Refer back to the structure-process-outcome (S-P-O) model discussed in Week 1. In addition, refer to the text reading pertaining to the quality management system (QMS) and answer the following questions:

• Compare how the two models define and measure quality outcomes.
• Which model best supports the framework of evidence-based medicine in defining and measuring quality outcomes? Why?
• How can an organization ensure that healthcare services are providing value to the patient? Justify using examples.

Homework assignment from week 1

Question 1

In the SPO model, the defining elements of quality performance in healthcare include administrative, financial, clinical, performance improvement measures, and policy development. Instrumental development is essential in evaluating healthcare quality. According to Ayanian & Markel (2016), quality in healthcare is defined in significant perspectives, such as the efficiency of the process, the effectiveness of the structure, and the outcome of the process to patients. Regarding the SPO model, quality is measured in terms of outcome measures to reflect the impact of healthcare on patients.

The outcome determines the efficiency of healthcare. For instance, a reported decline in mortality rates indicates a high quality performance of healthcare. Process measures reflect how the system and processes correlate to which the desired outcome. For instance, the length of time that a patient is expected to wait before clinical attendance and whether the patient receives the required standards of treatment. If the process is the length, the SPO model predicts low-quality performance in healthcare (Ayanian & Markel, 2016). Structural measures (input measures) depicts the attributes of service providers towards patients — for instance, staffs to patient ratio. Quality in healthcare services is dependent on such proportions.

Question 2

Structural characteristics in healthcare are the primary determinants in quality performance. Such characteristics include sufficient healthcare capacity in terms of accommodating patients, reliable healthcare systems such as equipment, effective staff training, and efficient payment programs. These characteristics determine the overall effectiveness of the process. Moreover, functional units form a unique feature in healthcare. SPO model characteristics are effective and efficient in ensuring quality in the healthcare process. For example, the entire process and outcome in a health facility are based on the structure of the organization. A well-defined structure guarantees high quality performance in outcome and operations in healthcare (Ayanian & Markel, 2016). Therefore, a satisfactory healthcare process is grounded on structural impact in service provision.

Question 3

Yes. Evidence-based medicine acts as a supplement of knowledge to healthcare service providers. Ayanian & Markel (2016), argue that evidence-based method involves the application of well-researched evidence in decision making. For instance, an evidence-based approach can provide information to healthcare on how to enhance structure, process, and outcome in attending patients. For example, supplement information on the need to acquire more healthcare facilities and the need for training medics. Also, the evidence-based model can provide a suggestion to adopt a digitalized system such as bank cards in sorting hospital bills to reduce congestion in the healthcare facility. Attendance for such suggestions will yield higher outcomes in the entire nursing process.

Reference

Ayanian, J. Z., & Markel, H. (2016). Donabedian’s Lasting Framework for Health Care Quality. New England Journal of Medicine, 375(3), 205–207. https://doi-org.southuniversity.libproxy.edmc.edu/10.1056/NEJMp1605101Week 1