Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Role of IT and informatics
Results of current approaches to quality assessment
Slide content:Challenges for Certain Practice Environments Small numbers in small hospitals can inflate performance relative to large hospitals (O Brien, DeLong, & Peterson, 2008) Safety-net hospitalsongoing funding and staffing issues impact ability to provide quality care. Mission could be adversely affected by P4P (Werner, Goldman, & Dudley, 2008) and worsen already existing disparities ( Casalino et al., 2007) Small practices have limited time, multiple payers, and low capital investment (Landon & Normand, 2008) Is it overly burdensome? (Vonnegut, 2007) 18
Slide notes:There are also challenges for certain practice environments. Some of the measures have been configured, for example, such that the small numbers of patients in smaller hospitals can inflate performance relative to large hospitalsmeasures need to be adjusted for different settings. It has also been shown that safety-net hospitals have ongoing issues with funding and staffing that impact their ability to provide quality care. They are, after all, safety-net hospitals where people can go for care when they may not have other options. In fact, the mission of these institutions could be adversely affected if tied into P4P, and this measure may actually worsen some of the health care disparities that these institutions are set up to address. Finally, small medical practices have challenges. These practices have limited time, multiple payers, and relatively small amounts of money for capital investment. For the area of Massachusetts in which one physician practices, he asks, Is it becoming overly burdensome for some of these practices to be overwhelmed by all of these different quality measurements and other aspects of computerization of their practices? 18