Synthesizing and Evaluating Valid and Reliable Research
Running head: QUALITY IMPROVEMENT FOR PUBLIC HEALTH FACILITIES 0
Quality Improvement for Public Health Facilities
Qualitative Research Methods Evaluation
AIU ONLINE
HLTH 335 1701A - 01
UNIT 2 IP
The type of study in the four listed articles include the following. Article one by Chaudhry et al., (2006) was a qualitative study. The authors conducted a system review from expert opinion and literature review to determine the role that information technology had played in enhancing health care quality, efficiency and costs of medical care. The authors hypothesized that information technology had played a significant role in improving the quality of medical care by increasing adherence to medical guidelines, improving disease surveillance and decreasing medication errors. The type of study for the second article was also a qualitative study that examined 260 hospital on the issue of pay for performance strategy. The authors compared their results to other hospital that did not have the current nationwide pay for performance system, (Werner et al., 2010). The authors hypothesized that pay-for-performance system improved quality health care among hospitals in this system. The third article was also a qualitative study where the authors hypothesized that public reporting of hospital quality data and the pay for performance have emerged as the widely advocated tools for these that accelerate health facility’s improvement (Lindenauer et al., 2007). The fourth article was also a qualitative study article. The authors of the article hypothesized that the Keystone ICU project was associated with a significant decrease on the hospital mortality within Michigan as compared to the surrounding areas, (Lipitz-Snyderman, et al., 2011).
Article one utilized data from published expert opinion and literature search from academic data bases. There was no direct involvement of the human subject when collecting data for this article. Article two utilized data from 260 hospitals. The authors chose acute care hospitals that began operating in 2004. The author’s excluded four critical-access hospitals. Researchers of the third article used 2490 health services providers nation-wide who met the criteria for Hospital Quality Alliance (HQA). In the fourth article, the authors chose the patients who were treated in Michigan’s 95 study hospitals from 238, 937 total admissions. All the samples and the populations for these studies were appropriate.
During the study documentation Chaudhry et al., (2006) reported that hospital facilities documented and reported data on costs and contextual factors. Limitations of data in this article is that the systematic review utilized a mixed data of private and public initiatives into hospital systems. The public and private initiatives have different agendas. Werner et al., (2010), study results indicated that the two groups of hospitals were similar with respect to market characteristics and pay-for-performance strategy. The authors also reported that hospitals experienced a better overall pay-for-performance demonstration project within participating hospitals. However, the difference of hospital groups began to differentiate in 2007 during the introduction of a new hospital payment system. The limitation of these results according to the authors is that they did not document other contributory factors that lead to high level of pay per-for-performance initiative within the study hospitals. Lindenauer et al., (2007) documented their results as many study hospitals were not having a for-profit pay-for-performance participation and ownership. The more likely urban hospitals were participating in sourcing for large funds to improve their facilities and services to a competitive advantage as compared to making a large profit margin. The limitation of the results of this study is that there were limiting variables of study. The variables of this study were ten measure yet the largest hospital system in America is dependant on market economy factors. In the last article, Lipitz-Snyderman, et al., (2011), documented their study results and showed that the patient’s characteristics of the hospitals admissions were similar in the study group as compared to the control group. The results of this article continued to indicate that teaching hospitals and not teaching hospitals had different proportions of performance with teaching hospitals having a large proportion of improved performance. The limitation of this study is similar with other limitations analyzed here in that pay-for-performance require more variables.
Chaudhry et al., (2016) results led to the conclusion that health information technology offer a discernible solution to the performance improvement of the health facilities. The application of this research information raise the needs to adopt information technology within the healthcare system tied with benefits of better performance. Werner et al., (2010), study results led to the conclusions that hospital payment systems are in constant change process. The payment system will change according to the policy and market demand changes. For example, payment system changed during the implementation of the Affordable Care Act, which implemented the performance-based payment. The application of the study results in the payment system is that hospital facilities should use systems that are familiar, but should aim at improving the familiar systems as compared to adopting new unknown system of payment strategies. Lindenauer et al., (2007) results led to the conclusion that financial incentives are modestly increasing the improvement of quality among hospitals that already engage in public reporting. Hospitals should not be given all the opportunities to choose their public reporting. Instead, this reporting should be standardized for the benefit of providing public incentives. The application of this reporting is that research is required to determine the most effective mode of payment model that can stimulate more meaningful improvements to the programs that are cost-effective. Lipitz-Snyderman, et al., (2011) results led to the conclusion that implementation of a new mode of payment leads to efficiency in service offering. The results led to the conclusion that efficiency in hospitals led to the improved hospital performance. Efficiency also led to improved cost reduction and reduced effects of quality improvement initiative. The application of this results indicated that hospital’s healthcare system as payers within an investment strategy was similarly successful in large scale hence robust quality improvement initiatives are critical in maximizing the benefits of patients and the hospitals.
Reference
Lipitz-Snyderman, A., Steinwachs, D., Needham, D. M., Colantuoni, E., Morlock, L. L., & Pronovost, P. J. (2011). Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis. BMJ, 342, d219.
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., ... & Shekelle, P. G. (2006). Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of internal medicine, 144(10), 742-752.
Werner, R. M., Kolstad, J. T., Stuart, E. A., & Polsky, D. (2011). The effect of pay-for-performance in hospitals: lessons for quality improvement. Health Affairs, 30(4), 690-698.
Lindenauer, P. K., Remus, D., Roman, S., Rothberg, M. B., Benjamin, E. M., Ma, A., & Bratzler, D. W. (2007). Public reporting and pay for performance in hospital quality improvement. New England Journal of Medicine, 356(5), 486-496.
