The document discusses challenges in developing tools to measure healthcare quality. It notes that appropriate measurement methods must be developed to accurately assess performance standards. Key challenges include deciding what to measure, how to measure it, and obtaining accurate and complete data quickly enough to derive useful measurements. Most current systems rely on medical record review due to incomplete administrative data. The document then describes Wisconsin's efforts over many years to develop an encounter data-driven system called MEDDIC-MS to measure Medicaid HMO performance using encounter data reported monthly to the state rather than self-reported by HMOs.
HS410 Unit 6 Quality Management - DiscussionDiscussionThi.docxAlysonDuongtw
HS410 Unit 6: Quality Management - Discussion
Discussion
This is a graded Discussion
. Please refer to the Discussion Board Grading Rubric in Course Home / Grading Rubrics.
Respond to all of the following questions and be sure to respond to two of your other classmates’ postings:
1.
What are the steps in the quality improvement model and how is benchmarking involved?
2. What are the stages in which data quality errors found in a health record most commonly occur?
3. What is the definition of risk management?
4. What are the parts of an effective risk management program?
5. What is utilization review and why is it important in healthcare?
6. What is the process of utilization review?
Please paper should be 400-500 words and in an essay format, strictly on topic, original with real scholar references to support your answers.
NO PHARGIARISM PLEASE!
This is the Chapter reading for this assignment:
Read Chapter 7 in
Today’s Health Information Management
.
INTRODUCTION
Quality health care “means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results.”1 The term quality, by definition, can mean excellence, status, or grade; thus, it can be measured and quantified. The patient, and perhaps the patient's family, may interpret quality health care differently from the way that health care providers interpret it. Therefore, it is important to determine—if possible—what is “right” and what is “wrong” with regard to quality health care. The study and analysis of health care are important to maintain a level of quality that is satisfactory to all parties involved. As a result of the current focus on patient safety, and in an attempt to reduce deaths and complications, providing the best quality health care while maintaining cost controls has become a challenge to all involved. Current quality initiatives are multifaceted and include government-directed, private sectorsupported, and consumer-driven projects.
This chapter explores the historical development of health care quality including a review of the important pioneers and the tools they developed. Their work has been studied, refined, and widely used in a variety of applications related to performance-improvement activities. Risk management is discussed, with emphasis on the importance of coordination with quality activities. The evolution of utilization management is also reviewed, with a focus on its relationship to quality management.
In addition, this chapter explores current trends in data collection and storage, and their application to improvements in quality care and patient safety. Current events are identified that influence and provide direction to legislative support and funding. This chapter also provides multiple tips and tools for both personal and institutional use.
DATA QUALITY
Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of.
Data Analysis and Quality Improvement Initiative Proposal .docxwhittemorelucilla
Data Analysis and Quality Improvement Initiative Proposal
Details
Attempt 1Evaluated
Attempt 2Evaluated
Attempt 3Available
Toggle Drawer
Overview
Prepare an 8–10-page data analysis and quality improvement initiative proposal based on a health issue of professional interest to you. The audience for your analysis and proposal is the nursing staff and the interprofessional team who will implement the initiative.
"A basic principle of quality measurement is: If you can't measure it, you can't improve it" (Agency for Healthcare Research and Quality, 2013).
Health care providers are on an endless quest to improve both care quality and patient safety. This unwavering commitment requires hospitals and care givers to increase their attention and adherence to treatment protocols to improve patient outcomes. Health informatics, along with new and improved technologies and procedures, are at the core of virtually all quality improvement initiatives. The data gathered by providers, along with process improvement models and recognized quality benchmarks, are all part of a collaborative, continuing effort. As such, it is essential that professional nurses are able to correctly interpret, and effectively communicate information revealed on dashboards that display critical care metrics.
Show More
Toggle Drawer
Questions to Consider
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
Reflect on QI initiatives focused on measuring and improving patient outcomes with which you are familiar.
How important is the role of nurses in QI initiatives?
What quality improvement initiatives have made the biggest difference? Why?
When a QI initiative does not succeed as planned, what steps are taken to improve or revise the effort?
Toggle Drawer
Resources
Required Resources
MSN Program Journey
Please review this guide for your degree program. It can help you stay on track for your practicum experience, so you may wish to bookmark it for later reference.
MSN Program Journey
|
Transcript
.
