Review the Chapter: Improving Quality in Health Care Organizations
Then, Response to the following questions:
1. Take the perspective of the CEO of a large health care system that owns its own managed-care health plan. Describe three major ways that you could improve the quality of health care in your organization. Critique your solutions regarding the extent to which your solution may cause other problems to surface (what kind?), and the extent to which you as the CEO should have the responsibility and power to implement these changes.
2. Using an HCO that you know well, provide three examples each of possible structural, process, and outcome measures of care quality. Would you expect these measures to be highly associated? Why or why not?
3. Consider a community hospital, a major teaching hospital, and a hospital in a large for-profit system. For each, list the major stakeholder groups (both internal and external). Indicate what kinds of quality criteria each group would be most likely to promote.
4. Hospital A and Hospital B both have as their major goal for this year the implementation of a QI program. Hospital A hired a consultant firm and sent its top managers to a program to learn how to change the corporate culture and to set up quality teams to investigate problems. They formed teams to plan strategies for meaningful QI in two specific areas: billing and use of the emergency room. Hospital B, lacking funds, tried to have study groups and use self-teaching but involved everyone from the CEO to the janitor. Which hospital do you think will succeed in implementing QI? Why?
5. Health System Q is located in the same geographic area as Health System P, its main competitor. While Health System Q touts its status as a community-based integrated delivery system. Health System P leverages its role as a research-intensive academic medical center. Both health systems have achieved Magnet designation for nursing. both have been listed among the "Most Wired" by HIMSS, and both have centers of excellence (or service lines) in the areas of cardiology, cancer, and women's health. You have heard that community members seem to favor Health System Q for most conditions, but appreciate having a local academic health system if they have problems that are out of the ordinary. You are considering a job with one of these health systems in the area of QI, and are trying to decide where your expertise will have the most impact. What factors would you consider in trying to evaluate which place might be better positioned to leverage your skills and move forward with QI efforts?