Over the course of this semester, you have repeatedly heard the terms cost, access, and quality. That's because these are the major cornerstones of health care delivery, and essentially the crux of the debate that is going on in America's current health care reform discussion. As you read Chapter 12, you can see that attempts to control the growing costs of health care expenditures through cost containment initiatives by the government, third-party payers, and employers, and to expand access to services, have been an ongoing effort. However, today, especially with an alarming rise in medical errors, the focus is also shifting toward quality improvement and safety issues, as well as public expectations and demands for quality health care services.

Learning Objectives

After successfully completing this unit, the student will be able to:

  1. Describe the existence, nature, and consequences of quality-related problems in the United States health care system.
  2. Describe alternative approaches to assessing quality through performance, process, and/or outcome measures. Define performance, process, and outcome measures.
  3. Utilize specific quality measures to describe the performance of a health care facility.
  4. Describe current management approaches to quality improvement within health care institutions, specifically the Lean Management (e.g., TPS from Virginia Mason Medical Center) and Six Sigma systems.
  5. Describe the current policy approaches to improving the quality of care within health care
  6. Discuss the magnitude of the problem of medical errors and the challenges to reducing them. Discuss the importance of clear communication between patient and provider.


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