Quality and Sustainability in the Healthcare

Subject: Nursing
Pages: 6
Words: 1572
Reading time:
7 min
Study level: Master

Quality and Safety Measures

Quality and safety indicators are standards for the delivery of healthcare services, according to which it is possible to determine how well healthcare providers are doing their job. Among the measures of quality are structural, process, and outcome measures. The first category includes the ability of the health care provider to provide care to patients. For example, it is about the number of appropriately qualified physicians and the prevalence of electronic patient registration systems. Process measures indicate what steps a healthcare provider is taking to maintain and improve patient health. This includes, for instance, whether or not many people have the opportunity to receive preventive check-ups. In addition, this criterion evaluates how many people have been diagnosed and assessed for chronic diseases. The last group of indicators shows the recipients of healthcare services and how the medical intervention has affected patients’ health (Kleinpell, 2021). Due to them, it is possible to detect which areas are still at increased risk and to adjust them (Kleinpell, 2021). The same division into three types of criteria is used to evaluate patient safety measures.

Safety is one of the significant components that ensure the quality of medical care, along with its accessibility, optimality, and patient satisfaction with the results of its provision. Taking into account the types of work performed by nurses, a system of indicators can be developed to assess their work visually (Nelson-Brantley & Chipps, 2021). Such generally accepted indicators are the quality and safety of the patients. For each indicator, it is necessary to determine the degree of performance that is appropriate for a particular clinic in accordance with the standards of medical services to which it aspires. The indicators help make a correct assessment of the quality of a nurse’s work (Kaiser, 2019). In order for them to be successfully applied in a particular clinic, they need to be competently formulated. The measures are thus a kind of standard that health professionals, and more specifically nurses, should be guided by in their practice. The purpose of this paper is to identify a way to solve the problem related to the health of patients.

Three Barriers and Three Facilitators

More and more people around the world are using online resources in the course of their care. Regulatory barriers still create various obstacles, placing restrictions on users of virtual medicine systems and medical professionals who are allowed to participate in virtual service delivery (see Appendix). The payment scheme for services provided also remains unregulated and ununified. In addition, some institutional barriers and restrictions hinder the introduction of quality medicines and medical devices on the market. High administrative barriers for some law-abiding business entities result in patients not receiving the treatment they need (see Appendix). However, this barrier included in the table will not be analyzed in detail within the framework of this paper. The specific nature of medical services also acts as a barrier to the development of healthcare marketing (see Appendix). The accuracy of diagnosis is largely determined by the technology and equipment used, while the physician’s workload determines the speed of service delivery. In terms of marketing barriers, problems arise for both providers and recipients of medical services.

The way to overcome the institutional barrier can be the abolition of administrative prohibitions that limit the freedom of the medical services market. Certainly, such measures should be implemented gradually and with an analysis of all the pros and cons. The use of relationship marketing will allow health care organizations to become closer to clients by developing long-term relationships based on careful attention to their needs in the process of providing medical services (see Appendix). Increasing the marketing autonomy of state healthcare organizations can also be an important way to solve this problem (see Appendix). The introduction of guidelines to implement digitalization of the healthcare industry would address regulatory barriers in healthcare. However, this paper will not specify detailed ways to reduce the impact of this barrier since only two ways of solving the problems need to be analyzed.

A Health Care Entity

The facility is an outpatient clinic and is located in New York City. The facility is profitable and is the seventh-largest in the state. It has been in operation for over twenty years and delivers a wide range of healthcare services. This clinic performs laboratory and diagnostic tests and provides assistance in a variety of areas. In this institution, each patient can enjoy the benefits of gynecology, urology, cardiology, neurology, proctology, endocrinology, and more. One of the activities of the clinic is MRI and ultrasound examinations. However, mainly the institution specializes in treating people who have recently come out of the hospital or other institutions after treatment. The latest imported medical equipment and excellent diagnostic facilities allow clinic specialists to use a comprehensive approach to solve patients’ problems with guaranteed responsibility for the result.

A Specific Contemporary Safety Issue

Hypertension is one of the most common cardiovascular diseases on the planet. As a rule, if arterial hypertension is not properly controlled and treated, complications can lead to serious health problems for the patient. Hypertension can be controlled with regular use of high blood pressure medications prescribed by a health care worker, diet, and regular exercise (Carey et al., 2018; Rêgo et al., 2019). It is the responsibility of nurses to take steps to prevent patients with this disease from worsening.

Hypertension in the elderly can be treated with medications and some lifestyle changes, depending on the severity of the disease. Uncontrolled arterial hypertension among elders is the most important risk factor for cardiac disorders at this age, such as heart attack (Arija et al., 2018). Currently, there are several types of antihypertensive medications that should be prescribed on a case-by-case basis. In addition, people with hypertension should have regular consultations with a specialist for blood pressure evaluation and treatment. It is possible to improve the condition of patients by monitoring their adherence to their chosen course of treatment and healthy lifestyle (Barone Gibbs et al., 2021). The nurse is the right person to supervise the course of treatment, adjusting the health risks based on the individual patient’s characteristics.

