Describe Structure, Process and Outcome - Quality Measurement - Medical Science Assignment Help

Assignment Task

Quality healthcare is a continuous process improvement objective.  Once a goal is met, it is time to reset the bar, always improving.  There is no end.  It is no surprise that accrediting bodies look at multiple facets of healthcare to assess for quality.  One facet alone is not enough to paint a true picture of a facility’s quality of service and care.  
Dr. Donabedian described quality measurement in three facets: Structure, process, and outcome (Young & Kroth, 2018).  His method would become what is known as the Donabedian model.  Structure could be described as staffing, equipment, guidelines, supplies, and facility. 
The Agency for Healthcare Research and Quality (AHRQ) also includes in structure the ratio of providers to patients.  This would be significant to ensure adequate staffing, adequate supplies, et cetera.  Process could be considered as the interaction between providers and patients or staff and patients.  It could also be described as examination and treatment.  Outcome, of course, would be the result of the structural factors and process factors.  Was the patient satisfied with the service?  Was there increased morbidity or mortality following the care?
         

In investigating a hospital-acquired central line associated bloodstream infection (CLABSI), all of these factors would be relevant.  Obviously, the outcome would be the CLABSI event.  The structure for this example includes staffing, evidence-based guidelines for central line insertion and its associated care bundle, and the equipment itself, e.g. the intravenous material, tubing, and insertion kit.  The process would be the actual insertion of the central line.  

These three elements paint as much of a picture as possible when reviewing quality of care.They cannot stand alone.  If a hospital has the staff, equipment and facility, this alone does not ensure a good outcome. The process could be suboptimal.  If the process is optimal, perhaps there is not enough staffing, and this could affect the insertion, as well.  Were staff stretched too thin, causing increased stress and carelessness?  Even with all of the optimal factors of structure and process, there is still a poor outcome.

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