Discussion: Interpret Changes in Healthcare due to Quality and Prevention

Discussion: Interpret Changes in Healthcare due to Quality and Prevention ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Interpret Changes in Healthcare due to Quality and Prevention Week 4 – Assignment: Interpret Changes in Healthcare due to Quality and Prevention Instructions Develop an analytical paper that addresses the following: Define quality and prevention in healthcare, including the benefits they provide. Discussion: Interpret Changes in Healthcare due to Quality and Prevention Describe how quality and prevention are being incorporated into healthcare systems, including the challenges experienced. Provide specific examples where appropriate. Support your paper with a minimum of three scholarly resources. In addition to these specified resources, other appropriate scholarly resources, including older articles, may be included. Length: 5-7 pages, not including title and reference pages Your paper should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards. course_8_week_4_assignment.docx course_8_week_4_info..pdf course_8_week_4__1_.pdf course_8_week_4__2_.pdf course_8_week_4__3_.pdf Week 4 – Assignment: Interpret Changes in Healthcare due to Quality and Prevention Instructions Develop an analytical paper that addresses the following: Define quality and prevention in healthcare, including the benefits they provide. Describe how quality and prevention are being incorporated into healthcare systems, including the challenges experienced. Provide specific examples where appropriate. Support your paper with a minimum of three scholarly resources. In addition to these specified resources, other appropriate scholarly resources, including older articles, may be included. Length: 5-7 pages, not including title and reference pages Your paper should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards. International Journal of Industrial Engineering, 22(4), 426-437, 2015 HEALTHCARE PERFORMANCE MEASUREMENT: IDENTIFICATION OF METRICS FOR THE LEARNING AND GROWTH BALANCED SCORECARD PERSPECTIVE Samin Emami1,*, Toni L. Doolen2 1 Mondel?z International Inc. 100 NE Columbia Blvd. Portland, OR 97211, U.S.A * Corresponding author’s e-mail: [email protected] 2 School of Mechanical, Industrial, and Manufacturing Engineering Oregon State University Corvallis, OR 97330, U.S.A While there is substantial literature devoted to measuring the performance of hospitals and clinics in terms of indicators such as health outcomes and finances, it is vital for hospitals and clinics to also develop a set of forward-looking metrics at the operational level that drive all aspects of performance. Discussion: Interpret Changes in Healthcare due to Quality and Prevention The purpose of this research is to identify and prioritize a set of metrics within one perspective of the Balanced Scorecard framework, called learning and growth, which aims at sustaining innovation, change, and continuous improvement. Using Analytic Hierarchy Process, the data provided by medical managers was analyzed to determine the most important learning and growth categories and metrics within each category. The results showed that “human capital” metrics have the most significant impact on the performance of the participating hospitals/clinics. The results also provide practitioners with metrics spanning each of the four performance categories identified to the learning and growth perspective. Key words: performance measurement, healthcare, balanced scorecard, learning and growth, AHP (Received on November 24, 2013; Accepted on June 21, 2015) 1. INTRODUCTION Healthcare is one of the fastest growing areas of the economy in most developed countries (Purbey, Mukherjee, & Bhar, 2006). Healthcare organizations are expected to deliver high quality service at reduced costs while dealing with swift changes in technology, patient load fluctuations, inefficient information access and control, and inter-process delays (Rasheed & Lee, 2014). Articles and reports on the implementation of various performance measurement frameworks in healthcare are being published at an increasing rate (Azizi, Behzadian, & Afshari, 2012). Many authors have commented on those aspects of a healthcare organization that need to be monitored on a regular basis. According to Kollberg and Elg (2010), healthcare organizations are often described as professional organizations in which the medical profession has a primary influence on healthcare. Therefore, healthcare organizations rely heavily on traditional forms of control, which makes measurement of operational drivers of performance difficult to capture. Hospitals and clinics around the world have mostly used performance metrics to measure indicators related to health outcomes and finances. Discussion: Interpret Changes in Healthcare due to Quality and Prevention Although it is important to monitor health and financial outcomes, Longenecker and Fink (2001) suggest that without integrating ongoing operational performance measurement and feedback into lower levels of healthcare organizations, performance improvement plans will not be implemented properly. Moreover, organizations without operational metrics tend to experience higher employee dissatisfaction and employee turnover. In recent years, some hospitals and clinics have started using a management tool called the Balanced