Show More
Assessment Instructions
Preparation
In this assessment, you will propose a quality improvement (QI) initiative proposal based on a health issue of professional interest to you. The QI initiative proposal will be based on an analysis of dashboard metrics from a health care facility. You have one of two options:
Option 1
If you
have access
to dashboard metrics related to a QI initiative proposal of interest to you:
Analyze data from the health care facility to identify.
There are several current trends in HR that employers are responding to, particularly rising health care costs. To control costs, employers are requiring higher deductibles, co-payments, and employee contributions to health insurance. They are also promoting wellness programs and consumer-driven health plans. Some employers are focusing on improving health outcomes for their sickest employees through top doctors and preventative services. On-site medical clinics are growing in popularity as well. Additionally, employers face pressure to increase wages through pay-for-performance programs and effective performance management.
Remove or Replace Header Is Not Doc TitleGuiding Questions.docxlillie234567
Remove or Replace: Header Is Not Doc Title
Guiding Questions
Quality Improvement Initiative Evaluation
This document is designed to give you questions to consider and additional guidance to help you successfully complete the Quality Improvement Initiative Evaluation assessment. You may find it useful to use this document as a prewriting exercise, an outlining tool, or a final check to ensure you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment.
Do not turn in this document as your assessment submission.
Remember, you are analyzing a current QI initiative that is already in place. You are not creating a new QI initiative (Assessment 3).
Analyze a current quality improvement initiative in a health care setting.
· What prompted the implementation of the quality improvement initiative?
· What problems were not addressed?
· What problems arose from the initiative?
Evaluate the success of a current quality initiative through recognized benchmarks and outcome measures.
· What benchmarks or outcome measures were used to evaluate success? Consider requirements for national, state, or accreditation standards.
· What was most successful?
Incorporate interprofessional perspectives related to initiative functionality and outcomes.
· How does the interprofessional team contribute to the success of the QI initiative?
· What are the perspectives of interprofessional team members involved in the initiative?
· Who did you talk to? From what other professions? How did their input impact your analysis?
Recommend additional indicators and protocols to improve and expand outcomes of a current quality initiative.
· What process or protocol changes would you recommend?
· What added technologies would improve quality outcomes?
· What outcome measures are missing, or could be added?
Convey purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.
· Is your analysis logically structured?
· Is your analysis 5–7 double-spaced pages (not including title page and reference list)?
· Is your writing clear and free from errors?
· Does your analysis include both a title page and reference list?
· Did you use a minimum of four sources? Were they published within the last five years?
· Are they cited in current APA format throughout the analysis?
1
image1.png
1
Quality Improvement Initiative Evaluation
Student’s Name:
Course Name:
Course Number:
Instructor’s Name:
This study source was downloaded by 100000855641916 from CourseHero.com on 12-20-2022 05:43:38 GMT -06:00
https://www.coursehero.com/file/176043112/Revised-QIIE-1edited-2editeddocx/
https://www.coursehero.com/file/176043112/Revised-QIIE-1edited-2editeddocx/
2
Introduction
In healthcare settings, plans for process-specific quality improvement are frequently
reactive and focused on act.
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
Data Analysis Quality Improvement Initiative Proposal.docxstudywriters
This document provides instructions for a 8-10 page data analysis and quality improvement initiative proposal. Students are asked to analyze existing dashboard metrics from a healthcare facility to identify an area for improvement. They must then outline a quality improvement proposal that defines the issue, proposes strategies for improvement, and establishes interprofessional roles and responsibilities. Effective communication strategies between the interprofessional team must also be addressed. The goal is for students to apply data analysis skills and evidence-based practices to propose an initiative that enhances patient outcomes, cost-effectiveness, work-life quality, and interprofessional collaboration.
Assessment 2
Quality Improvement Proposal
Overview:
Write a quality improvement proposal, 5–7 pages in length, that provides your recommendations for expanding a hospital's HIT to include quality metrics that will help the organization qualify as an accountable care organization.
Health care has undergone a transformation since the release of the Institute of Medicine's 2000 report
To Err Is Human: Building a Safer Health System.
The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The Institute of Medicine challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Quality and Research (AHRQ), vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations (ACOs).
Health information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine's goal of improving safety and quality.
Understanding HIT is important to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.
This assessment provides an opportunity for you to make recommendations for expanding a hospital's HIT in ways that will help the hospital qualify as an ACO.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the relationship between care coordination and evidence-based data.
Recommend ways to expand an organization's HIT to include quality metrics.
Identify potential problems that can arise with data gathering systems and outputs.
Competency 3: Use health information technology to guide care coordination and organizational practice.
Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Write clearly and concisely, using correct grammar and mechanics.
Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
Reference
.
The document discusses current trends in human resource management, including rising health care costs, employer responses to control costs, and strategies to improve employee productivity and performance management. Specifically, it outlines how employers are implementing more consumer-driven health plans, wellness programs, on-site clinics, and pay-for-performance programs to link compensation to goals. It also discusses challenges in implementing performance-based pay and the importance of clear communication and employee involvement in the process.
HS410 Unit 6 Quality Management - DiscussionDiscussionThi.docxAlysonDuongtw
HS410 Unit 6: Quality Management - Discussion
Discussion
This is a graded Discussion
. Please refer to the Discussion Board Grading Rubric in Course Home / Grading Rubrics.
Respond to all of the following questions and be sure to respond to two of your other classmates’ postings:
1.
What are the steps in the quality improvement model and how is benchmarking involved?
2. What are the stages in which data quality errors found in a health record most commonly occur?
3. What is the definition of risk management?
4. What are the parts of an effective risk management program?
5. What is utilization review and why is it important in healthcare?
6. What is the process of utilization review?
Please paper should be 400-500 words and in an essay format, strictly on topic, original with real scholar references to support your answers.
NO PHARGIARISM PLEASE!
This is the Chapter reading for this assignment:
Read Chapter 7 in
Today’s Health Information Management
.
INTRODUCTION
Quality health care “means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results.”1 The term quality, by definition, can mean excellence, status, or grade; thus, it can be measured and quantified. The patient, and perhaps the patient's family, may interpret quality health care differently from the way that health care providers interpret it. Therefore, it is important to determine—if possible—what is “right” and what is “wrong” with regard to quality health care. The study and analysis of health care are important to maintain a level of quality that is satisfactory to all parties involved. As a result of the current focus on patient safety, and in an attempt to reduce deaths and complications, providing the best quality health care while maintaining cost controls has become a challenge to all involved. Current quality initiatives are multifaceted and include government-directed, private sectorsupported, and consumer-driven projects.
This chapter explores the historical development of health care quality including a review of the important pioneers and the tools they developed. Their work has been studied, refined, and widely used in a variety of applications related to performance-improvement activities. Risk management is discussed, with emphasis on the importance of coordination with quality activities. The evolution of utilization management is also reviewed, with a focus on its relationship to quality management.
In addition, this chapter explores current trends in data collection and storage, and their application to improvements in quality care and patient safety. Current events are identified that influence and provide direction to legislative support and funding. This chapter also provides multiple tips and tools for both personal and institutional use.
DATA QUALITY
Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of.
Data Analysis and Quality Improvement Initiative Proposal .docxwhittemorelucilla
Data Analysis and Quality Improvement Initiative Proposal
Details
Attempt 1Evaluated
Attempt 2Evaluated
Attempt 3Available
Toggle Drawer
Overview
Prepare an 8–10-page data analysis and quality improvement initiative proposal based on a health issue of professional interest to you. The audience for your analysis and proposal is the nursing staff and the interprofessional team who will implement the initiative.
"A basic principle of quality measurement is: If you can't measure it, you can't improve it" (Agency for Healthcare Research and Quality, 2013).
Health care providers are on an endless quest to improve both care quality and patient safety. This unwavering commitment requires hospitals and care givers to increase their attention and adherence to treatment protocols to improve patient outcomes. Health informatics, along with new and improved technologies and procedures, are at the core of virtually all quality improvement initiatives. The data gathered by providers, along with process improvement models and recognized quality benchmarks, are all part of a collaborative, continuing effort. As such, it is essential that professional nurses are able to correctly interpret, and effectively communicate information revealed on dashboards that display critical care metrics.
Show More
Toggle Drawer
Questions to Consider
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
Reflect on QI initiatives focused on measuring and improving patient outcomes with which you are familiar.
How important is the role of nurses in QI initiatives?
What quality improvement initiatives have made the biggest difference? Why?
When a QI initiative does not succeed as planned, what steps are taken to improve or revise the effort?
Toggle Drawer
Resources
Required Resources
MSN Program Journey
Please review this guide for your degree program. It can help you stay on track for your practicum experience, so you may wish to bookmark it for later reference.
MSN Program Journey
|
Transcript
.
Show More
Assessment Instructions
Preparation
In this assessment, you will propose a quality improvement (QI) initiative proposal based on a health issue of professional interest to you. The QI initiative proposal will be based on an analysis of dashboard metrics from a health care facility. You have one of two options:
Option 1
If you
have access
to dashboard metrics related to a QI initiative proposal of interest to you:
Analyze data from the health care facility to identify.
