Final Quality Project Part 1: Quality Improvement and the EHR

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4508 Final Quality Project Part 1: Quality Improvement and the EHR

 

Overview

This activity focuses on Quality Improvement using EHRs. The activity uses online resources as well as copies of actual medical records. For this assignment, you will perform an audit of the documentation of consents in the chart for accuracy and quality. Afterwards, you will make recommendations about the consent and audit process. This encompasses quality management, performance improvement and initiatives within a healthcare system.

Quality Improvement (QI): Systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups. (www.hrsa.gov) Continuous Quality Improvement (CQI): Is a quality management process that encourages all health care team members to continuously ask the questions, “How are we doing?” and “Can we do it better?” (Edwards, 2008). To address these questions, a practice needs structured clinical and administrative data. (www.healthit.gov) Rapid-Cycle Quality Improvement: A QI methodology that was developed out of the need to see improvement quicker. It reduces wasted activity and efforts for a quick turnaround on QI projects. PDSA/PDCA: Plan, Do, Study/Check, Act. A commonly used QI strategy that is a four step rapid-cycle quality improvement strategy.

• Plan: Identify an opportunity to improve and plan a change • Do: Carry out the plan on a sample number of patients. • Study/Check: Examine the results. Were your goals achieved? • Act: Use your results to make a definitive decision. Incorporate the changes into your

workflow.

SMART Goals:

• Specific (simple, sensible, significant). • Measurable (meaningful, motivating). • Achievable (agreed, attainable). • Relevant (reasonable, realistic and resourced, results-based). • Time bound (time-based, time limited, time/cost limited, timely, time-sensitive).

 

 

 

 

Activity 1

Watch video: Implementing EHRs to Improve Healthcare Quality: https://youtu.be/okO8Z7ZPPuw

Watch video: The Path to Interoperability: https://youtu.be/PaWcU7rqqyA

Answer questions 1-3.

1. Most physicians feel as if EHRs do not save them time. What is your response to this? a. Were EHRs designed to “save time” in the healthcare documentation process? b. If not, what was the EHR designed to do? Be thorough in your response.

 

2. When implementing organization wide QI initiatives, many employees and physicians take the attitude of “that won’t work here.”

a. How should the organization respond? b. What would be different ways of implementing an initiative that could combat this

response?

3. Do you feel quality improvement is an easier process now that many healthcare organizations are utilizing an EHR? Why?

 

Activity 2

Use the chart forms linked in the assignment description on Canvas to complete this activity:

You are completing an internship in the Quality Department at General Hospital. As part of your internship, the director of the department has asked you to complete a small quality improvement project utilizing their EHR. The director would like you to determine if randomly selected five charts meet the following criteria:

• The consent is detailed and addresses the following 8 items: o Permission o Unforseen Conditions o Anesthesia o Specimens o Photographing, Videotaping, etc. o Explanation of Procedure, Risks, Benefits, and Alternatives o Blood Transfusion o No Guarantees

• All signatures required are present o Patient/Relative/Guardian o Physician o Witness

 

 

 

4-8. Record chart findings: (questions will be individual on quiz). All valid electronic signatures are denoted by an /es/ with the name of the individual signing and the date/time of the signature.

Question # Chart # Yes No

4. 1 5. 2 6. 3 7. 4 8. 5

 

9. Based on your findings from the 5 charts, what would be a goal for improvement (use the SMART goal format)?

 

Analyze the process and come up with your QI process (keep it simple)

10. Plan: 11. Do: 12. Check/Study: 13. Act:

 

Activity 3

You are the director of the Health Information Management Department of Hospital XYZ. The hospital has been using an EHR for 6 years and has been part of the Meaningful Use Incentive Program for 3 years. Part of your success has been the routine audits of medical records. The clinical staff is short-handed and has admitted to not being able to document as they used to as evidenced by the results of Activity 2. Your current staff of two are not able to meet the demands of auditing the charts and you will be hiring a third person to work with you. Among your many duties as manager is keeping policies and procedures up-to-date. Your team has composed the step by step process for a policy about auditing but after you review it you notice there are key elements missing that you as director must complete. The policy with the highlighted areas needed is located on the Modules page under this assignment (Critical thinking is required)

14. Title of policy 15. Purpose of auditing 16. Individuals responsible for documenting clinical information in the medical record 17. Individuals responsible for auditing the medical record to ensure documentation is complete

 

 

18. Definitions – do not define, just list the words from the policy that should be defined

Listed below are the balance sheet and statement of operations for Wynn Memorial Nursing Home

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Listed below are the balance sheet and statement of operations for Wynn Memorial Nursing Home for 2008 and 2009.

