Health information & Healthcare Industry Discussion

Health information & Healthcare Industry Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Health information & Healthcare Industry Discussion From the reading of the PPT slides (Extra Materials) and your own external source research, answer the following : Health information & Healthcare Industry Discussion Q1) With regards to Patient Safety and quality performance, What is Just Culture and its Error Types? explain in details Q2) What are the most frequent Safety Issues with regards to National Patient Safety Foundation (NPSF)? explain in details Q3) With regards to technologies used to support medication administration, what are the benefits of computerized physician order entry (CPOE)? explain in details ———————- Please pay attention to the Assignment Grading Rubric: Note: Regarding Assignment 6, please incorporate “1 or more” external sources for every question answered for full points, no need to use your primary textbook for week 6 . (You may use your 2nd book as an external source) Minimum 500 words applies to the total minimum number of words for all the questions answered within the assignment to achieve full grade on word count for this assignment . Not necessarily minimum 500 words per question answered within assignment. Turnitin Requirements: For each assignment, your similarity score must meet a threshold of no more than 20% . Assignments with greater than 20% similarity must be revised and resubmitted to Turnitin until the 20% threshold is achieved. For resubmissions, it may take up to 24 hours for a new similarity score . It is your responsibility to allow enough time to receive a Turnitin similarity score report. Assignments with more than 20% threshold will receive a zero. Do not copy the assignment questions into your answer file when submitting. This should help with keeping your TII below 20% threshold. Also when using information verbatim from a source please “quote” properly to keep your TII below 20% threshold . Health information & Healthcare Industry Discussion chapter22_latourkathleenm_2013_clinicalqual_healthinformationmana.pdf Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. chapter 22 Clinical Quality Management Chris R. Elliott, MS, RHIA Learning Objectives Explain performance improvement (PI) principles Describe team-based performance improvement processes ?? Summarize the concept of quality and its importance in healthcare ?? Summarize the importance of patient safety and the Joint Commission’s National Patient Safety Goals ?? ?? Identify major organizations that publish clinical quality standards and guidelines ?? Explain common ways that healthcare organizations manage the prevention and occurrence of infections ?? Key Terms Accountable care organization (ACO) Agency for Healthcare Research and Quality (AHRQ) Allied health professional performance review Benchmark Board of directors (BOD) Case management Clinical guideline Commission on the Accreditation of Rehabilitation Facilities (CARF) Common cause variation Consumer Assessment of Healthcare Providers and Systems (CAHPS) Continuous quality improvement Core performance measure Credentialing process Dashboard Evidence-based medicine External customer Ground rule Health Care Quality Improvement Program (HCQIP) Infection review Internal customer ISO 9000 Medication usage review Mortality review National CAHPS Benchmarking Database (NCBD) National Committee for Quality Assurance (NCQA) National Patient Safety Goals (NPSGs) Nursing staff performance review Outcome indicator Outcome measure Pay for performance Performance Performance improvement (PI) Performance measure Privileges Process indicator Quality improvement organization (QIO) Quality indicator Quality management Quality management board (QMB) Quality management liaison group (QMLG) Scorecard Sentinel event Six Sigma Special cause variation Stakeholder Standard Standard of care Structure indicator Tracer methodology 649 23-AB103311_ch22.indd EBSCO : eBook Business Collection Trial – printed on 4/14/2018 6:01 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 649 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:29 PM 650 Chapter 22 Copyright @ 2013. AHIMA Press. Health information & Healthcare Industry Discussion All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. Introduction The concept of achieving something better is a mainstay of American life. American people expect that the quality of their lives and the lives of their offspring will become better, that is, improve, over the course of their lifetimes. It is the pursuit of the better life that has driven the development of American society: development of educational systems, conformation of political processes, personal and family habits of product consumption, innovation of new products and services, and, most importantly for this text, expectations of interactions with the US healthcare delivery system. When people go to a doctor they expect to be made better or at least to be assured of maintaining a state of good health. If they receive services from one of the myriad healthcare organizations, they expect the experience to be as comfortable as possible and the end results of the services to be beneficial. Recent and continuing public debate about healthcare access, eligibility, and economics demonstrates that this is not the case. Those who provide healthcare services in the United States also have expectations of themselves. Caregivers were concerned about the quality of care they provided to people even in ancient times. Around the 5th century B.C., for example, the Greek physician Hippocrates advised young physicians to “First, do no harm.” That directive is still part of the physician’s oath today. Throughout the history of medicine, providers have had benefit to their patients and clients at the heart of their desire to practice and by and large still do so today. As scientific inquiry advanced in its process, healthcare providers were interested in improving the outcomes of patient care. Florence Nightingale, for instance, is considered to have been the founder of modern nursing in the mid19th century. She advocated the use of a uniform scientific method of collecting and evaluating statistics that compared mortality rates among hospitals.Health information & Healthcare Industry Discussion The results of her measurement efforts showed wide variation among hospitals. She implemented sanitary procedures such as simple handwashing that greatly improved the results or outcomes of hospital care. Throughout history we can find individuals involved in the provision of healthcare services making minor as well as major improvements in the way the services are provided, up to and including those involved in the healthcare delivery system today. The recent debate regarding the issues in our healthcare delivery system from the access, eligibility, and economic perspectives has made Americans recognize the complexity of the