Scorecard (BSC) to monitor operational metrics in the organization along with health outcome metrics. BSC is recognized as an important management tool for 21st century companies (Steele, 2001). BSC is both a performance framework and a management methodology. BSC was developed by Robert Kaplan and David Norton after an extensive research project in 1990. Kaplan and Norton believed that traditional performance measurement systems that focused primarily on financial measurements actually hindered organizational growth and success. The conclusions were that, contrary to popular practice, organizations should not be managed solely based on “bottom line” results (Kaplan & Norton, 1992). BSC was initially used in the private and profit sectors. In the late 1990s, non-profit organizations, including healthcare and educational organizations, began considering BSC as an applicable management tool (Azizi et al., 2012). BSC typically includes organizational ISSN 1943-670X ??INTERNATIONAL JOURNAL OF INDUSTRIAL ENGINEERING Emami and Doolen Healthcare Performance Measurement performance metrics across four balanced and linked perspectives: financial perspective, customer perspective, internal business perspective, and learning and growth perspective. Metrics within the learning and growth perspective answer the question of whether or not organizations are able to sustain innovation, change, and continuous improvement. These metrics relate to an organization’s intangible assets and the ability to excel in the future (Voelker, Rakich, & French, 2001). According to Marr and Adams (2004), the learning and growth perspective of the balanced scorecard has long been ignored by many organizations. Marr and Adams (2004) suggested that few organizations have figured out how to find meaningful and relevant metrics within this perspective. Discussion: Interpret Changes in Healthcare due to Quality and Prevention A study conducted by Gurd and Gao (2008) to investigate the implementation of BSC in healthcare organizations indicated that only 50% of hospitals and clinics included in the study incorporated a learning and growth (or innovation and learning) perspective in the performance measurement system. Furthermore, Speckbacher et al. (2003) concluded that more than 30% of BSC users do not have the learning and growth perspective, not merely because of lack of recognition of this perspective, but because of the difficulty of obtaining suitable metrics. Based on these findings, it seems that hospitals and clinics are not always taking a holistic view of performance or integrating all BSC perspectives. Previous research on designing performance measurement systems (PMS) has focused largely on “recommendations”, “frameworks”, and “systems” (Folan & Brown, 2005). Many researchers have proposed “recommendations” for defining metrics and specifying relationships between metrics and organizational principles or for designing effective PMS. Another group of researchers have proposed performance “frameworks” that employ a particular set of recommendations and assist in the process of PMS building by determining performance measurement boundaries, performance measurement dimensions and also relationships among the performance measurement dimensions (Rouse & Putterill, 2003). Medori and Steeple (2000) argued that most of the proposed performance frameworks in the literature suggest some areas in which performance metrics might be useful, but provide little guidance on how to identify appropriate metrics, introduce such metrics, and/or use selected metrics to manage the business. This research tests the application of a new approach for identifying metrics and for prioritizing metrics within a family of metrics. This approach factors in the healthcare managers’ judgment on the importance, understandability, and accessibility of specific metrics.Discussion: Interpret Changes in Healthcare due to Quality and Prevention Using data provided by managers from clinics and hospitals and an analysis technique called Analytic Hierarchy Process (AHP), the most important learning and growth performance categories that drive the future performance of a healthcare organization will be determined. Moreover, a set of metrics will be identified to enable hospital/clinic managers to monitor the capabilities inside the organization to detect areas that need to be improved. 2. BACKGROUND There are many challenges in designing and implementing a comprehensive performance measurement system in a healthcare organization. Performance measurement systems employed in healthcare must be capable of not only meeting expectations of different stakeholders, but also of giving the most realistic image of the status and the progress that are being made to the system. There are various issues in the healthcare industry that need to be addressed. Long wait times, increasing costs of healthcare, low productivity, and the competency of people who work in hospitals and clinics all need to be assessed (Purbey et al., 2006). It is only through becoming informed of the status of different elements influencing the quality of services that healthcare organizations can start to look for the shortcomings and deficiencies in their operations and identify paths to carry out processes more efficiently and effectively in a way that leads to all stakeholders’ satisfaction. According to Loeb (2004), the