Quality Assurance in Managed Care of Chronic Conditions
QualityAssurance in Managed Care of Chronic Conditions
TheNature of Chronic Diseases and Hindrances to Ensuring Quality Care
Patternsof health, illness, and death vary intensely between nationsregarding the levels of economic advancement, health procedures andmedical modernization. Chronic illness is termed as having a singleor more of long-lasting features with ambiguous treatment. Asillustrated by Novak, Mart & Beansland (2013), chronic illnessnecessitates special handling of the patient for rehabilitation andrequires a continued management. Chronic infections may includediabetes, stroke, cancer, renal illness among many others. They varyin harshness from those that are fairly mild, prevented by clinicaltreatments and variations in fitness characteristics to those thatare severe, deadly, require extensive medical care and causedisability.
Chronicillnesses occur in multifaceted interdependencies and processesacross the life span and they are ranked highest to cause death inindustrialized nations. They frequently develop progressively as aresult of the of environmental and hereditary factors however in manyinstances, the exact cause cannot be defined and its diagnosis can beproblematic. Equally, chronic illnesses have enhanced the assumptionsof current medication thus their rise has enhanced the role played byfamilies in offering care for the disabled (Falvo & Donna, 2013).
Onthe other hand, when the health care system fails, chronically illpatients are often affected the most. For instance, the U.S.’shealth care structure cannot optimally deliver the services desiredby individuals with chronic illnesses. In this case, a number ofthese trends obstruct the delivery of ideal or quality care. Theobstacles to these area as follows: First, care is often fragmentedand poorly coordinated this threatens medical care quality andeffectiveness for many patients since it becomes worrying for thosewith complex chronic disorders.
Secondly,familyand patient roles are too restricted to manage the conditionnormally, individuals with chronic conditions get improved healthresults and are more contented with their care if they take partpassively in managing their well-being thus restricting their roleshinder quality care delivery. Thirdly, failure to practiceevidence-based medicine this is a planned design that take the bestavailable systematic evidence and allow clinicians to apply theoutcomes in medical exercise. Failing to practice this approach, thequality of care will not improve as the gap between the treatmentcommended based on clinical evidence and the actual handling providedwill not be closed (Cole, Robert & Reiss, 2013).
Fourth,technological advancement is not fully utilized it is critical fordelivering better chronic care as digital technology used increating, keeping, disseminating information to aid the deliveringprocess of health is necessary thus the rate of implementation ofadvanced technology in health care is slow and there has been greathesitancy within health care to capitalize on information technology.
Fifth,today’s health care system is ill-equipped to manage patients withchronic illness and breaks down fast when challenged with patientswith multiple chronic conditions. This happens because the disasterpresented by acute model emphases on treating a patients’ immediateneeds or signs and outlines every patient relation with health caresystems as an isolated encounter. This model overlooks theinterdependent nature of multiple conditions (Anonymous, 2012).
Sixth,neglected appointments impact doctors and health providers who getpayment only for those patients who attend an appointment. Forinstance, in the United States, the approximate cost of “no-shows”accounts for almost 4 % to 15% of total outpatients’ clinicrevenue. Likewise, the physicians are more likely to miss the chanceto plan other appointments during this time slot hence they areintensified from a social perspective.
StepsTaken to Improve Quality Care
Improvingchronic infection care will need more than the less significantchanges and accommodation to healthcare system therefore, thefollowing steps can be taken to improve the quality of chronicconditions. First, chronic conditions such as diabetes and renalinfections should receive regular intensive care to prevent theillness from growing to adverse levels extensive management ofchronic conditions is crucial to both developing health results ofpoor people and encountering charges in the health care system.
Secondly,appointment scheduling programs should be reviewed so that clinicappointments are more reachable and valuable marginalized patients.In this case, the chronically ill people are likely to have aconsistent care delivery team that comprehends the patients’exceptional therapeutic and social history as a result of having aprovision team, the lead professional is at a better position tohandle the patients to sustain wellness by routine appointment evenif the individual is not encountering challenging symptom (Gottlieb &Benjamin, 2013).
Thirdly,empowering community members to promote collective neighborhoodwellness on chronic illness will improve efficient coordination amongpatients and care providers. They pursue to encourage patientdevotion to care by taking part in regular home appointments andmobile calls to the affected persons. Similarly, medicalpractitioners are incentivized to use the services of public healthpersonnel by local, state and private grant funding. This qualitycare improvement approach is cost efficient from the providers,patients, and the clinical system perception.
Whatworks, what does not Work and Recommendations to Improvements
Wrongmodels are often used in the management and treatment of chronicillness hence the quality of care is compromised. For instance, theacute model is useful for understanding and handling medicalillnesses leading to remarkable attainments in identifying the causeand mechanism of infections as well establishing appropriatetreatments. The model has improved the acute conditions however it isnot an appropriate outline for managing chronic conditions.
Onthe other hand, the chronic care model which is an administrativemethod of managing individuals with prolonged illnesses in a majorcare context. It is appropriate since it is population-oriented andmakes practical, compassionate, evidence-based collaborations betweena well-versed and a prepared proactive practice team. The modelrecognizes basic essentials of a health care scheme that promotefirst-class chronic illness care. Therefore, this model works best inchronic disease management (Cramm, 2013).
Forcontinued improvement of chronic illness, I recommend the followingto be done. First, while projecting the forthcoming demand and supplyof health care providers in chronic illness care, a significantchange in health care profession education is necessary in order tohave trained and skilled practitioners who will handle the diverseneeds of patients with chronic conditions. Secondly, optimizinginformation technology is fundamental this will provide and improveclinical decision-making processes, collect and share clinicalinformation concerning chronic illness, reduce errors and enhancingpatient/clinician relationships. Thirdly, patients and familiesshould be allowed to take part in managing chronic conditions sincethey are best placed to correctly identify and illustrate chronicdesigns.
Anonymous.(2012). Remaking chronic care in the age of healthcare reform:Changes for lower-cost, higher-quality treatment. Health Affairs,31(5), 1123.
Cole,Robert E., & Reiss, D. (Eds.). (2013). How do families cope withchronic illness? Routledge.
Cramm,J. M., & Nieboer, A. P. (2013). High-qualitychronic care delivery improves experiences of chronically illpatients receiving care. International journal for quality in healthcare,25(6), p.689. Retrieve from the Trident Online Library.
Falvo& Donna. (2013). Medical and psychosocial aspects of chronicillness and disability. Jones & Bartlett Publishers.
Gottlieb& Benjamin. H. (Ed.). (2013). Coping with chronic stress.Springer Science & Business Media.
Novak,Marta., Costantini, L., Schneider, S., & Beanlands, H. (2013,March). Approaches to self‐managementin chronic illness. Blackwell Publishing Ltd.
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