1. Compute Wynn Memorial Nursing Home’s current ratio.

2. Compute Wynn Memorial Nursing Home’s acid (or acid-test) ratio.

3. Compute Wynn Memorial Nursing Home’s days in accounts receivable.

4. Compute Wynn Memorial Nursing Home’s average payment period.

5. Compute Wynn Memorial Nursing Home’s long-term debt to net assets ratio.

6. Compute Wynn Memorial Nursing Home’s net assets to total assets ratio.

7. Compute Wynn Memorial Nursing Home’s total asset turnover ratio.

8. Compute Wynn Memorial Nursing Home’s fixed asset turnover ratio.

9. Compute Wynn Memorial Nursing Home’s return on total assets.

10. Compute Wynn Memorial Nursing Home’s operating margin.

Listed below are the industry standards of the above ratios for Wynn Memorial’s peer group. Use this information as you answer problems 11 to 14.

 

Nursing Home Financial Ratios–Industry Median
Current ratio1.98
Acid test ratio0.20
Days in accts receivable67.19
Average payment period56.13
Total asset turnover1.02
Fixed asset turnover2.20
Operating margin0.02
Return on total assets0.04
Long-term debt to net assets0.62
Net assets to total assets0.53

11. Comment on Wynn Memorial’s liquidity. Cite at least one meaningful ratio to support your observations.

12. Comment on Wynn Memorial’s efficiency in its use of assets. Cite at least one meaningful ratio to support your observations.

13. Comment on Wynn Memorial’s profitability. Cite at least one meaningful ratio to support your observations.

14. Comment on Wynn Memorial’s capital structure. Cite at least one meaningful ratio to support your observations.

 

Be sure to answer each question thoroughly and include citations of outside sources where appropriate.

 

Policy Evaluation Analysis Template

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To Prepare: Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources. Select an existing healthcare program or policy evaluation or choose one of interest to you and get approval to use it from your Instructor. Review the healthcare program or policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.  The Assignment: (2–3 pages)  Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following: Describe the healthcare program or policy outcomes. How was the success of the program or policy measured? How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? At what point in program implementation was the program or policy evaluation conducted? What data was used to conduct the program or policy evaluation? What specific information on unintended consequences was identified? What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples. Did the program or policy meet the original intent and objectives? Why or why not? Would you recommend implementing this program or policy in your place of work? Why or why not? Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

Final Project Milestone Two Guidelines and Rubric Situational Analysis

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IHP 510 Final Project Milestone Two Guidelines and Rubric Situational Analysis

Overview: For Final Project Milestone One, you analyzed Bellevue Hospital, and in your Module Four Worksheet, you practiced completing a very basic SWOT analysis. Now, for this second milestone, due in Module Five, you will conduct a full situational analysis to identify the internal and external market factors that impact the Bellevue Hospital, propose a service to market for the organization, and generate a marketing goal for this proposed service. Prompt: First, review the text readings and course resources you have so far studied. In addition, review your Final Project Milestone One and Module Four Worksheet submissions and instructor feedback to those submissions. The SWOT analysis you completed in the Module Four Worksheet is one method by which to conduct a situational analysis. Use this process to assist you as you complete the situational analysis in this milestone. Also refer back to the Bellevue: Community Health Needs Assessment to inform your analysis. Next, in 2 to 3 pages, conduct a situational analysis that analyzes the internal and external market factors that impact Bellevue Hospital. In addition, propose a service to market for the organization and develop marketing goals for this proposed service. The paper should explain how the proposed marketing goals align with the mission, vision, and strategic goals of the organization. Keep in mind that your marketing goals should follow the SMART goal framework (specific, measurable, achievable, realistic, and timely). The following critical elements must be addressed:

I. Situational Analysis: In this section of the marketing plan, you will be conducting a needs analysis to identify and propose a service for the organization.