A key measurement of patient safety is the level of health risks associated with the introduction of physical activity into the patient’s routine. Risks will be assessed based on summary measures and specific variables. The patient’s findings will be compared to those of a healthy individual. The nurse will monitor whether there is a positive trend once patients agree to regular exercise (Giuliano, 2017). This kind of monitoring involves taking notes and recording the physiological parameters of the patient (Giuliano, 2017). Moreover, such a type of surveillance should be carried out systematically (Giuliano, 2017). If necessary, quick interventions are allowed if the patient’s condition deteriorates (Giuliano, 2017). This method of observation will also be appropriate in an outpatient setting since patients will be in constant contact with nurses (Russell Rodriguez, 2021). In this way, the nurse will have measurable data about how the treatment is going as a result of analyzing this metric.

The Current Safety Program

Nowadays, numerous circumstances and influences determine a person’s level of health and the state of his cardiovascular system to a greater or lesser degree. Often physicians refer to so-called risk factors in conversations with patients. These are those features of a person’s body, life, and behavior that may contribute to the development of arterial hypertension or other cardiovascular diseases. Everyone should be aware of the most serious risk factors because some of them can be influenced by themselves or with the help of a doctor. Thereby they can reduce the risk of arterial hypertension and its complications.

The outpatient clinic created a health promotion program for hypertension patients in order to change their lifestyle, taking into account individual characteristics. With the help of a nurse, each patient can learn what nonpharmacological methods are available to prevent the disease from worsening. Patients admitted to outpatient clinics are encouraged to incorporate sports into their weekly routine. After obtaining their consent to regular physical exercise, nurses monitor the patient’s health status changes. Such qualitative components as patient satisfaction with the course of treatment and the sufficiency of the staff with knowledge of how to treat hypertension are assessed. Certainly, there are also metrics that track exactly how the incorporation of sport affects health.

However, since the evidence-based effects of these activities have already been confirmed by numerous studies, the detectable effects of the health program only confirm the conclusions drawn earlier. Few patients agree to the introduction of sports into their lives, and there are those who give it up after a while. Programs are observed in this part of the program. However, those who proceed to participate in receiving information about hypertension prevention and regularly participate in sports have seen a positive dynamic.

Summarize the Specific Variables Used

Certainly, first and foremost, the important variable is blood pressure level. However, on a broader scale, whether patients are satisfied with their stay in the outpatient clinic is also evaluated. The nurses monitor how, in addition to lowering blood pressure, the inclusion of 90 minutes of sports per week affects the patient’s overall health. In order to get an unbiased impression of the results, the results are assessed both individually and by overall assessment. Particular attention is paid to the elderly population because due to their age, they are more susceptible to the risk of complications.


Arija, V., Villalobos, F., Pedret, R., Vinuesa, A., Jovani, D., Pascual, G., & Basora, J. (2018). Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: Randomized clinical trial. Health and Quality of Life Outcomes, 16, 1-11.

Barone Gibbs, B., Hivert, M. F., Jerome, G. J., Kraus, W. E., Rosenkranz, S. K., Schorr, E. N., Spartano, N. L., Lobelo, F., & American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology (2021). Physical activity as a critical component of first-line treatment for elevated blood pressure or cholesterol: Who, what, and how?: A scientific statement from the American Heart Association. Hypertension, 78(2), e26–e37.

Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and control of hypertension: JACC Health Promotion Series. Journal of the American College of Cardiology, 72(11), 1278–1293.

Giuliano, K. K. (2017). Improving patient safety through the use of nursing surveillance. Biomedical Instrumentation & Technology, 51(s2), 34–43.

Kaiser, B. (Host). (2019, June 11). Aligning financial incentives with quality incentives (No. 38) [Audio podcast episode]. In The Business of Healthcare Podcast. Center for Healthcare Leadership and Management.

Kleinpell, R. M. (2021). Outcome assessment in advanced practice nursing (5th ed.). Springer Publishing Company.

Nelson-Brantley, H. V., & Chipps, E. (2021). Implementation science and nursing leadership: Improving the adoption and sustainability of evidence-based practice. JONA: The Journal of Nursing Administration, 51(5), 237-239.

Rêgo, M. L., Cabral, D. A., Costa, E. C., & Fontes, E. B. (2019). Physical exercise for individuals with hypertension: It is time to emphasize its benefits on the brain and cognition. Clinical Medicine Insights: Cardiology, 13, 1-10.

Russell Rodriguez, S. (2021). Perspectives in ambulatory care. Return on investment of a centralized telephonic case management program in a commercial population. Nursing Economic$, 39(1), 39-42.

Appendix A

Table One

Current barriers to the health care system Ways to solve these problems
Regulatory barrier (slow digitalization, restrictions on the introduction of new technologies) Dissemination of recommendations on how the process of transition to more technological methods of medical care should be carried out
Marketing barrier (limitations in the field of virtual medicine, difficulties in paying employees who deliver telemedicine services) Increasing the marketing autonomy of public health organizations and the use of relationship marketing
Institutional barrier (laws that oppress market freedom in health care) Gradual repeal of current laws and introduction of initiatives that support competition and market freedom