central issue in performance measurement remains the absence of agreement among researchers and practitioners with respect to what should be measured. Careful consideration and thought must be used when deciding upon what should be measured. According to Curtright et al. (2000), the National Committee for Quality Assurance’s (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) incorporates performance indicators that cover quality of care, access to and satisfaction with care, resource utilization, finances, and organizational management. Curtright et al. also mention that the Joint Commission on Accreditation of Healthcare Organizations, ORYX system asks that hospitals measure performance in the domains of clinical quality, health status of patients, patient satisfaction, and financial strength. The National Health Service (NHS) Performance Assessment framework included in the NHS plan suggests six categories for measuring the performance of healthcare organizations. Discussion: Interpret Changes in Healthcare due to Quality and Prevention These six categories include: health improvement, fair access, effective delivery of appropriate healthcare, efficiency, patient/career experience, and health outcomes of care (Moullin, 2004). Also, Griffith et al. (2002) evaluated the use of a set of nine multidimensional hospital performance measures derived from Medicare reports. The measures include cash flow, asset turnover, mortality, complication, length of inpatient stay, cost per case, occupancy, change in occupancy, and percent of revenue from outpatient care. According to Griffith et al., except for the occupancy measures, the other seven measures represent a potentially useful set for evaluating most U.S. hospitals. Many studies in the field of performance measurement in healthcare indicate that healthcare organizations mostly focus on health outcomes from the perspective of physicians and patients / service users (e.g. whether an ill patient recovers) and 427 Emami and Doolen Healthcare Performance Measurement the financial status of healthcare organizations. While these criteria are important, it is vital to consider that metrics related to health outcomes and financial issues are the metrics that, at best, indicate the image of the hospital’s/clinic’s performance in the past. In other words, financial and health outcome criteria are “lagging” indicators of performance in a hospital/clinic. The problem with these types of metrics is that lagging indicators are historical in nature, do not reflect current activities, and also lack predictive power. Lagging indicators show the final result of an action, usually well after it has been completed and dominate at the higher levels in an organization (Macpherson, 2001). To determine the factors driving future performance in terms of quality and financial issues, healthcare organizations need to develop a set of prospective and forward-looking indicators, or “leading indicators”, that are implemented in balance with lagging indicators. Leading indicators are those that reliably foretell or indicate a future event. As an example, employee satisfaction is usually recognized as a leading indicator of customer satisfaction. Leading indicators tend to dominate at lower levels of an organization (Macpherson, 2001). Discussion: Interpret Changes in Healthcare due to Quality and Prevention The next section describes the use of the balanced scorecard framework in healthcare. 2.1. Use of BSC in Healthcare The Balanced Scorecard (BSC) framework is one of the most popular performance measurement frameworks used by hospitals and clinics to address issues of measuring performance. BSC creates a balance between financial, operating and other organizational metrics and provides a set of forward-looking performance indicators, linking strategy to specific actions. Developing and implementing these metrics and indicators provide healthcare managers with a comprehensive view of organizational performance. The literature in the field of performance measurement in healthcare includes case studies of BSC implementations conducted in different hospitals or clinics in different countries. These case studies often include steps that hospitals and clinics have gone through to define balanced perspectives of performance, define appropriate metrics within each of those perspectives, and analyze the results of the measurement system to improve performance in different parts of the organization. Based on the organization’s requirements, the number of defined perspectives and the types of metrics these perspectives cover can vary from one healthcare organization to another. Studies on the application of BSC metrics in healthcare clearly indicate that the learning and growth metrics have been deployed in these organizations at a rate that is slower than the three other perspectives (Inamdar et al., 2002, Gurd & Gao, 2008). The next section will discuss the learning and growth perspective and the content and principles that Kaplan and Norton suggested for this perspective. 