A Rising Consensus that Safety and Quality Failures in Healthcare

A Rising Consensus that Safety and Quality Failures in Healthcare
Background Information
There is a rising consensus that safety and quality failures in healthcare organizations are increasingly attributed to processes and systems rather than human errors. In order to address this issue, healthcare administrators should apply process-oriented and quality improvement management interventions (Antonacci et al., 2021). This paper evaluates the University of Maryland Medical System (UMMS) health care delivery framework, use of health information technologies, management of operations, quality assurance, as well as accreditation competencies. In addition, the report includes recommendations for healthcare practice to improve healthcare delivery processes and quality outcomes.
Health Care Delivery and Models
The UMMS is an Accountable Care Organization (ACO) committed to providing high-quality, cost-effective, and coordinated care (Health.Maryland.gov, n.d.). According to Barath et al. (2020), an ACO is a community-centered care reimbursement and delivery framework where sets of health care facilities, physicians, and other medical providers freely integrate efforts to offer high-quality care to a pre-specified population and are jointly fiscally responsible for care quality and associated costs. The rationale for the categorization is that the health care organization comprises their employed doctor groups, as well as independent doctor groups and practices within its service area, a 14-county adjoining area within Maryland touching the Chesapeake Bay, surrounding the Baltimore metropolitan (Health.Maryland.gov, n.d.).
As an ACO, UMMS should provide inpatient, outpatient, and ancillary services to the Baltimore population. Inpatient care services will include complex surgeries and other routine ones, serious medical issues or illnesses that require significant monitoring, childbirth, and rehabilitation services for substance misuse, psychiatric illnesses, or serious injuries. Outpatient care services that will be provided include but are not limited to CT scans, MRIs, X-rays, and other imaging types; lab tests (bloodwork), colonoscopies, minor surgeries, mammograms, radiation treatment or chemotherapy, routine physical examinations, and follow-up services or consultations (St. George’s University, 2021). The organization’s ancillary services include but are not limited to cardiac monitoring, hearing, audiology, ambulance services, behavioral health, dialysis, and ambulatory surgery center services. E-health services include mobile apps and texts to support chronic care and behavioral change, telemedicine, patient data entry, logging, tracking, and retrieval services (Bauer, 2018).
Figure 1: A map detailing UMMS delivery of care (services).
The process map above details health care delivery from patient interaction with the health care system to service delivery. Once the patient enters the healthcare organization, patient-physician exchanges and consultations based on electronic medical records (EMR) system are necessary for optimal service delivery (McLaughlin & Olson, 2017a). Patient confidentiality and security are important transports within the healthcare delivery process (Kruse et al., 2017).
Information Systems
The UMMS uses the Epic electronic medical record (EMR) system to monitor patient information. The Epic EMR will contain records and data collected by health care professionals in the hospital to diagnose and treat patients (Davis & Khansa, 2016). The information would be stored in the cloud. Epic is a cloud-based EMR built for healthcare organizations with the ability to handle routine practice operations, including patient health records. Information management strategies include capturing, organizing, maintaining, and retrieving patients’ health records (Davis & Khansa, 2016).
Some of the standards used by the health system include the Healthcare Insurance Portability and Accountability Act (HIPAA). More specifically, the information system will be anchored on HIPAA privacy and security standards for the patient’s EMR (Kruse et al., 2017). The policies include rules of engagement anchored on defining and executing nationwide trusted information sharing that fosters prudent governing practices across and within communities. The policy framework will consist of trust, business, technical, and organizational principles (Healthit.gov, n.d.). The critical security measures are outlined in the HIPAA and include physical, technical, and administrative safeguards. The above measures range from techniques concerning computer location to the utilization of firewall software to safeguard medical information for different stakeholders within the health system (Kruse et al., 2017). UMMS will promote interoperability by using Epic to share information required to support patient care. The organization will also use EpicCare Link to access the patient’s records in other facilities using Epic. Another approach entails seeking partnerships with other facilities to promote Epic system use and thus enjoy EMR benefits (Epic, n.d.).
Operations Management
Figure 2: Simple care delivery process map.
The process map depicts a high-level overview of patient flow across and through the care continuum, offering the basis to delineate partner roles and impact on outcomes (value generated) within the care pathway. It is an avenue to capture types of health care providers, and their interactions as clients move through their care from referral to acute care and need stabilization of a particular clinical pathway (Roy, n.d.).
Figure 3: Patient-centered care process map.
The patient-centered care process map can help health care professionals solve care quality issues and make effective decisions on the steps to take in delivering care that considers the client’s needs, preferences, and expectations. The humanizing process follows patient-centered care steps leading to organizational care quality improvement (Cheraghi et al., 2017).
Figure 4: Process map reflecting inputs, outputs, and process steps to reduce waiting time.
McLaughlin and Olson (2017b) state that a level 4 organization engages in multiple process improvement programs. In this context, the UMMS would need to implement Lean and Six Sigma tools as part of process improvement efforts. Lean is selected because it contributes to value creation and mitigates staff and patients’ burdens experienced every day (McLaughlin & Olson, 2017b). It is crucial in sustaining high satisfaction levels, morale, safety, and quality. With the rising financial constraints in the health care system, UMMS should use Six Sigma to augment efficiency and improve or maintain outcomes (Hernández-Lara et al., 2021).
Quality Assurance and Accreditation
Each health care system domain (safe, patient-centered, timely, equitable, efficient, and effective) could substantially impact the care quality of health care professionals. By comprehending the respective domains and their significance, healthcare providers could enhance care quality across the six domains. Regarding safety, UMMS providers should take all necessary steps to safeguard their clients from injuries, including medical harm and mistakes. UMMS delivers effective services to enhance safety and offer the desired benefits to clients. The organization provides equitable health care to ensure no population group is discriminated against or preferred in care delivery to another. The healthcare organization delivers patient-centered care by maintaining an approach and philosophy to healthcare delivery that emphasizes the value of patients’ perspectives. In order to enhance efficiency, the health care organization uses its resources well to generate optimal output. Lastly, the UMMS delivers medical services on schedule to keep patients safe wh...