system. Even before the recent debate, the healthcare system had recognized in the late 20th century that it had significant issues around the quality of its processes and results. It also recognized that everyone who worked in the system potentially affected that quality. Obviously, individuals who actually interact and assist patients can affect healthcare quality. But because of the complexity of the system, individuals who basically have little to no contact with the patient or client can also impact the perceptions of patients regarding their healthcare, whether the experience was better or worse. This recognition now becomes the reason why this chapter must be undertaken in this textbook. You, the developing health information technician, along with all of your colleagues in health professions programs, and with all of the practicing nurses, doctors, and therapists in all the healthcare organizations in the country, make contributions to the perceptions of the quality of healthcare services with which patients and clients come away from the healthcare system every day. Performance Measurement and Quality Improvement The most important concept in an introductory discussion of quality is that of measurement. Over the decades of attempting to deal with the issues involved in healthcare quality, healthcare professionals have struggled with where to put the emphasis of their resources. Ultimately, they recognized— with the assistance of the theoretical writings of general industry quality masters—that the key to improvement lay in the measurement of the important characteristics of their practice (figure 22.1). The characteristics could be related to the practice of a physician, nurse, or therapist, or it could be the practice of an organization. The important thing to notice is that the model fits for most individuals, groups, and levels of a healthcare organization. Definition of Performance Improvement The word performance has been defined as “the execution of an activity or pattern of behavior; the application of inherent or learned capabilities to complete a process according to prescribed specifications or standards” (Meisenheimer 1997). Performance is measured using one or more performance indicators. Health information & Healthcare Industry Discussion For example, performance can be measured against financial indicators, such as the average cost per laboratory test, or productivity indicators, such as the number of patients seen per physician per day. It is important to measure the aspects of performance that exemplify its quality and that point conclusively to the aspects of performance that require improvement. The term performance improvement (PI) is a “process for involving personnel in planning and executing a continuous flow of improvements to provide quality healthcare that meets or exceeds expectations” (McLaughlin and Kaluzny 2006). Although a number of terms and acronyms are frequently used to represent this PI concept (for example, continuous quality improvement [CQI] and total quality management [TQM]), this chapter uses performance improvement. Numerous improvement models and quality philosophies have been developed over the years. The key feature of performance improvement as implemented EBSCO : eBook Business Collection Trial – printed on 4/14/2018 6:01 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 23-AB103311_ch22.indd 650 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:29 PM Clinical Quality Management 651 Figure 22.1. Quality masters Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. A number of individuals have contributed to the theoretical underpinnings of continuous performance improvement. Over the decades, various aspects of their writings have been integrated into the current philosophy of improving quality in the healthcare arena. Go online and see what you can find about two or three of these theoreticians. 23-AB103311_ch22.indd Walter A. Shewhart Walter Shewhart was a statistician and research engineer for Bell Telephone Laboratories from 1925 until 1956. During that time, he pioneered the use of a quality control mechanism called statistical process control. Its purpose was to reduce variation in processes. Shewhart was the first person to suggest that two types of variation could be at work in a process: variation that was the result of chance, and variation that was the result of a definable cause. He used this method to improve the stability of processes. He also was the first to develop what he called the “act of control.” This concept evolved into the plan–do–check–act cycle. W. Edwards Deming built on Shewhart’s work. W. Edwards Deming W. Edwards Deming was an American statistician. He is often credited with revitalizing the Japanese economy after the Second World War. He wrote the book Out of the Crisis in 1983. In his book, he described his methods for improving quality.Health information & Healthcare Industry Discussion Like Shewhart, Deming discussed variation and identified two types: common cause variation (variation caused by chance) and special cause variation (variation assigned a cause). Deming believed that quality must be built into the product. He made a number of controversial statements about standard management techniques. For example, he declared that he did not believe in performance appraisals, management by objectives, or work standards. Deming also developed a 14-point plan to help executives lead their organizations. Several of his points can be recognized in the principles of performance improvement. He believed that senior administrators need to communicate a constancy of purpose in which the vision and mission statements are made known. He proposed focusing on the process and not the results. Another of the 14 points was that organizations must not rely on inspection for defects but, rather, continually work to improve production and service. According to Deming, the organization’s leadership also must provide training, education, and self-improvement opportunities for employees and work to help employees achieve excellence in their jobs. Fear must be driven out of the organization because it impedes self-actualization. Barriers among departments and staff must be broken because barriers prevent people from communicating effectively and processes from being improved. Joseph M. Juran Joseph Juran also consulted with the Japanese in the 1950s and wrote several books on quality control. In the 1980s, he claimed that management could control over 80 percent of quality defects by using the three central principles of quality: planning, control, and improvement. He believed that training and hands-on management are basic requirements for meeting the needs of customers. Armand F. Feigenbaum Armand Feigenbaum built on Deming’s statistical approach. In the early 1980s, he emphasized the necessity of integrating the functions of total quality control. Feigenbaum stated that the planning, design, and setup of the product or