Use your course readings and resources to complete this assignment. The assigned video, “How to use the AHRQ National Quality Measures Clearing House” will assist you, also, with this assignment.

1. Go to the National Quality Measures Clearinghouse (Links to an external site.) website.
2. In the top-right search box, use the search function to identify one survey for each of the four medical experiences listed below:
   1. Patient Experience
      • Wait time for an ointment in a pediatric clinic?
   2. Ambulatory/Office-Based Care
      • What is the length of time between being put into an exam room and the doctor coming into the room?
   3. Hospital Inpatient
      • Wait time for radiology diagnostic test?
   4. Hospital Outpatient
      • What is a response to patient questions post-surgery?
3.  Once you find the survey, identify at least one different quality measure (survey question) for each quality domain (i.e. Patient Experience > Wait time for an appointment in a pediatric clinic). Each quality indicator will have a numerator and denominator.
4. Discuss how the results of the quality indicator could impact quality medical services within the associated medical settings. For each quality indicator, the discussion should be a minimum of three (3) paragraphs, with a maximum of five (5) paragraphs.
5. For the assignment, remember to include the numerator, denominator and cite the survey/study referenced.

Format

Students should use the following format for their written assignment.

1. Use APA format and cite sources, as necessary. If you need a refresher on APA, reference the APA Learning UnitLinks to an external site.. Do your resources meet the CRAAP test?
2. Include Headings and Sub-headings, as needed.
3. Include a Reference page.
4. Students must use a minimum of one survey per medical setting as listed in question number two above.

No plagiarism

Textbook Title: Applying Quality Management in Healthcare: A Systems Approach

Edition: 4

Author: Patrice L. Spath and Diane L. Kelly 

 

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Measurement Systems and Methods

 The process of constructing a balanced scorecard for either financial goal setting or tracking of patient and employee satisfaction can be controversial. For example, a hospital’s financial scorecard provides a snapshot of gathered data for the hospital, but the data may be out of context, which makes it difficult to identify specific problems. It is evident that both scorecards and dashboards have a place in the health care setting; however, will all organizations and accrediting bodies agree on the aspects of implementation, data analysis, and levels of effectiveness?
 

To prepare:

• Consider      the various uses of scorecards and dashboards presented in this week’s      Learning Resources and media presentation.
• Reflect      on how these measurement systems and measurement methods impact      organizational goal setting in the areas of overall performance and      financial stability.
• Explore      the key indicators involved with scorecards and dashboards as well as the      external quality standards to which they are compared.
• Ask      yourself: What do the metrics used in the balanced scorecard and dashboard      mean to my organization and nursing practice? Has my organization      established goals for these metrics and are they currently being met?

By tomorrow Tuesday 12/19/17 12 pm, write a minimum of 550 words essay in APA format with 2 references from the list of required readings below. Include the level one as numbered below:

post a cohesive scholarly response that addresses the following:

1) Select any setting (Hospital) and describe the extent to which the patient’s experience of care is measured, tracked, and set for improvement goals. 

2) Evaluate whether goals at your organization are established for these metrics and whether or not they are currently being met.

3) Describe some of the provocative issues that have or will emerge. For example, what has been the impact of CAHPS or HCAHPS in the setting described (if applicable).

 

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

• Chapter      9: “Measuring and Improving Patient Experiences of Care”

Frith, K. H., Anderson, F., & Sewell, J. P. (2010). Assessing and selecting data for a nursing services dashboard. Journal of Nursing Administration, 40(1), 10–16. doi:10.1097/NNA.0b013e3181c47d45 

This article highlights the benefits of nurses using dashboards to help with staffing issues. It considers the sharing of data that dashboard can facilitate from the perspectives of nurses, units, hospitals, and patients.

Grossmeier, J., Terry, P. E., Cipriotti, A., & Burtaine, J. E. (2010). Best practices in evaluating worksite health promotion programs. American Journal of Health Promotion, 24(3), TAHP 1–9. 

In this article, the authors discuss how to measure success when analyzing worksite health promotion (WHP). They then cover how to organize these measurements, assess WHP programs, and determine factors related to best-practice evaluation frameworks.

Stanley, R., Lillis, K. A., Zuspan, S. J., Lichenstein, R., Ruddy, R. M., Gerardi, M. J., & Dean, J. M. (2010). Development and implementation of a performance measure tool in an academic pediatric research network. Contemporary Clinical Trials, 31(5), 429–437. 

The details of this article focus on a multi-center research network that initiated an evaluation method using balanced scorecards. The first three years of the measurement tool’s implementation are covered, and the achievements and challenges are discussed.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Benchmarking outcomes. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

In this program, Barbara Epke and Carrie Brady discuss methods that health care organizations use to gather data for measuring outcomes, and explain how data are used to measure key indicators of quality and safety.

 

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Measures of Quality

 Health care quality is a nationally recognized topic that is addressed through public policies, licensure, and accreditation standards for health care professionals and organizations. Throughout history, numerous organizations have been involved in developing health care quality and safety initiatives.
 

