Promoting education and transparency for healthcare consumers


Quality measures, accreditation, certification and any other tools used to assess quality in healthcare are beneficial and promote patient safety. However, measuring quality in healthcare can be difficult, so we'll discuss some of the advantages and limitations here.

The advantages of healthcare quality assessment are fairly obvious. Quality measures promote evidence-based medicine and attempt to hold providers accountable for offering proven and effective care. Accreditation and certification validates a provider organization's or physician's commitment to high standards of care. All of this information is valuable, and utilizing the resources available to help find a high quality provider is always a good idea. Ultimately, that is what quality in healthcare is all about, striving to ensure that patients get the best care possible from competent and compassionate providers.

Notwithstanding all of the advantages of quality efforts, there are limitations. Quality measurement is relatively new in terms of the history of healthcare and continues to evolve as further knowledge is obtained. Proven measures are generally only available to report on the most common conditions or processes, so a large portion of patient care is not measured. There is also a lack of consistency in the measures developed by different quality organizations, which causes confusion. A significant limitation from a consumer perspective is that quality reporting generally does not incorporate any cost data, so it's not possible to compare quality and cost side by side.

From a provider's perspective, especially a small provider, the biggest challenge with quality measures and accreditation is the significant amount of resources it takes to report and comply with standards. Many times this requires staff, infrastructure, and capabilities that smaller providers may not have and may not be able to afford. In addition, some accreditation requirements can be burdensome for practices and inhibit their efficiency.

The bottom line is that quality assessment is great, but it is not the end all be all, and it may not be appropriate to exclude a provider from your care simply due to a lack of quality measures or accreditation. Some providers choose to not participate in quality reporting or accreditation because they find it financially restrictive, but they may still have excellent doctors that will offer high quality care. One general suggestion that seems to be valuable in most circumstances is to find out the board certification status of your physicians. These days, the vast majority of physicians are board certified in their specialty, so it's reasonable to expect a board certified physician to provide your care.

Essential QSA Knowledge

There are many advantages of quality assessment in healthcare but also some limitations. Proven quality measures generally only exist for the most common medical conditions, so a large portion of patient care is not measured, and it's nearly impossible to compare quality and cost side by side. Quality reporting and accreditation can be financially prohibitive for some providers, which may incline them not to participate. Checking the board certification status of your physicians can help assess their expertise regardless of their organization's quality status.

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