service must be integrated with its production and distribution. In turn, the product’s production and distribution must be integrated with training, data analysis, and user feedback. Thus, customers and suppliers are all incorporated into the total quality concept. The goal is to meet the expectations and requirements of the organizations’ customers. Philip B. Crosby Philip Crosby was a quality consultant working in the 1980s. He did not agree with his predecessors’ focus on statistics. Instead, he proposed the concepts of zero defects and conformance to requirements. Crosby also proposed four absolutes of quality: • Do it right the first time. • Defect prevention is the only acceptable approach. • Zero defects is the only performance standard. • The cost of quality is the only measure of quality. This means that it is less costly to produce a high-quality product the first time than to manage the losses that result from producing a low-quality product. Brian Joiner Brian Joiner, also consulting in the 1980s, maintained that quality begins at the top and funnels down through the organization. He developed the Joiner triangle. This concept has three basic elements: • Quality to ensure customer satisfaction and loyalty • A scientific approach to root out underlying causes of problems • The all-one-team method that encourages and empowers employees to work together to break down departmental barriers and creates buy-in to improvement, ownership in the process, and commitment to quality EBSCO : eBook Business Collection Trial – printed on 4/14/2018 6:01 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 651 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:29 PM Copyright @ 2013. AHIMA Press.Health information & Healthcare Industry Discussion All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 652 Chapter 22 in today’s healthcare organizations is that it is a continuous cycle of measurement, analysis, monitoring, planning, designing, and evaluating. Performance monitoring is data driven. Monitoring performance based on internal and external data is the foundation of all PI activities. Each healthcare organization must identify and prioritize the processes and outcomes (in other words, types of data) that are important to monitor based on its mission and the scope of care and services it provides. A logical starting point for performance improvement activities is identifying areas to monitor. Monitoring should include important organization functions, particularly those that are high risk, high volume, or problem prone. Outcomes of care, customer feedback, and the requirements of regulatory agencies are additional areas that organizations consider when prioritizing performance measures. Once the scope and focus of performance monitoring are determined, the leaders define the data collection requirements for each performance measure (Shaw and Elliott 2013). As shown in figure 22.2, measuring performance depends on the identification of performance measures for each service, process, or outcome determined important to track. A performance measure is a quantitative tool (for example, a rate, ratio, index, percentage) that provides an indication of an organization’s performance in relation to a specified process or outcome. Monitoring selected performance measures can help an organization determine process stability or can identify improvement opportunities. Specific criteria are used to define the organization’s performance measures. Components of a Figure 22.2. good performance measure include a documented numerator statement, a denominator statement, and a description of the population to which the measure is applicable. In addition, the measurement period, baseline goal, data collection method, and frequency of data collection, analysis, and reporting must be identified (Shaw and Elliott 2013). The sum total of the performance measures selected as applicable to a healthcare organization make up the “Performance Measurement System” required by the Joint Commission for use in accreditation processes (Joint Commission 2009a). For example, one indicator of quality might be that a physician sees patients within 30 minutes after their arrival at the facility. The organization could measure the minutes that it took from the time the patient stated his or her name to the time the physician first saw the patient. As long as patients were seen within that 30-minute time frame, the organization could assume that it was providing high-quality care. No attempts would be made to analyze the process or take corrective action unless the number of minutes increased beyond the 30-minute threshold. In this traditional approach, organizations actively address quality and performance issues only when they fail to meet the level of quality defined in performance measures (Shaw and Elliott, 2013). Health information & Healthcare Industry Discussion An example of an outcome that hospitals are required to continuously monitor is the monthly delinquent health record rate. The elements included in this performance measure are the medical staff and inpatient health records. Tracking this outcome allows the hospital to continuously monitor its Organization-wide performance improvement process 2. Measure performance Start here 1. Identify performance measures 3. Analyze and compare internal/external data 4. Identify improvement opportunity 5. Perform ongoing monitoring EBSCO : eBook Business Collection Trial – printed on 4/14/2018 6:01 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 23-AB103311_ch22.indd 652 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:29 PM Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. Clinical Quality Management rate or percentage of delinquent health records. If the health record delinquency rate exceeds the hospital’s established performance standards (an internal comparison) or nationally established performance standards (external comparison), an opportunity for improvement has been identified. Once an issue has been identified, a team-based performance improvement process may be initiated. When an organization compares its current performance to its own internal historical data, or uses data from similar external organizations across the country, it helps establish a benchmark, also known as a standard of performance or best practice, for a particular process or outcome. Establishing a benchmark for each monitored performance measure assists the healthcare organization in setting performance baselines, describing process performance or stability, or identifying areas for more focused data collection. The Joint Commission is one available external resource that can be used to establish the performance measure of the average monthly health record delinquency rate for a hospital. The Joint Commission will cite a healthcare organization with a requirement for improvement if the total average health record delinquency … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10