Multiple types of issues affect quality assurance (QA) in the health care sector. These include economic, legal and regulatory issues. QA in healthcare requires the input of multiple fields of study; through these various layers, the goal is to achieve quality in care for the individuals within the healthcare sector.
Economic issues that affect healthcare QA are many. One of the most recent significant developments for QA due to an economic stand put is the attempt to decrease the incidence of hospital-acquired conditions (HACs). HACs include infections, surgical errors and injuries from falls. This also required a regulatory input on behalf of the Centers for Medicare and Medicaid Services (CMS). In the Deficit Reduction Act of 2005, significant changes were enacted to improve QA in hospitals while reducing costs (CMS, 2012). In 2008, CMS stopped reimbursing healthcare providers and facilities for the costs associated with HACs. While HACs have always been of concern to healthcare facilities, there was now an economic incentive to reduce their incidence. The healthcare facility would be required to absorb the costs associated with them. The savings to taxpayers has been substantial; the average annual savings from this change in reimbursement regulations is $20 million dollars (Black, 2010). Due to the significant economic burden this has on healthcare facilities, many of them are now improving their methods to reduce HACs. This is good for both taxpayers and the patients.
Legal issues also affect the use of QA in healthcare applications and healthcare providers. Healthcare providers and facilities must be licensed and credentialed through various agencies. These credentials are a legal means to ensure the quality of all healthcare facilities and providers. An important legal issue regards the credentialing of health care industrial representatives (HCIRs). HCIRs often utilize new medical devices to demonstrate them to facilities and providers. If they are utilized on a patient, there is a legal and QA issue regarding whether or not the person is credentialed to do so. This is currently a legal issue receiving more debate regarding its solution (Lerner, 2007).
- Black, H. (2010) Hospital-acquired conditions guidelines produce $20 million in savings. Retrieved April 21, 2013, from: http://www.thehospitalist.org/details/article/834431/HospitalAcquired_Condition_HAC_Guidelines_Produce_20M_in_Medicare_Savings.html
- CMS (2012) Hospital-acquired conditions. Retrieve April 21, 2013, from: http://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/HospitalAcqCond/Hospital-Acquired_Conditions.html
- Lerner, A. (2007, May 30) Hospital credentialing of medical device sales representatives: increasing legal issues on the horizon. Retrieved April 21, 2013, from: http://www.crowell.com/NewsEvents/AlertsNewsletters/Health-Provider-Alert/Hospital-Credentialing-of-Medical-Device-Sales-Representatives-Increasing-Legal-Issues-on-the-Horizon