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Controlling variation to improve outcomes

How do you control variation to improve outcomes? How might health care administration leaders implement approaches to control for variation for their health services organization?

Within a health services organization different processes and workflows contribute to the overall aim of delivering health services. Not surprisingly, when resources become constrained—for example, with influxes of new patients or even changes in health care policy and law—these changes may result in differences, that is, variation in how these workflows and processes are executed for health care delivery. As a current or future health care administration leader, you may encounter the need to control for variation to maximize the efficiency and effectiveness of health care delivery for your health services organization.

For this Discussion, review the resources for this week and reflect on the approaches health care administration leaders may use to control for variation. Then, select a health process or outcome that might benefit from variance reduction and consider how you might measure the effectiveness of variation reduction for this health process or outcome. Reflect on the McWilliams, Chernew, Landon, & Schwartz (2015) article in this week’s resources and consider how accountable care organizations (ACOs) may compare in relation to non-ACOs.

Post, a description of the health process or outcome you selected and explain why.

Then, explain variance reduction measures that might be appropriate for improving performance for this health process or outcome.

Explain how you would measure the process or outcome to ensure that variance reduction measures worked

. Then, explain how well accountable care organizations (ACOs) performed in comparison to non-ACOs as suggested by the McWilliams, Chernew, Landon, & Schwartz (2015) article.

Explain whether you believe that ACOs will be effective in controlling cost, quality, and access variation.

Then, explain whether you, as a health care administration leader, would encourage a health organization to move toward the ACO model. Why or why not?

Full Answer Section

Accountable care organizations (ACOs): ACOs are groups of health care providers that work together to coordinate care for patients. ACOs are paid a lump sum for each patient they enroll, and they are rewarded for providing high-quality, efficient care. A study by McWilliams, Chernew, Landon, & Schwartz (2015) found that ACOs performed better than non-ACOs on a number of metrics, including cost, quality, and access. For example, ACOs had lower per-patient costs and higher patient satisfaction scores than non-ACOs. Whether ACOs will be effective in controlling cost, quality, and access variation: I believe that ACOs have the potential to be effective in controlling cost, quality, and access variation. ACOs have a strong financial incentive to provide high-quality, efficient care, and they have the ability to coordinate care across different settings. Whether I would encourage a health organization to move toward the ACO model: As a health care administration leader, I would encourage a health organization to move toward the ACO model. I believe that ACOs have the potential to improve the quality and efficiency of care, and they can help to reduce costs. However, it is important to note that there are some challenges associated with the ACO model. For example, ACOs need to be able to coordinate care across different settings, and they need to be able to measure the quality of care they provide. Overall, I believe that the ACO model has the potential to improve the quality and efficiency of care, and I would encourage health organizations to consider moving towards this model.

Sample Answer Health process or outcome: I would select the process of patient discharge as a health process or outcome that might benefit from variance reduction. Patient discharge is a critical process in health care, as it is the point at which patients are transitioned from the hospital to home or another care setting. A smooth and efficient discharge process can help to ensure that patients are safe and well-cared for after leaving the hospital. Variance reduction measures: There are a number of variance reduction measures that could be implemented to improve the patient discharge process. These measures could include:

Standardizing the discharge process: This could involve developing a checklist of tasks that need to be completed for each patient before discharge.
Providing clear and concise discharge instructions: This could involve giving patients written instructions about their medications, follow-up care, and signs and symptoms to watch for.
Ensuring that patients have transportation home: This could involve arranging for transportation for patients who do not have their own transportation.
Communicating with patients' families and caregivers: This could involve providing families and caregivers with information about the patient's discharge plan and how to care for the patient at home.

Measuring the process or outcome: The effectiveness of variance reduction measures could be measured by tracking the following metrics:

The number of patients who are discharged on time: This metric would measure the efficiency of the discharge process.
The number of patients who experience complications after discharge: This metric would measure the quality of the discharge process.
The number of patients who are satisfied with their discharge experience: This metric would measure the patient experience of the discharge process.

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