in value-based healthcare: The case of aortic valve disease. BMJ Open Quality, 8(4), e000716. http://dx.doi.org/10.1136/bmjoq-2019-000716

CDC. (2021). Facts about falls. https://www.cdc.gov/falls/facts.html

CDC. (2022). An update on cancer deaths in the United States. https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm#:~:text=Cancer%20was%20the%20second%20leading,females%20and%20317%2C731%20among%20males.

CDC. (2022). Health and economic costs of chronic diseases. https://www.cdc.gov/chronicdisease/about/costs/index.htm#:~:text=Nothing%20kills%20more%20Americans%20than,lost%20productivity%20on%20the%20job.

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: A nonrandomized controlled trial. JAMA Network Open, 3(11), e2025889-e2025889. https://doi.org/10.1001%2Fjamanetworkopen.2020.25889

Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: An implementation science study. Journal of Medical Internet Research, 21(1), e10008. https://doi.org/10.2196/10008

Kampstra, N. A., Zipfel, N., van der Nat, P. B., Westert, G. P., van der Wees, P. J., & Groenewoud, A. S. (2018). Health outcomes measurement and organizational readiness support quality improvement: A systematic review. BMC Health Services Research, 18(1), 1-14. https://doi.org/10.1186/s12913-018-3828-9

Meza, R., Jeon, J., Toumazis, I., Ten Haaf, K., Cao, P., Bastani, M., … & Kong, C. Y. (2021). Evaluation of the benefits and harms of lung cancer screening with low-dose computed tomography: modeling study for the US Preventive Services Task Force. Jama, 325(10), 988-997. doi:10.1001/jama.2021.1077