The Joint Commission and Centers for Medicare and Medicaid Services (CMS) developed quality and safety indicators for various health care systems. These indicators seek to establish accountability for health care organizations through a reporting system, which is available to the public. For this Discussion, explore various accrediting organizations and specific measures that pertain to quality. In your research on accrediting organizations, consider how these quality measures affect quality outcomes, support ethical principles, and influence the delivery of clinical services.
 

To prepare:

• Select one specific quality indicator      from the Week 2 Discussion and compare it with those outlined in this      week’s Learning Resources (In week 2 discussion, I spoke about nosocomial      infections and pain management as quality indicators).
• Review the accrediting body standards      that pertain to your organization focusing on those standards that require      your organization to define its quality management program.
• Consider regulatory requirements at      the state or national level that affect quality outcomes in your      organization.
• Ask yourself: How do the Centers for      Medicare and Medicaid Services (CMS) restricted reimbursements affect      quality management or improvement efforts at my organization? How do these      standards and regulations influence or support ethical principles and      influence patient care and nursing practice?

By tomorrow Wednesday 12/13/17, write a minimum of 550 words in APA format with at least 3 references from the list below that addresses the level one & two headings as numbered and lettered below:

post a cohesive scholarly response that addresses the following:

1) Choose any measurement and explain the extent to which your chosen measure is affected by CMS driven incentives and disincentives. 

2) From a systems perspective, discuss how this measure affects:

a. Quality outcomes 

b. Supports ethical principles 

c. Influences patient care and nursing practice.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 5: “Data Collection”

Chapter 6: “Statistical Tools for QI”

Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefitted financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251.

Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting.

Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406.

This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable.

Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/

Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF).

Required Media

Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.

 

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Measuring Quality Guidelines and Grading Rubric

In an 8 to 10-page paper, APA format and 5 references, describe three rate based measurements of quality.

Select three rate based measurements of quality that you will use as the primary basis for this paper.

These measurements must relate to some aspect of clinical or service quality that directly relates to patient care or the patient’s experience of care.  For the purposes of this assignment, an analysis of staffing levels is not permitted.  You can find useful information on quality indicators that are of interest to you on these websites and resources.  You may choose only one of the three measures to be some form of patient satisfaction measure. 

Deconstruct each measure to include descriptions of the each of the following as numbered below: 

1) The definition of the measure 

2) The numerical description of how the measurement is constructed (the numerator/denominator measure counts, the formula used to construct the rate, etc.)  

3) Explain how the data for this measure are collected 

4) Describe how the measurement is compared externally to other like settings; differentiate between the actual rate and a percentile ranking.  

5) Explain whether the measure is risk adjusted or not.  If so, explain briefly how this is accomplished.  

6) Describe how goals might be set for each measure in an aggressive organization, which is seeking to excel in the marketplace. 

Describe the importance of each measure to a chosen clinical organization and setting. 

Using these websites and resources you can choose a hospital, a nursing home, a home health agency, a dialysis center, a health plan, an outpatient clinic or private office; a total population of patient types is also acceptable, but please be specific as to the setting. That is, if you are interested in patients with chronic illness across the continuum of care, you might home in a particular health plan, a multispecialty practice setting or a healthcare organization with both inpatient and outpatient/clinic settings. Faculty appointments and academic settings are not permitted for this exercise. For all other settings, consult the instructor for guidance. You do not need actual data from a given organization to complete this assignment. 

Relate each measure to patient safety, to the cost of poor quality, and to the overall cost of healthcare.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 5: “Data Collection”

Chapter 6: “Statistical Tools for QI”

Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

1. The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefited financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251.

Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting.

Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406.

This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable.

Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/

Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF).

Required Media

Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.

 

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Competency

Examine the application of statistical functions and derivatives as instruments for measuring risks.

Instructions

You will assume the role of a senior analyst hired by a fictitious company, Premium Acceptance, a midsized property insurance carrier. Premium Acceptance is performing well with respect to several key performance indicators, including policies in force, policy retention, and new business counts.

One of your objectives as the newly appointed senior risk analyst is to develop a framework for managing loss ratios which is one of the firm’s largest key performance indicators. A loss ratio is simply the difference between the ratio of claims paid by an insurance carrier and the ratio of premiums paid. The board of directors depends on the ability to forecast loss ratios, which in turn enables them to forecast profitability metrics to the shareholders. The organization will now consider implementing the use of statistics for measuring risks.

Your deliverable should be composed in a report. Be sure to address the following items:

• Explain how statistics is used to formally define risk in the risk assessment process.
• Discuss at least two statistical tools that can be employed to measure risk.
• Convey which tool best serves the company’s purposes and explain why it is.
• What are the ramifications of the organization electing not to use statistics in this process?
• Include:

1.An accurate overview that includes specific examples of how statistics support the risk assessment process is given.

2.At least two valid statistical tools that can be employed to measure risk are discussed with details on specific applications.

3.Correctly identifies which tool best serves the company’s purpose AND gives an explanation of why it is the best tool that includes specific examples of an application of the tool.

4.At least two valid ramifications of choosing to not use statistics in the risk assessment process are thoroughly explained.

2 pages minium

2 pages references 

 

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