There are several current trends in HR that employers are responding to, particularly rising health care costs. To control costs, employers are requiring higher deductibles, co-payments, and employee contributions to health insurance. They are also promoting wellness programs and consumer-driven health plans. Some employers are focusing on improving health outcomes for their sickest employees through top doctors and preventative services. On-site medical clinics are growing in popularity as well. Additionally, employers face pressure to increase wages through pay-for-performance programs and effective performance management.
Remove or Replace Header Is Not Doc TitleGuiding Questions.docxlillie234567
Remove or Replace: Header Is Not Doc Title
Guiding Questions
Quality Improvement Initiative Evaluation
This document is designed to give you questions to consider and additional guidance to help you successfully complete the Quality Improvement Initiative Evaluation assessment. You may find it useful to use this document as a prewriting exercise, an outlining tool, or a final check to ensure you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment.
Do not turn in this document as your assessment submission.
Remember, you are analyzing a current QI initiative that is already in place. You are not creating a new QI initiative (Assessment 3).
Analyze a current quality improvement initiative in a health care setting.
· What prompted the implementation of the quality improvement initiative?
· What problems were not addressed?
· What problems arose from the initiative?
Evaluate the success of a current quality initiative through recognized benchmarks and outcome measures.
· What benchmarks or outcome measures were used to evaluate success? Consider requirements for national, state, or accreditation standards.
· What was most successful?
Incorporate interprofessional perspectives related to initiative functionality and outcomes.
· How does the interprofessional team contribute to the success of the QI initiative?
· What are the perspectives of interprofessional team members involved in the initiative?
· Who did you talk to? From what other professions? How did their input impact your analysis?
Recommend additional indicators and protocols to improve and expand outcomes of a current quality initiative.
· What process or protocol changes would you recommend?
· What added technologies would improve quality outcomes?
· What outcome measures are missing, or could be added?
Convey purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.
· Is your analysis logically structured?
· Is your analysis 5–7 double-spaced pages (not including title page and reference list)?
· Is your writing clear and free from errors?
· Does your analysis include both a title page and reference list?
· Did you use a minimum of four sources? Were they published within the last five years?
· Are they cited in current APA format throughout the analysis?
1
image1.png
1
Quality Improvement Initiative Evaluation
Student’s Name:
Course Name:
Course Number:
Instructor’s Name:
This study source was downloaded by 100000855641916 from CourseHero.com on 12-20-2022 05:43:38 GMT -06:00
https://www.coursehero.com/file/176043112/Revised-QIIE-1edited-2editeddocx/
https://www.coursehero.com/file/176043112/Revised-QIIE-1edited-2editeddocx/
2
Introduction
In healthcare settings, plans for process-specific quality improvement are frequently
reactive and focused on act.
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
Data Analysis Quality Improvement Initiative Proposal.docxstudywriters
This document provides instructions for a 8-10 page data analysis and quality improvement initiative proposal. Students are asked to analyze existing dashboard metrics from a healthcare facility to identify an area for improvement. They must then outline a quality improvement proposal that defines the issue, proposes strategies for improvement, and establishes interprofessional roles and responsibilities. Effective communication strategies between the interprofessional team must also be addressed. The goal is for students to apply data analysis skills and evidence-based practices to propose an initiative that enhances patient outcomes, cost-effectiveness, work-life quality, and interprofessional collaboration.
Assessment 2
Quality Improvement Proposal
Overview:
Write a quality improvement proposal, 5–7 pages in length, that provides your recommendations for expanding a hospital's HIT to include quality metrics that will help the organization qualify as an accountable care organization.
Health care has undergone a transformation since the release of the Institute of Medicine's 2000 report
To Err Is Human: Building a Safer Health System.
The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The Institute of Medicine challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Quality and Research (AHRQ), vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations (ACOs).
Health information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine's goal of improving safety and quality.
Understanding HIT is important to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.
This assessment provides an opportunity for you to make recommendations for expanding a hospital's HIT in ways that will help the hospital qualify as an ACO.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the relationship between care coordination and evidence-based data.
Recommend ways to expand an organization's HIT to include quality metrics.
Identify potential problems that can arise with data gathering systems and outputs.
Competency 3: Use health information technology to guide care coordination and organizational practice.
Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Write clearly and concisely, using correct grammar and mechanics.
Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
Reference
.
The document discusses current trends in human resource management, including rising health care costs, employer responses to control costs, and strategies to improve employee productivity and performance management. Specifically, it outlines how employers are implementing more consumer-driven health plans, wellness programs, on-site clinics, and pay-for-performance programs to link compensation to goals. It also discusses challenges in implementing performance-based pay and the importance of clear communication and employee involvement in the process.
Data Analysis And Quality Improvement Essay 2.pdfsdfghj21
The document provides instructions for an assignment to develop an 8-10 page quality improvement initiative proposal based on analyzing health care data. It includes:
1) Gathering internal and external benchmark data on a selected health issue and analyzing dashboards to identify areas for improvement.
2) Making evidence-based recommendations to improve outcomes related to the issue while considering challenges to meeting benchmarks.
3) Developing communication strategies to engage the interprofessional team and promote the initiative's success through improved strategies.
The document discusses using a health production function to analyze two existing programs and make recommendations about allocating resources. The programs aim to reduce diabetes among low-income obese individuals in Detroit. Program 1 focuses on bariatric surgery centers while Program 2 emphasizes healthy lifestyle education and coaching. The analysis recommends reallocating funding from Program 1 to Program 2 due to the latter's lower costs and ability to impact more patients through preventative efforts aligned with current health trends prioritizing prevention over treatment. Stakeholder views also influenced preferring Program 2's community-based approach.
The document discusses using a health production function to allocate resources between two programs in Detroit, Michigan. Program 1 is "Bariatricity Detroit", which establishes bariatric surgery centers. Program 2 is "Healthy Lifestyles Detroit", which provides education and coaching on healthy behaviors. The health production function shows that allocating funding to the smaller Program 2 would yield larger decreases in diabetes rates among low-income individuals due to diminishing returns. Marginal analysis also supports funding Program 2, as its marginal cost per individual is lower than Program 1's. The executive summary should recommend funding the lower-cost Program 2 to maximize health outcomes efficiently.
Capella Data Analysis Quality Improvement Initiative Proposal.docxstirlingvwriters
The document provides instructions for a quality improvement initiative proposal based on analyzing healthcare data and metrics. Students will either use provided data from a fictional hospital or obtain real data from their own institution. They will identify an issue or area for improvement, evaluate current quality indicators and initiatives, and propose strategies to enhance processes, outcomes, roles, and communication for interprofessional teams. The proposal should be 8-10 pages including analyses, benchmarks, target areas, and recommendations to improve patient safety, cost-effectiveness, and staff work-life quality through quality improvement.
ECO/561 Week 5 Assignment Rubric
Individual Assignment: Effectiveness of the Counter-Cyclical PoliciesPurpose of Assignment
This assignment addresses how both monetary and fiscal policies have been used during the so-called Great Recession, which began in December 2007 and ended in June 2009, to the present to moderate the business cycle. Resources Required
Tutorial help on Excel® and Word functions can be found on the Microsoft® Office website. There are also additional tutorials via the web offering support for Office products.Grading Guide
Content
Met
Partially Met
Not Met
Comments:
Selected an industry that suffered heavy losses during the Great Recession and produced an Excel® Workbook including the following data from December 2007 to the present:
· One dataset related to the U.S. housing industry such as housing starts, the FHFA housing price index, or another dataset of your choice related to the housing market.
· One dataset related to personal or household income or to personal or household saving.
· One dataset related to the labor market such as the unemployment rate, initial claims for unemployment insurance, or another dataset of your choice related to the U.S. labor force.
· One dataset related to production and business activity within the market or industry you choose to analyze.
15 points
Using data results analyzed the economic and sociological forces that drove the market equilibrium to unsustainable heights, commonly referred to as "bubbles," and the shocks that brought the markets back down.
10 points
Discussed specific changes in supply and demand within the markets and/or industries you chose to analyze.
10 points
Determined whether specialization of industry had any influence on the impact of the recession. 10 points
Examined prior government policies and legislation that might have exacerbated the impact of the shocks. Also, discuss government actions/regulations that might be undertaken, and/or have been undertaken, to moderate the effects of extreme economic fluctuations. 15 points
Evaluated the actions of the federal government (fiscal policy) and the Federal Reserve (monetary policy) to restore the economy and foster economic growth. Based your evaluation on information available at Internet sources such as, but not limited to, the Fed's The Economy Crisis and Response website as well as other appropriate sources found on the Internet and in the University Library. You did address the effectiveness of those counter-cyclical policies. 20 points
The analysis is a minimum of 1,050 words in length. 5 points
Total Available
Total Earned
85
#/85
Writing Guidelines
Met
Partially Met
Not Met
Comments:
The paper—including tables and graphs, headings, title page, and reference page—is consistent with APA formatting guidelines and meets course-level requirements. 10 points
Intellectual property is recognized with in-text citations and a reference page. 10 points
Paragraph and s ...
