How is Patient Care Measured?

Hospitals regularly measure patient care, which is defined as any health care service provided to an individual. It is determined in different ways according to the type of health care service provided. However, there are basic principles that guide how all patient hospital care is calculated.

What are the Measurements of Care?

According to the Centers for Medicare & Medicaid Services (CMS), care measurements are quality benchmarks that are based on care standards, industry guidelines and practice scopes. Care calculations are based on statistical evidence and scientific data.

Care measurements require numeric data and patient feedback. Raw data can be sourced from the primary software program, such as the hospitals Health Information Management System, and processed through big data analytics. Insurance and Medicare claims are also sources of raw data. Patient feedback is continually elicited through the nationally recognized Centers for Medicare and Medicaid Services (CMS) patient survey. All acute hospitals in the U.S. participate in the CMS survey. Patients are typically surveyed after they are discharged. The results are available through the Medicare website.

What Aspects of Care are Measured

The CMS survey provides insight into specific areas of hospital service. Patients are surveyed about their experience and are asked questions about the quality of care received, communication by the staff and timeliness of service. There are also condition categories that the CMS focuses on, such as Emergency department care. The CMS survey will calculate the average time that emergency patients had to wait before being seen or receiving pain medication. The CMS report also provides statistics related to how likely patients will experience complications, readmissions and death. For example, hip or knee patients often experience complications after surgery. In addition to this, the CMS survey also monitors the use of medical imaging, such as MRIs and CT scans, and how the patient payments match patient outcomes.

Why Benchmark Performance?

According to the Health Resources and Services Administration (HRSA), the goal of measuring performance is to understand weaknesses or problems and make appropriate improvements. Measuring performance allows health care organizations to improve quality of care and patient outcomes. Therefore, these organizations become more transparent and accountable to their patients and the public. In addition to this, certain certifying bodies, such as the Accreditation Association for Ambulatory Health Care (AAAHC), rely on these performance measurements for certification purposes. Finally, the CMS actually offers financial incentives to health care professionals and hospitals with certified Electronic Health Records (EHR) technology. Therefore, the more hospitals can calculate care levels, the better treatment patients will receive. In the end, successful health care facilities will be share their useful data with other facilities.

How Can Performance Be Improved

Measuring performance is meaningless without actual care improvements. Performance management is a continual process of data analysis, review, process changes and evaluation. For example, hospitals should set performance goals and standards and then measure how well their organization performs. This process should be documented, shared with appropriate parties and then used to make informed decisions to improve the standards of care and related procedures.

In the end, care is calculated through quantifiable data and patient surveys. The data and information is used to improve all aspects of the patient health care experience. Overall, hospitals must measure patient care in order to provide the best health care services to patients.