Quality Metrics for Chronic Disease Management
According to the CDC, chronic diseases are the leading cause of death in the United States, with almost 50% of the population suffering from at least one chronic illness. As a result, almost 80% of health care spending is devoted to its management (CDC, 2010). To this end, the National Committee for Quality Assurance (NCQA) developed performance measures. These performance measures allow organizations to compare yearly quality improvement outcomes in the management of chronic diseases. As a nurse engaged in advanced practice, you may find yourself at the forefront of prevention and care management efforts.
- Review the National Committee for Quality Assurance report, presented in the Learning Resources, and examine current trends and measures associated with at least two chronic diseases. This information will form the basis for this Discussion.
- Review examples of measures that address the management of chronic diseases for an inpatient setting that might not be relevant in an outpatient setting. Be sure to explore the companion metrics that influence a patient’s ability to manage chronic disease.
- Consider how these metrics facilitate change and improve the management of chronic disease.
- Examine the efficiency of current automated trigger systems for managing patient safety. Ask yourself: How do these automated trigger systems help improve quality of health care, patient education, and management of chronic illnesses?
By Day 3, post a cohesive response that addresses the following:
- Compare one quality metric for managing chronic disease that applies to your practice setting to ametric that applies in a different practice setting (i.e. hospital nurse compared to home health nurse).
- Evaluate how these quality metrics facilitate change and improve the management of chronic disease.
- Take a stance on the efficiency of current automated trigger systems to help manage patient safety. Do you believe these to be proactive or reactive responses when educating patients on disease management?
Quality Metrics for Chronic Disease Management
The quality metric for managing chronic disease measures the performance of a health care organization in the management of the chronic disease by supporting the needs of the patients (US Department of Health and Human Services, 2010). Chronic disease management may be undertaken within the hospital setting by hospital nurse or at home by home care nurse. This paper seeks to compare patient’s length of hospital stay as a quality metric for managing chronic disease in the hospital setting and patient satisfaction as a quality metric in the home care setting.
The length of stay of a patient in the hospital can be used as an indicator of the quality of the management of the patient’s condition hence, acting as a quality metric (Austin, Wills, Blizzard, Walters, Wood-Baker, 2010). Notably, longer hospital stays of a patient with chronic disease signify poor quality management of the patient’s condition while quicker recoveries characterized by shorter hospital stays clearly posit high-quality management of the patient’s condition. Similarly, patient satisfaction is a quality metric for managing chronic disease in home care setting. However, in this setting, patient satisfaction is evaluated through personal interaction between the patient with chronic disease and the home care provider (Browne, Roseman, Shaller, Edgman-Levitan, 2010). By conducting a one-on-one interview with the patient about his/her health management progress, the level of satisfaction of the patient can be determined and used as a metric to measure the quality of services offered.
Both of these metrics are critical in facilitating change that may improve the management of the chronic disease. For instance, increased length of hospital stay may have some underlying factors grounded on infectivity and inefficiency of the organizational policies (Austin, Wills, Blizzard, Walters, Wood-Baker, 2010). Therefore, this metric may induce the need for change in the organizational policy to improve the effectivity and efficiency of the healthcare organization thus, facilitate changes that may improve management of chronic disease. Patient satisfaction, on the other hand, is a critical indicator for quality of services and patient outcomes as it posits the true picture about the performance of healthcare providers in both practice settings. In a hospital setting, patient satisfaction is a quality metric that measures how much the patients are satisfied with the quality of services offered by health professionals in the setting (Browne, Roseman, Shaller, Edgman-Levitan, 2010). To measure this satisfaction, patients with chronic disease in the hospital setting participate in a survey in which they fill questionnaires designed to evaluate the quality of services in the hospital. This way, the data collected can be used as a metric of quality for the management of the chronic disease. Notably, the feedback obtained from such survey and interviews can be used to make necessary changes in the clinical setting focused on improving patient satisfaction (Browne, Roseman, Shaller, Edgman-Levitan, 2010). That way, patient satisfaction, as a quality metric may facilitate change that may improve management of chronic disease.
The current automated trigger systems are very effective in managing patient safety because it occurs retrospectively or prospectively and without any dependence on the care giver’s willingness to report self-report (Muething, Conway, Kloppenborg, Lesko, Schoettker, Seid, Kotagal, 2010). For instance, automated trigger systems efficiently identify triggered cases such as the occurrence of an adverse drug event for further review. However, I believe these systems are reactive responses when educating patients on disease management because they only focus on the occurrences around the patients’ safety while impacting very little, if any, in the educational process of the patient. Notably, the current automated trigger systems are focused on events around the patients that triggers a reactive response to review other than educating the patient on disease management (Muething, Conway, Kloppenborg, Lesko, Schoettker, Seid, Kotagal, 2010).
US Department of Health and Human Services. (2010). Multiple chronic conditions—a strategic framework: optimum health and quality of life for individuals with multiple chronic conditions. Washington, DC: US Department of Health and Human Services.
Browne, K., Roseman, D., Shaller, D., & Edgman-Levitan, S. (2010). Analysis & commentary measuring patient experience as a strategy for improving primary care. Health Affairs, 29(5), 921-925.
Austin, M. A., Wills, K. E., Blizzard, L., Walters, E. H., & Wood-Baker, R. (2010). Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. Bmj, 341, c5462.
Muething, S. E., Conway, P. H., Kloppenborg, E., Lesko, A., Schoettker, P. J., Seid, M., & Kotagal, U. (2010). Identifying causes of adverse events detected by an automated trigger tool through in-depth analysis. Quality and Safety in Health Care, 19(5), 435-439.