High-quality care is safe, effective, patient-centered, timely, and efficient. Unfortunately, the healthcare system doesn’t always provide these services well.
For example, many payers (like Medicare) rate hospitals on quality using measures that are hard to understand for consumers. And the fee-for-service model can create incentives for providers to order unnecessary tests and procedures.
Patient-Centered Care
Patient-centered care, or person-centered healthcare, aims to make patients active partners in their own health. It involves doctors, nurses and other staff putting patients first by listening to their needs and concerns and respecting them. It also means engaging with them to identify and respond to any gaps in care, whether those are for routine maintenance or meeting quality standards that affect billing.
A person-centered approach to healthcare has many benefits, including improved satisfaction and higher engagement levels. It also reduces medical costs. As a result, it’s a crucial part of value-based care models. However, it can be difficult to implement in practice. One of the biggest challenges is changing from a fee-for-service model to a patient-centered care model.
This shift requires a change in mindset from the traditional “doctor knows best” mentality to a team approach. It also means a deeper understanding of how to engage patients and a focus on building trust. A good way to start is by providing patients with a clear and comprehensive overview of their condition. This will help them understand the nature of their illness and what to expect from treatment.
Patient-centered care also includes involving patients in decisions and recognizing that each individual has unique values, beliefs and preferences. This can include respecting their autonomy, dignity and cultural sensitivity. It’s important to be aware of the social and emotional support needs of your patients, which may require referrals to peer support programs, transportation services, financial counselors or specialized language assistance. It’s also important to accommodate family and friends, who can be a great source of support for patients and help keep them engaged in their own health.
Safe Care
The SafeCare model provides a staged, motivating, technology-powered path to sustainable quality improvement. Its internationally accredited standards measure and empower healthcare providers to improve their services. It helps them achieve sustainable improvements while demonstrating their commitment to patients and communities.
The Safe Care framework and its accompanying Diagnostic Tool provide clarity and guidance for achieving safe, reliable and effective care in any setting. The framework focuses on the key strategic, clinical and operational components that make up a system of safety.
The National SafeCare Training and Research Center (NSTRC) provides implementation support, training, technical assistance and quality assurance for agencies that implement the SafeCare model. The NSTRC also hosts an annual, all-day update conference for active SafeCare providers and offers regular webinars on advanced topics. In addition, NSTRC staff facilitate peer learning through an online discussion forum and support new agencies with a mentorship program.
SafeCare is implemented by a variety of state and local agencies. These include public health departments, departments of family and children’s services, intensive family preservation programs, agency programs serving parents with intellectual disabilities or mental health problems, and criminal justice programs that serve families recently released from jail or prison.
In a randomized trial, it was found that parents who received the SafeCare home visiting model were significantly more likely to have a positive child outcome than did families receiving services as usual. This outcome was measured in terms of the risk of future child maltreatment.
Families served by the SafeCare model typically receive 18 home visits from a trained SafeCare provider. The provider works with the family until the parents demonstrate they have mastered a set of skills, usually within three to five sessions, depending on the initial level of parental skill observed at the baseline assessment.
Timely Care
In the United States, 200,000 people die each year from sepsis, a life-threatening condition that can be prevented by early diagnosis and treatment. Sepsis is caused by the body’s overreaction to infection. Patients with a low immune system are at higher risk for developing sepsis and have a greater chance of dying from it if untreated.
Students using TimelyCare have access to on-demand emotional support from a therapist, scheduled counseling appointments (12 sessions per academic year) and health coaching. They can also visit the Explore tab within TimelyCare for guided self-care content, including meditation and yoga sessions. The service is free to all enrolled Case Western Reserve University, Cleveland Institute of Art, Cleveland Institute of Music and Kent State University School of Podiatric Medicine students.
TalkNow is an on-demand telehealth service that allows students to speak with a licensed therapist about their concerns, including anxiety, relationships, depression and school-related stressors. Students are able to schedule a TalkNow session with a therapist within a few hours of their initial request, and most sessions are completed within 15 minutes.
If a student needs additional help, the therapist will reach out to CAPS if necessary and provide a referral for that assistance. Students can also use the CAPS telehealth line during their appointment to speak with an on-call therapist in case of an emergency or urgent need.
The therapists and providers who work with TimelyCare have been trained in the unique issues facing college students and are familiar with the types of issues that are frequently discussed with them. They also hold a wide range of specializations, identities and training. Almost half of the providers in the service have a BIPOC identity and all are licensed mental health professionals.
Efficient Care
In our nation’s current environment of high and rising health care costs, federal and state policy makers, private payers and systems leaders are seeking ways to reduce waste, increase efficiency and allocate resources to improve quality, safety, equity and access. At the same time, consumers want to know how to get the most value for their own health care dollars.
Research shows that improving organizational efficiency has many benefits, including cutting costs, decreasing wait times and making health care more accessible to patients. But it is important to balance efficiency gains with other goals such as increasing patient satisfaction and quality of care.
Ultimately, successful organizations seek to deliver high-value services with a low cost. To do this, they must focus on two areas: team productivity and internal technical processes. For example, a hospital that has better process automation and staffing models can more effectively manage the workflows of its physicians, nurse practitioners and physician assistants. This frees them up to spend more time with each patient, which is a key driver of satisfaction.
A recent study found that hospitals with more efficient processes were able to cut costs by 26 percent without sacrificing patient safety or quality of care. One way to achieve these savings is by reducing waste, which could include anything from streamlining forms to using email to communicate with patients instead of a fax machine.
Similarly, a number of studies have shown that financial incentives can help improve efficiency. For example, a study of tiered employee benefit plans found that workers who were offered financial rewards to choose hospitals that met the Leapfrog Group’s three patient safety standards were more likely to do so for medical admissions but not surgical admissions.
Equitable Care
As healthcare organizations strive to deliver high quality care to all their patients, they must also ensure that the same benefits are available for everyone. This requires a shift from equal access to equity. Equal access means that all people have access to healthcare services regardless of their clinical needs. In contrast, equitable access takes into account a person’s individual clinical needs as well as their social conditions. This is the basis for addressing health disparities and creating policies that improve health outcomes for underserved populations.
While achieving equity is a challenge, it is possible with the right leadership and resources. One important tool is to identify and eliminate barriers, such as limited access to a quality healthcare facility or low literacy levels that contribute to poor health outcomes. Another is to provide culturally safe care that respects a patient’s culture and identity, and provides them with a voice in their own care. Additionally, a system that understands and addresses the social determinants of health can better address the needs of all patients.
Achieving the goal of equitable care should be a top priority for every healthcare organization. It has many benefits, including healthier communities, more productive workforces, and increased productivity overall. By focusing on the root causes of inequity, healthcare organizations can make a lasting impact on improving the health and lives of their communities. In a recent study, researchers analyzed data from 195 countries to identify which conditions most affect a person’s ability to receive good-quality care. They found that deaths from 32 diseases could be prevented if all people had access to healthcare facilities and were treated adequately. However, a great deal of work remains to be done in order for this to become a reality.