Quality care, providing

Provider policies. The database can identify which providers voucher bearers favor. This information can be used to drop ineffective providers by not renewing their contracts, if voucher bearers are expected to make more than one visit to a clinic, the proportion who fail to make a second visit may be used as an indicator of poor-quality care Providers who provide such care can be dropped. 

All the objectives presented in Box 11.1 can be described as quality improvement in the structure and process to support improvement in each patient s health outcome. This support the patient medication care process presented in Fig. 3.1. Various problems and tools and models for improvement have been described in this book. Another approach to prevent medication errors and to improve care is to be open and continuously learn from mistakes. The basis for this is not to punish health care providers who make errors, as this may lead to less reporting of errors. In Britain, the government has taken steps away from this blame-culture (Wise 2001). In a declaration it is stated that honest failure should not be responded to primarily by blame and retribution, but by learning and by a drive to reduce risk for future patients. 

The discovery of new medicines and their introduction into the market will not optimally have positive impacts on health if the needed essential medicines are not available and affordable, if they are not of good quality and if they are not properly utilized by the health care providers and consumers. This chapter will highlight the issues related to commonly occurring problems in the area of medicines in developing countries, and relevant policies and programme to deal with them. In particular, the chapter will highlight the problems of access to... 

Its mission is to ensure effective, up-to-date health care coverage and quality care for beneficiaries of Medicare and Medicaid, two programs that provide prescription drug benefits. 

The quantity of wine for chemical analysis should be at least four bottles of about a litre each. Transparent bottles should be used and they should be rinsed first with water and then with the wine so that no trace of any substance previously present can remain. The bottles should be filled, carefully stoppered with new corks of good quality and provided with sealing-wax seals and with a label giving all the particulars necessary for the identification of the sample. Further, on a special sheet are given the name and address of the holder of the wine, the capacity of the casks or other vessels from which the sample is drawn and the extent to which they are filled, any production of scum (so-called " fleurs de vin ) being noted and, if possible, the type, place of origin and year of production of the wine itself. 

An amalgamation of these definitions may provide the best explanation of the concept of quality in health care. Each provides additional insight into quality, what we can expect from quality, and how quality can be perceived. Webster s definition supports the idea that quality is a continuum of excellence or the lack thereof. From the Office of Technology Assessment definition it can be said that in medical care, quality can be measured and used to evaluate the care delivered by health care providers. This definition also implies that the care offered to patients should increase the probability of positive outcomes (e.g., getting rid of an infection) and decrease negative outcomes of care (e.g.,... 

Second, CQI demands that the quality improvement process is continuous or never-ending (Blumenthal and Kilo, 1998). Improvement occurs by integrating information concerning quality into the cyclic redesign and improvement of care (Godwin and Sanborn, 1995). The changes can be quick and on a small scale but should be occurring constantly. In this manner, CQI empowers health care providers to improve quality on a daily basis (Shortell et al., 1998). 

The Joint Commission is a nonprofit organization founded in 1951 by the American Medical Association and the American College of Surgeons (O Malley, 1997). The Joint Commission was established to continuously improve the safety and quality of health care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations ... 

Provides oversight and feedback to pharmacy technicians that ensures quality care and adherence to departmental policies and procedures. 

The economic evaluation of medical care may occur from many perspectives. These perspectives, or viewpoints, will influence the costs and consequences identified, measured, and compared for a program or treatment alternative. An economic evaluation can be conducted from a single perspective or multiple perspectives. Common perspectives are those of the patient, provider, payer/insurer, and society. There are subtle differences between perspectives. A patient may be extremely concerned with his or her quality of life, level of pain, ability to see health care providers, or how much time is spent in the hospital or nursing home, in addition to the actual direct costs of health care. However, a payer may be interested only in the direct costs of health care to its organization. In fact, while a patient who is at the end of his or her life may be interested in extending life as long as possible, a payer may see this as an expensive prospect. 

Based on the descriptions of independent community pharmacy practice and the characteristics of the individuals who pursue this career path, several points must be made. First, independent pharmacists are placed in a difficult situation because of their need to possess expertise in pharmacy practice and business. All pharmacy organizations must stay in business so that they may provide goods, services, and care to patients. Second, independent community pharmacy practice represents one of the most accessible health care venues for patients. Because of this, there exist numerous clinical opportunities for pharmacists in the provision of quality patient care and positive patient outcomes. Third, independent community pharmacists contribute to the overall health of any community not only in the care provided but also in contributions to the economic and civic health of the community. As a health care provider, the pharmacy adds a stable business to any town s economic structure. Additionally, through involvement of the owner and other staff members in civic organizations, these individuals serve as volunteer leaders in activities ranging from school and hospital boards to elected offices. 

Based on the counsel of his advisors. President Richard Nixon believed that the Kaiser Health Plan could be replicated at a national level as a means to control health care costs. Because many of President Nixon s advisees were Californians, they were familiar with the Kaiser health system, the home of some of Mr. Kaiser s first prepaid health plans. They knew that HMOs at the time offered numerous possible advantages to the traditional health care system. These HMOs (1) were cost effective, (2) provided quality care, (3) decreased administrative waste, (4) instituted health care utilization controls, and (5) demonstrated a high degree of patient satisfaction. ... 

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