A. Analyze the internal and external market factors impacting the healthcare organization. B. Propose a service to market for this organization. Include an explanation as to whether it is addressing an opportunity or weakness from the

market factor analysis. C. Develop a marketing goal for the proposed service, applying the SMART goal framework. D. Justify the alignment of the marketing goal to the mission, vision, and strategic goals of the organization. E. Analyze the competition for the proposed service. F. Evaluate how the current marketing strategies used by the organization adhere to industry ethical criteria.

Refer to your completed Final Project Milestone One and Module Four Worksheet, as well as to the text readings and other course resources to support your responses. Be sure to incorporate instructor feedback on this milestone submission into your final project.

 

 

 

 

Rubric Guidelines for Submission: This milestone should be submitted as a Word document, 2 to 3 pages in length, double-spaced, using 12-point Times New Roman font, one-inch margins, and the latest edition of the APA manual for formatting and citations.

Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value

Situational Analysis: Market Factors

Analyzes the internal and external market factors impacting the healthcare organization

Analyzes the internal and external market factors impacting the healthcare organization, but analysis is incomplete or unclear

Does not analyze the internal and external market factors impacting the healthcare organization

15

Situational Analysis: Propose a Service

Proposes a service to market for this organization, explaining whether service is addressing an opportunity or weakness based on market factor analysis

Proposes a service to market for this organization, explaining whether service is addressing an opportunity or weakness based on market factor analysis, but response has gaps in detail, clarity, or logic

Does not propose a service to market for this organization

15

Situational Analysis: Marketing Goal

Develops a marketing goal for the proposed service, applying the SMART goal framework

Develops a marketing goal for the proposed service, applying the SMART goal framework, but goal is incomplete or unclear, or framework is applied inaccurately

Does not develop a marketing goal for the proposed service

15

Situational Analysis: Alignment of Goal

Justifies the alignment of the marketing goal to the mission, vision, and strategic goals of the organization

Justifies the alignment of the marketing goal to the mission, vision, and strategic goals of the organization, but response is incomplete or unclear

Does not justify the alignment of the marketing goal to the mission, vision, and strategic goals of the organization

15

Situational Analysis: Competition

Analyzes the competition for the proposed service

Analyzes the competition for the proposed service, but with gaps in detail, clarity, or accuracy

Does not analyze the competition for the proposed service

15

Situational Analysis: Ethical Criteria

Evaluates how current marketing strategies adhere to industry ethical criteria

Evaluates how current marketing strategies adhere to industry ethical criteria, but with gaps in detail, clarity, or accuracy

Does not evaluate how current marketing strategies adhere to industry ethical criteria

15

Articulation of Response Submission has no major errors related to citations, grammar, spelling, syntax, or organization

Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas

Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas

10

Total 100%

 Describe the difference between cost-saving and cost-increasing technology-based innovations.

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 Describe the difference between cost-saving and cost-increasing technology-based innovations. Provide an example of each and analyze why a cost-increasing innovation would continue to be used. PROVIDE IN TEXT CITIATION

Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources

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To Prepare: Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources. Select an existing healthcare program or policy evaluation or choose one of interest to you and get approval to use it from your Instructor. Review the healthcare program or policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.  The Assignment: (2–3 pages)  Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following: Describe the healthcare program or policy outcomes. How was the success of the program or policy measured? How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? At what point in program implementation was the program or policy evaluation conducted? What data was used to conduct the program or policy evaluation? What specific information on unintended consequences was identified? What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples. Did the program or policy meet the original intent and objectives? Why or why not? Would you recommend implementing this program or policy in your place of work? Why or why not? Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

What are some non-monetary statistics—besides labor hours and patient volume—that have a direct effect on the financial management of a health care organization?

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Write a 175- to 265-word response in APA format to the following questions:

  • What are some non-monetary statistics—besides labor hours and patient volume—that have a direct effect on the financial management of a health care organization?
  • Are there statistics that do not translate into a monetary effect?

Please use sources listed below:

Gapenski, L. (2015). Healthcare finance: An introduction to accounting & financial management (sixth edition).  Health Administration Press.   ** Chapters 6 and 16 **

Prompt: First, review the text readings and course resources you have so far studied

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Prompt: First, review the text readings and course resources you have so far studied. In addition, review your Final Project Milestone One and Module Four Worksheet submissions and instructor feedback to those submissions. The SWOT analysis you completed in the Module Four Worksheet is one method by which to conduct a situational analysis. Use this process to assist you as you complete the situational analysis in this milestone. Also refer back to the Bellevue: Community Health Needs Assessment to inform your analysis.

