Assignment: Quality Scientific Evidences
Assignment: Quality Scientific Evidences
Health care organizations and our health care system as a whole should be striving towards achieving high value. All stakeholders in health care delivery systems benefit from increased value including patients, providers, payers, and suppliers who reap benefit from a stable and well-supported system. As value is defined by outputs, measurement and outcomes are critical to demonstrating increased value and driving iterative improvement to achieve even greater value. The relationship of outcomes relative to cost may define value, and this has been popularized as a value equation where value is equal to quality over cost (dollars spent).1,2
Quality itself has been defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”3 Professional knowledge implies consideration for the best evidence to inform clinical decision-making based on studies and scientific literature with a goal of provision of the right care to the right child at the right time. Evidence-based practice should not be construed to imply that published or high quality scientific evidence is available to inform all clinical questions, rather, that an evidence-based model of care includes consideration for scientific evidence, physician clinical expertise, patient and family values and preferences, clinician preferences, and available resources contextualized to the specific clinical care question for which a recommendation will be derived.4
Variation and the emergency medical services for children continuum
The Institute for Healthcare Improvement has suggested a triple aim framework for optimizing health system performance: (1) a better overall patient experience, (2) improving the health of a population, and (3) delivering care at a better value.5 Application of the triple aim would be relevant for care delivered across the pediatric emergency medicine (emergency medical services for children or EMSC) care continuum. Although thought of as beginning in prehospital or hospital care, the EMSC continuum begins with an incident and involves potentially multiple care venues and providers with ultimate return of the patient to the community and their medical home (Figure 1).
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