Measuring Healthcare Productivity: Navigating Complexity & Variation - Essay Sample

Introduction

Measuring health care productivity is always a challenging process as patients often have a great variation deal in their treatment options, comorbidities, symptoms, as well as effort and time needed to provide individual care. There are various external forces which direct specific outcomes, control or influence the utilization of resources, establish safety parameters, and affect minimum standards as humans, together with their health requirements, are highly complex. Therefore, with human complexity, numerous productivity surrogates which can be utilized when evaluating health care are always required. Direct and simple measurements such as net revenue, gross billing, and patient volume might be used as they are easy to understand and operate (Buppert, 2017). However, the same measurements are always limited and provide numerous incomplete pictures as they cannot account for the illness severity as well as care acuity. The required technical abilities and professional knowledge in providing quality care with the associated resource utilization costs and malpractice liabilities are always ignored (Nagelkerk, Ritola, & Vandort, 1998).

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In trying to establish more sophisticated and accurate productivity surrogates in health care, the relative value unit (RVU) must be created. The RVU always tries to standardize the clinical operations into numerical units which can be combined to create a simple volume measure that is divided by each clinician in aggregate to evaluate and examine the productivity per provider, multiplied by numerous factors of conversion to compare the effort of each task across medical or surgical disciplines. The work RVU can also be used in other manipulations and calculations (Naylor & Kurtzman, 2010).

The RVU was established to alter or convert many factors into a single measurable unit. The depicted factors include the judgment and mental effort that is needed of the health care providers, the period the RVU takes to perform a specific task or service, the technical skills required by a service, as well as the risk of liability associated with the service. Therefore, the RVU cornerstone is assigning a code of Current Procedural Terminology (CPT) to the provided clinical service (Buppert, 2017). The CPT code is then used to describe the diagnostic, surgical, and medical services. Additionally, the code will communicate uniform and relevant information regarding the procedures and services among the accreditation organizations, health care providers, patients, coders, and payers for analytical, financial, and administrative purposes. Thus, the CPT code is used by numerous health care services to determine reimbursement (Kleinpell, 2013).

Peer Review

Peer review gets construed as the analysis and evaluation of an individual's creative task or performance by colleagues in the same field. Therefore, in assessing the performance, peer review must be included in the medical institution or organization. The primary aim of conducting the peer review is always to help in the formulation of various informed judgments regarding someone's professional practice of professional health care to determine and identify ways to maintain and improve quality care (Buppert, 2017). The advantages of conducting the peer review are that there is always no doubt that the procedure is not perfect. However, it grants the reader to make specific judgments regarding the relative merit and quality of the research (Rout & Roberts, 2018).

Peer reviewing allows different opinions to be theoretically discussed, thereby removing any forms of pre-set ideas and personal biases from the equation. The procedure also curbs numerous poor and substandard science from reaching a publication because the reviewers must be well acquainted with up to date developments and be experts in their field to reject plagiarized documents or duplicate research. However, the disadvantages of conducting the peer review are that the entire process consumes a lot of time and is expensive. In most cases, documents are always held up for a long period while seeking for approval. Thus, in case a researcher has a planned experiment series, their progress might be hampered (Blair & Jansen, 2015).

In most scenarios, the power of making decisions is always in the editors' hands, who are the link between the referee and the author. The case might be okay as it makes the process to run smoothly, but it might lead to authority misuse. The editors are often accused of reject manuscripts arbitrarily before reaching the peers. Nonetheless, there is always no systems of grading regarding the peer review quality, and thus, different journals always have varying standards. The action makes the professionals not to know the quality and expertise of the editors or reviewers (Rout & Roberts, 2018; Blair & Jansen, 2015).

Quality Assurance

The main aim of assuring quality is always to document specific ways advanced nurse practitioners can contribute to the quality delivery of culturally competent health care services to all patients in practices of primary urban care. Therefore, to ensure that APNs and PAs address the concerns related to patient care and cultural diversity patient care, various data sources shall be drawn from multi-year and multi-site studies (Krichbaum, Rowan, Duckett, Ryden, & Savik, 2014). The data will consist of more than 50 intensive interviews with relevant health care professionals. Repeated observations will also be conducted in more than three primary health clinics in the depicted region to ascertain quality services are always being delivered in the medical institutions.

For the practice implications and conclusions, the various medical professional will always be required to report common perspectives on the generated cultural competence associated with distinctive patient communities such as addressing root causes, advocacy, and altruistic motivations while treating diverse patients (Nagelkerk et al., 1998). Moreover, the ANPs and PAs will always be required to create culturally sensitive partnerships with their patients, adjust their practices to meet the needs of the patients, address contextual considerations, and encourage self-advocacy. Also, they should develop niches in different disciplinary teams which emphasize holistic approaches in creating trust and relevant cross-cultural boundaries, both with their diverse patients as well as other health professionals (Krichbaum et al., 2014).

References

Blair, K. A., & Jansen, M. P. (Eds.). (2015). Advanced practice nursing: core concepts for professional role development. Springer Publishing Company. ISBN: 978-0-8261-7251-8

Buppert, C. (2017). Nurse practitioner's business practice and legal guide. Jones & Bartlett Learning. ISBN 13: 9781284117165

Kleinpell, R. M. (2013). Measuring advanced practice nursing outcomes: Strategies and resources. Critical care nurse, 23(1), S6-S6. Retrieved from https://go.galegroup.com/ps/anonymous?id=GALE%7CA98045468&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=02795442&p=HRCA&sw=w

Krichbaum, K., Rowan, M., Duckett, L., Ryden, M. B., & Savik, K. (2014). The clinical evaluation tool: A measure of the quality of clinical performance of baccalaureate nursing students. Journal of Nursing Education, 33(9), 395-404. Doi: 10.3928/0148-4834-19941101-05

Nagelkerk, J., Ritola, P. M., & Vandort, P. J. (1998). Nursing informatics: the trend of the future. The journal of continuing education in nursing, 29(1), 17-21. Doi: 10.3928/0022-0124-19980101-05

Naylor, M. D., & Kurtzman, E. T. (2010). The role of nurse practitioners in reinventing primary care. Health Affairs, 29(5), 893-899. Doi: 10.1377/hlthaff.2010.0440

Rout, A., & Roberts, P. (2018). Peer review in nursing and midwifery: a literature review. Journal of clinical nursing, 17(4), 427-442. Doi: 10.1111/j.1365-2702.2007.01934.x