Next, in 2 to 3 pages, conduct a situational analysis that analyzes the internal and external market factors that impact Bellevue Hospital. In addition, propose a service to market for the organization and develop marketing goals for this proposed service. The paper should explain how the proposed marketing goals align with the mission, vision, and strategic goals of the organization. Keep in mind that your marketing goals should follow the SMART goal framework (specific, measurable, achievable, realistic, and timely).

I have attached the rubric for this assignment as well as the assignments that are needed for reference. A SWOT worksheet is attached as well as the SWOT assignment completed in Module four as an example.

 Is it necessary for organizational mission statements to include all the components discussed in this chapter? How do you decide what components to include?

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Chapter 5 Q’s 1-10

 

1. Is it necessary for organizational mission statements to include all the components discussed in this chapter? How do you decide what components to include?

2. Think of an organization that you know relatively well and attempt to construct a mission statement in light of the components of missions discussed in this chapter. What components did you choose to emphasize in the statement? Why? What component do you think really embodies the distinctiveness of the organization?

3. Where do organizational missions originate? How do you explain the evolution of organizational missions as an organization grows and matures? If mission statements are “relatively enduring,” how often should they be changed?

4. Indicate two ways in which an organizational vision is different from other types of directional strategies.

5. It has been said that vision is necessarily a responsibility of leaders. Why is it important for health care organizations to have “keepers of the vision?”

6. Who determines the values of the health care organization? What values do you think should be shared by all health care organizations? Why?

7. Why are values referred to as an organization ’s guiding principles? In what sense do values constitute a directional strategy for the organization?

8. How many strategic goals should a health care organization develop?

9. How can health care managers more effectively use directional strategies to stimulate higher levels of performance among all personnel?

10. Why is the board of directors an important group to include in the formulation of directional strategies? What is the board’s proper role in formulating these strategies?

 

Chapter 9 Q’s 1-5

 

1. What part does internal environmental analysis play in the development of value adding support strategies? What part does strategy formulation play?

2. How do the value-adding support strategies create the “context” for strategy implementation?

3. What is organizational culture? How does it implement strategy?

4. What are the basic building blocks of structure? What are the advantages and disadvantages of each?

5. In what circumstances might a high level of standardization be required? A high level of flexibility?

Business Plan Part 4: Implementation Schedule

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Rubic_Print_Format

Course CodeClass CodeAssignment TitleTotal Points
HCA-470HCA-470-O101Business Plan Part 4: Implementation Schedule70.0
CriteriaPercentageUnsatisfactory (0.00%)Less Than Satisfactory (65.00%)Satisfactory (75.00%)Good (85.00%)Excellent (100.00%)CommentsPoints Earned
Content90.0%
Action Steps30.0%Critical action steps necessary for plan implementation are not included.Critical action steps necessary for plan implementation are incomplete and/or incorrect.Critical action steps necessary for plan implementation are minimal and lack clarity and details.Critical action steps necessary for plan implementation are included, clear, and detailed.Critical action steps necessary for plan implementation are thorough and expertly crafted.
Resources and Competencies30.0%Identification of resources and competencies and description of how each is matched to the strategic initiative is not included.Identification of resources and competencies and description of how each is matched to the strategic initiative is incomplete and/or incorrect.Identification of resources and competencies and description of how each is matched to the strategic initiative is included but lacks clarity and specificity.Identification of resources and competencies and description of how each is matched to the strategic initiative is complete, clear, and specific.Identification of resources and competencies and description of how each is matched to the strategic initiative is exemplary.
Action Plan Alignment30.0%Identification of how the action plan aligns to the organization’s strategic initiatives is not included.Identification of how the action plan aligns to the organization’s strategic initiatives is incomplete and/or incorrect.Identification of how the action plan aligns to the organization’s strategic initiatives is included but lacks explanation and supporting details.Identification of how the action plan aligns to the organization’s strategic initiatives is complete and includes explanations and supporting details.Identification of how the action plan aligns to the organization’s strategic initiatives is thorough and includes substantial supporting details.
Organization, Effectiveness, and Format10.0%
Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0%Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.Writer is clearly in command of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0%Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct.Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage100%