Essay Example on Health care professionals must have provided the best quality of Care

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Health care professionals must have provide the best quality of care while dealing with patients Quality of healthcare is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge Managed care is a system of care delivery involving complex organizational arrangements between institutions and clinicians explicit financial incentives defined access to service controls on the use of services 3 coordination and integration of services McConnell C 2010 Cost balance is health professionals trying to balance the cost while improving the quality of care Although these health professionals are for improving the quality and cost balance in healthcare it is taking a strain on them with the rising cost of healthcare especially since the Affordable Care Act ACA has increased the number of people with insurance seeking medical care Cost balance is becoming important because one third of health spending is wasted on unnecessary services fraud and other problems Institute of Medicine 2012



More physicians are opting out of Medicare and other forms of insurance restricting the number of patients they see However there is a way of controlling the healthcare cost balance and quality It is the three aims developed by Japanese quality expert Noriaki Kano Eliminating Quality Problems Eliminating quality problems that arise because the expectations of consumers of healthcare are not met Nolan Bisognano 2006 Different organizations are becoming more experienced at finding quality problems measuring their frequency and engaging healthcare professionals in reducing these defects By physicians following this step they are helping patients by coming aware of the problems and fixing them They are also having different performance requirements that will help them understand like interviews surveys and focus groups With this requirement it's easier to succeed because the more you improve them the better the outcome is Reducing Cost Significantly Noriaki Kano s second requirement was reducing cost significantly while maintaining or improving quality This requirement provides a huge opportunity for health care Cost reduction through redesign is considered part of everyone's job Verduyn David 2014 



Physicians and management must watch the cost coming in and going out of their facilities so that they can improve the quality of care In the book the Balanced Budget Act of 1997 was created to relieve fiscal pressure caused by the growth of Medicare costs and overall to achieve a balanced federal budget McConnell C 2010 Managers must find ways to reduce cost complying with the new government rules Expanding the Expectations Expanding the expectations of consumers by providing products and services that they perceive as unusually high in value Verduyn David 2014 Things like drugs for aids and laser eye surgery are medical breakthroughs that more patients are willing to receive because they can afford it This expectation is like the Patient Protection and Affordable Care Act of 2010 where legislation intended to increase health insurance coverage and affordability for more people require insurers to cover all applicants regardless of preexisting conditions and reduce costs and improve healthcare outcomes McConnell C 2010 Resolving Conflict between Quality and Cost The answer to controlling costs and increasing value lies in a balance among Kanos three key categories of customer satisfaction Currently an imbalance exists leading to nonproductive tensions Nolan Bisognano 2006 Clinicians often see themselves defending patients and professional standards against the finance department 



They see themselves as the protectors of quality The finance professionals see themselves protecting the resources of the organization The finance department usually provides supervisors with weekly or monthly cost reports of expenditures against the budget McConnell C 2010 This is difficult for management because the clinicians see that they need new equipment to help the patients and the finance professionals see unnecessary spending that could be saved for something more important Management must figure out how to decipher how to keep their clinicians happy and finance professionals happy Management must figure out how to handle difficulty between staff members and ways to reduce the cost but keep the quality of care up especially with the budget the finance department have gave them Quality and Cost Balance Quality and cost balance correlate to one another because management must figure out how to handle the cost balance in their facility with also dealing with the quality of care The quality of care is important in the healthcare field because if the readmission rate increase in your facility if the quality of care is at a high Management must find ways to make sure that all their patients are able to get the best help from their facility even those who are on Medicaid Medicare and ones with no insurance Medicare patients are at high risk for readmission to acute care and phasing out of physician owned specialty hospitals McConnell C 2010 This can put a lot of stress on management when trying to handle the finances of your facility while making sure that the quality of care is up to par Conclusion


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