2.2. Learning and Growth Perspective The question that metrics in the learning and growth perspective seek to answer is that whether the organization is able to sustain innovation, change, and continuous improvement. These metrics relate to an organization’s more intangible assets and the organization’s ability to excel in the future. The learning and growth perspective constitutes the base of the balanced scorecard framework (Voelker et al., 2001). Discussion: Interpret Changes in Healthcare due to Quality and Prevention The objectives in the learning and growth perspective provide the infrastructure to achieve higher performance in the other three perspectives. Only through adequate investment in this perspective can an organization achieve long-term success. Kaplan and Norton (1996) introduced the concept of “intangible assets” as the content of the learning and growth perspective. Kaplan and Norton classify intangible assets into three principle categories, based on their experience in building balanced scorecards across a wide variety of service and manufacturing organizations. These three categories include human capital, information capital, and motivation and empowerment. 2.3. Decision Making Tools This study used an analysis technique called Analytic Hierarchy Process (AHP) to develop a prioritized set of learning and growth performance categories and metrics that could be used to foster growth at a hospital or clinic. The AHP method has attracted the interest of many researchers and practitioners in various domains due to the nice mathematical properties of the method and the fact that the required input data are relatively easy to obtain (Triantaphyllou & Mann, 1995). With Analytic Hierarchy Process, pairwise comparisons are used to determine the relative importance of one category or metric over other categories or metrics. These comparisons are made using either a numerical or verbal scale and are used to develop a ranking of the categories or metrics. Factors affecting this comparison include accessibility of data to calculate metrics, alignment with the organization’s strategy, and understandability of metrics. AHP is a technique in which perceptions and experiences of decision makers need to be taken into account in a rational manner (Borchartdt et al., 2012). Therefore, medium and high-level medical managers were targeted as the subject population of this research. AHP is part of a much larger family of Multi-Criteria Decision-Making (MCDM) techniques. MCDM techniques are used in situations where there are discrete decision spaces. In other words, MCDM techniques can be applied when the decision alternatives are known. Most MCDM techniques incorporate both alternatives (that are being selected between) 428 Emami and Doolen Healthcare Performance Measurement and attributes (or criteria by which the best alternative is selected). Discussion: Interpret Changes in Healthcare due to Quality and Prevention While there are a wide variety of MCDM techniques that have been developed and tested in a variety of decision domains, see for example, Triantaphyllou (2000), AHP was identified as an appropriate technique for the problem domain addressed within this research. AHP has been widely applied to decision making problems in a variety of domains, including evaluating performance measurement systems in healthcare. Leung, Lam, and Cao (2006) proposed AHP as a method to facilitate the implementation of BSC within an organization. Leung et al. suggested that AHP could be used to address some of the traditional problems of BSC, such as the dependency relationship between metrics and the use of subjective versus objective measures. Kumar Dey, Hariharan, and Clegg (2006) conducted a study to develop a performance measurement model for service operations using the AHP approach. The study applied a performance measurement model (which was developed by reviewing the PMS literature) to the intensive care units of three different hospitals in developing nations. AHP was felt to be of particular use in this research, due to the relatively simple structure, enabling the results to be explained to stakeholders with limited mathematical and statistical training. This is consistent with the findings of previous research, which indicate that the widespread application of AHP is due in part to its simplicity and the ability to incorporate both qualitative and quantitative criteria (Ho, 2008). Discussion: Interpret Changes in Healthcare due to Quality and Prevention There are three primary steps in using AHP. To start the process, the decision domain must be decomposed into criteria or factors, using an appropriate hierarchy. Following the development of the decision criteria and hierarchy, pairwise comparisons are made among criteria at the same level. These comparisons must be conducted by subject matter experts in the decision domain. In this research, the AHP fundamental scale was used for these comparisons as the criteria were not able to be articulated as quantitative variables. The AHP fundamental scale maps discrete linguistic choices with numbers. These numerical values are then used to provide a weighting. The AHP fundamental scale has been used in a variety of decision domains and has been validated as a result of its widespread use (Escobar & Moreno-Jiménez, 2002). In the third step, the degree of inconsistency experienced in the assignment of numerical weights must be checked, using a computed value, called the consistency ratio. The specific details of the methodology used for this research are described next. 3. METHODOLOGY A review of the perf … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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