HOLY ANGEL UNIVERSITY

GRADUATE SCHOOL OF NURSING

Master of Science in Nursing

The International Society of Quality in Health Care 2018

Submitted by:
Marilyn D. Palpal

Submitted to:
Jonathan D. Cura PhD, RN

March 2019
 The International Society of Quality in Health Care 2018

1. How can you evaluate the presence of transformed healthcare?

With the fast-paced condition of the health care industry, new, integrated and transformed healthcare
has been emerging to replace or improve obsolete healthcare practice and services. To evaluate these
ground-breaking changes, one must look into the core of it all which is quality. According to Ted Ross,
even with increased access to services, health improvements can remain elusive unless those services are
of sufficient quality to be effective. We are looking forward to a universal health care that could cover
health problems of many, but without quality, this remains an empty promise.
Quality in the sense that, does this address the key challenges in healthcare identified through
extensive research? Quality health care always has its focus on the client, the subject, the people. We are
aiming for a comprehensive, coordinated, people-centered, continuous, and accessible primary health
care. Then, for us to be closer to if not completely achieved it, the identified obstacles must be given
attention first. That being said, the presence of a transformed healthcare can be evaluated if the system
itself has something to do to improve or provide actions to these challenges.
One of the key challenges mentioned in the convention is how fragmented the health care system of
most are, Philippines included. With the introduction of integrated system, it aims to standardized system
under a single government policy that evolves into a unique health system. In the Philippines, this could
be hard to implement as healthcare is highly political. Those in power, though they tried to focus their
attention as much to healthcare, there are other areas that needs to be prioritized like education and
infrastructure, especially in a third world country.
Does this transformed healthcare aids in solving the problems in disparity of quality in health. The
introduction of technology in healthcare might be a closer solution to this problem. In Kenya, mobile
technology is used to access physicians, ordering of blood is done through text messages and delivery is
done by drone in some country, and in South Africa, they have this program called Mom Connect that
give reminders, advices, and maternal health related information to women and expectant mothers.
Through this all are in equal footing in accessing health care in some specific areas.
Private public partnership are being studied for implementation in Malaysia. Through this, they are
hoping for service integration to enhance care as well as reduced cost in order that every money spent,
best maximum outcomes can be attained. Optimization of available resources is one area to look also look
at. Rather than asking for what we don’t have, maximizing limited resources to achieve good endings
seems to be practical.
A good, high performing transformed healthcare is directed to addressing the existing hurdles and
challenges faced today by our current healthcare system. It must not focus only on access but also
emphasis on improvement of services to increase return of investments in terms of patient outcomes. As
what Margaret Chen said, “What good does it do to have a free maternal care, when the quality of the care
is substandard or even dangerous”. Alike to a country that focused on immunization coverage and not the
quality of immunization only to be hit by outbreaks in areas that have achieved high vaccination
coverage.
2. How do you differentiate patient-based care from patient centered care?
Not until recently that I thought patient based care and patient centered are alike and can be
synonymously used in healthcare. As it turns out the two are quite different from each other.
 Patient centered care according to the Institute of Medicine is providing care that is respectful of and
responsive to individual patient preferences, needs and values, and ensuring that patient values guide all
clinical decisions. This is a care based on collective information on a disease, specific area, or situation
that are processed and analyzed to come up with a general system that hopes to address concerns of
patients as a whole.
Patient based care on the other hand as what Professor Cliff Hughes reiterated in his talk, are based on
the assumption that people have the right and duty to participate individually and collectively in their own
care. That what the patient said about their condition are the basis of everything we do, think, and say.
Come to think of it. This has always been present when we do our nursing assessment, diagnosis, and
intervention. We always write in our plan to encouraged verbalization of the patient’s feelings and
concerns. From then, we determine our interventions and address the main health problems which are
what the patients tell us about.
While patient centered care can be done in a pre-determined time and place, patient based care is
dependent on the current situation, thus it varies from one person to another. In a community setting,
patient centered care is when we developed programs for the good of the community like conducting
seminars on hypertension from the findings that high cases of hypertension is reported in that area. Patient
based care happens when we do a home visits. The basis of care we render are dependent on our
assessment of the individuals from each household.
3. In what ways can technology be used to improve health service delivery?
Quality initiative by innovation and creativity introduces technology to healthcare. Taking advantage
of what science has to offer, we can improve health care delivery in the following ways:
a. Easy access
The presence of application through internet or mobile technology allows anyone to
connect to doctors available to cater health needs. Disease burden across the continent is strongly
related to demography and poverty. With technology, it gives hope to people who are in remote
areas to have the same access to health information or advices as those who are in urban areas.
Also, the introduction of personal health record provides clinicians with immediate
access to up to date and aggregated summary of health information of a patient that can hasten
medical interventions needed. Mobility and cloud enablement also improve patient engagement
and maintain patient records systematically.
In hospital area, the utilization of computerized physician order entry hopes to improve
quality of care through reduction of errors related to the ambiguity of handwriting or transcription
of medication order. If regulated accordingly with strong security system, it can further optimize
patient safety and efficiency of care.

b. Cost reduction
Proper diagnosis and appropriate medical advice from abled physicians leads to decrease
hospital stay, ergo reduction of cost. Investment in advanced diagnostic technologies aids
physicians in quick diagnosing and prompt treatment sparing the patient from additional financial
burden of longer hospital admission due to delayed medical attention.

c. Time
Time is important in healthcare. Every minute matters, every second missed might cause
a person’s life. Significant delays caused by inevitable circumstances from using obsolete or
traditional services might cause a persons’ life. Through technology, it is now possible in some
countries to order blood by just a text message and have it delivered via drone in emergency
situations.
d. Facility congestion
Acquiring appointment in hospitals or clinics online can regulate the flow of service thus
preventing congestion of the facility. Long queue as well as long waiting hours can also be
avoided as patients are seen in a scheduled time one at a time.
Likewise, having patient sought initial consult through health enabled application catered
by competent doctors can determine patients that need emergency care and those who do not thus
also reducing the number of unnecessary hospital visits.

e. Convenience
Telehealth systems permit health care providers to remotely monitor and communicate
with patients, allowing for timely identification of emerging issues and consultations that are
convenient to patients.
Econsults allows patient to have the medical attention they need in the comforts of their
home in collaboration with the patients’ significant others. Wearable devices to measure vital
signs and other health related statistics is also becoming a trend nowadays. This enable patients to
monitor their health status without disrupting their activities of daily living.
f. Patient centered
Genomics and advanced analytics are paving a way to fight unique disease with
personalized medicine. Artificial Intelligence enables 24/7 patient interaction with access to
emergency care allowing intervention to be tailored solely for the benefit of one independent to
other consults.

g. Evidence based practice

Health care providers may use information technologies to advance evidenced based
practice. Data contained in electronic health record can be used to rapidly assess the effectiveness
of interventions for specific patients, as well as to assess broader relationship between care
processes and patient outcomes. These can be taken advantage to meet immediate care needs and
to guide organization policies towards care improvement.