As for its inhabitants. As a first world nation,

As modern technology continually advances and improves, so does the healthcare of citizens. Healthcare is a sign of a nation’s well-being and ability to care for its inhabitants. As a first world nation, America has a well-modeled healthcare system that provides adequate care for citizens, we are known for our highly adequate procedures, for example, we have succeeded in improving HIV management, and reduction in the percentage of Americans who smoke. However, not all areas of America’s healthcare system are as developed as they can be. There are many aspects of the healthcare system that have to be analyzed and tracked for better health outcomes in the nation. Such as the Quality of Domains, strategies to better the healthcare system, and ways to improve quality by using quality measurements.Many people have different perspectives on what quality of health is. For example, patients believe the quality of health is the basic service that you need, such as staying healthy, preventions, living with a certain illness, etc. Hospitals believe that the clinical quality of care is a notable factor. The quality that is delivered in a healthcare aspect is the most important since it plays a significant role in the outcomes. “The Institute of Medicine defines health care quality as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” (Understanding Quality Measurement, 2012) The quality of healthcare has improved tremendously over the years. This is because, the Institute of Medicine has come up with quality domains, which were essentially put into place to increase the health outcomes as well as being compatible with the current knowledge of healthcare. There are six parts to the Quality of Domains, each having a meaning behind them, they are, Effectiveness, Efficiency, Equity, Patient Centeredness, Safety, and Timeliness. The first quality of domain is Effectiveness, which focuses on providing care that is supported by scientific evidence, one example according to the article Across the Chasm, “every elderly heart patient who would benefit from beta-blockers should get them, and no child with a simple ear infection should get advanced antibiotics”. Second Efficiency, which is the ability to expand the quality of healthcare delivered and to succeed in a benefit by using a certain resource available. As I read in Across the Chasm, the most important way to effectively care for a patient that is beneficial to the healthcare system is, “Constantly seeking to reduce the waste — and hence the cost — of supplies, equipment, space, capital, ideas, time, and opportunities”. By using what you have around you to the degree you need it, can help lower costs overall, and decrease the time you are with a patient, which then leads to a better healthcare outcome. Equity is providing the equal amount of care no matter their individual traits, besides their specific condition. According to Across the Chasm  “Race, ethnicity, gender, and income should not prevent anyone in the world from receiving high-quality care. We need advances in health care delivery to match the advances in medical science so the benefits of that science may reach everyone equally”. In order to advance in our outcomes, preventions, and technologies it is important to accept everything and everyone no matter who they are, or where they come from. Patient Centeredness focuses on providing the need and care for a patient in many different ways, such as support or knowledge of the care they are receiving. The patients have right to have a key role in their decision-making process with anything from their privacy to their specific culture. For example, if someone declines any treatments due to their culture, healthcare workers have to respect that and move on. Safety and timeliness focus on making sure the patient isn’t physically harmed and has received the care in a timely manner. For example, the longer a sick patient waits in an emergency room, the worse their health can get. By placing the time domain in place, it encourages doctors to work more efficiently and balanced to ensure their patients are receiving the best care. Also, it helps healthcare facilities work in a more efficient manner with their patients. Safety is always the number one goal for a healthcare facility. This also makes it easier to understand the purpose of quality measures. The Institute for Healthcare Improvement has also come up with strategies to reduce medical mishaps which is, The Err is Human: Building a Safer Health System. This report had brought along a huge amount of support and insight to the healthcare quality system, this is because it showed the critical errors that were being made due to the lack of knowledge of effective care. Also, by setting foot this strategy would help make the healthcare system safer since The Err is Human had mentioned: “…the problem is not bad people in healthcare–it is that good people are working in bad systems that need to be made safer”. This quote has a huge impact on the whole healthcare system, because of its truth. People will always blame the physicians, nurses, and healthcare facilities, sometimes it might be them. But, if there isn’t an effective system put in place there won’t be as many effective outcomes to come out of it. Measuring these outcomes are just as important as well. According to Quality Measures “Quality measures are tools that help us measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for healthcare”. These quality measurements are used in many different programs such as public reporting, pay-for-reporting programs, and quality improvement. There are many ways to gather these reports such as claims, assessment instruments, and registries. Evaluating each healthcare facility individually can give you an example of the quality being delivered, as well as give you steps to improve the healthcare quality that is being given in that exact location.There are four different types of quality measures, which are structure, process, outcome, and patient experience.  The structure measures the structure of a doctor’s office to make sure they have the ability to provide efficient care. These are some examples of the measurements that are taken, ” staffing of facilities and the capabilities of these staff, the policy environment in which care is delivered, and the availability of resources within an institution”. (HSI Quality Measurements, 2017) The process measurement is to measure the ability of care that the doctor offers and the services a physician would recommend, such as preventive screenings or shoots being done yearly. The feedback that is given is to improve the care that is provided, but not all aspects are analyzed under the process measurements, such as  “…whether the care provided was appropriate, or whether a provider coordinated treatment for patients with physical and mental illnesses, for example”. (HSI Quality Measurement, 2017) One example of process care is if the doctors are recommending routine physicals, breast screenings, and blood pressure. Outcome measures the outcomes of the patient after they have received care from a physician, either they can be expected or not. They also measure if the goal of the meeting was accomplished, such as “Patients are interested in surviving illness and improving their health, not the clinical processes that support these outcomes”. (HIS Quality Measurement, 2017) To get these results for the outcomes can be quiet difficult at times. This is because you need an abundance of detailed medical information, that is hard to obtain, as well as very expensive. One example of this measurement is, how many patients have quit smoking due to preventative care and physicians recommendations? Lastly, Patient Experience which is clarity, information that is provided by the doctor, lab results, and getting patients in for an appointment at a timely rate. These measures are very important and critical details of the outcomes to come. This is because if the patient isn’t receiving these measures it could be very dire for the healthcare facility. An example of this measurement could be if the healthcare facility called the patient twenty-four hours after their visit to ask how they are feeling. These measurements are crucial because it tells how the healthcare system is doing in a particular area, and how they can improve their techniques for better health outcomes. Also, using these measurements with children will help improve care for the children, for a better future in healthcare, as well as advancing their techniques while caring for children. These improvements, new techniques, innovations, and cures are all due to these quality domains and quality measurements. Quality domains are a significant factor in the outcomes, to make sure we are following the right protocols, as well as quality measurements. Having healthy patients is the number one goal in healthcare, by reassuring them that the healthcare system has critical guidelines can help the patient feel more comfortable and have more trust in the healthcare system. Having data and reports available that can provide us with real-time examples, help improve the healthcare that is offered to us for now, and the future. Advancing in our techniques it key to success.