This report is written for the Board of Directors of the Nazarene Community Health Clinic (NCHC). It outlines the importance and necessity of quality management as it pertains to the health care reform’s mandate that all Americans have access to quality, affordable health care.
FINAL MSmith_ Medn Measures that Matter_ AJPB_Jan-Feb 2015Marie Smith, PharmD
This document discusses the need for new quality measures that assess medication management across care settings and providers. It notes that while current measures address prescribing and adherence, they do not address optimization, coordination of medications prescribed by multiple providers, or medication management during care transitions. The document advocates developing measures that close these gaps, such as those assessing comprehensive medication reviews, reconciliation of medication lists during care transitions, and development of patient medication action plans. It provides examples of how measures could be organized into families and sets that cut across conditions and specialties to promote coordination and alignment of quality measurement.
Emerging Public Health Issues Health Equity (Page 3) Public Health Accreditat...CookCountyPLACEMATTERS
"This tip sheet is provided to accredited health departments to use as they prepare their annual reports." "Health equity is noted as an emerging public health issue because best and promising practices are moving the science and practice of public health beyond the traditional considerations of minority health and health disparities to more comprehensive concepts associated with ensuring deliberate consideration of the multiple determinants of health."
Data Analysis and Quality Improvement Initiative Proposal.docxwrite31
This document provides instructions for developing an 8-10 page quality improvement initiative proposal. It involves analyzing internal and external data to identify an area for improvement, developing evidence-based recommendations, and creating communication strategies to gain support from interprofessional team members. Key aspects include measuring outcomes, validating data, focusing on best practices, and using health informatics and technologies to enhance patient outcomes through quality improvement initiatives.
The Healthy County Health Department convened organizations to develop a community health improvement plan. A council was established to improve population health through prevention and health promotion. The council used the MAPP process to conduct four assessments to identify health issues: community health status, forces of change, local public health system, and community themes/strengths. A subcommittee prioritized health problems using assessment data. The result was a plan identifying priority issues and goals. Performance management could be enhanced by developing standards, regular reporting, and quality improvement processes for addressing priority health issues.
M Heenan_PhD Dissertation Lecture_eHealth Lecture_Engaging Leaders in KPI Sel...Mike Heenan
Presentation of the proliferation of measurement in health care and how organizations should redesign indicator selection processes to engage and motivate managers to improve performance. Presentation to eHealth students based on 2023 PhD dissertation.
Pharmacy Services Development within ACO MSO Business Proposal.pdfsdfghj21
The document discusses implementing pharmacy services within an ACO/MSO business proposal. It provides background on ACOs, MSOs, and the evolving healthcare landscape. The proposal should include 1) pharmacy services to implement like medication therapy management, annual wellness visits, or chronic disease management and 2) how these services will improve patient care by impacting benchmarks for quality, care coordination, preventive health, and management of at-risk populations. The literature demonstrates benefits of these pharmacy services including reduced costs and improved outcomes.
ACT500 Research Evaluation TablesArticle 1 Measuring Perfo.docxbobbywlane695641
ACT500: Research Evaluation Tables
Article 1: Measuring Performance
Insert reference in APA formatting, 6th ed. 4th printing
Research Topic
The topic is a broad subject. The topic is not the problem to be solved; that comes later. Example: Balanced Scorecard
Problem or Opportunity
The problem is established with factual data and is found in the introductory portion of the research article or report.
Purpose for the Research
The purpose of the study defines what the researcher wants to find out and is found in the introductory section of the research article. Sometimes the purpose contains a research question/s.
Research Methods
A researcher makes a decision about the broad nature of a research approach: typically quantitative/confirmatory or qualitative/exploratory. Research design strategies are driven by the chosen research approach and the research purpose. Research design strategies include: types of data collected, how the data is collected, and what preparation of data is used, analytical techniques, and presentation of information.
Audience
The groups, associates, profession, and/or individuals that the researcher suggests might benefit from the findings of this study
Research Evaluation
Assess the study’s Research Methods and Analytic Techniques. Are the research methods and analytic techniques applicable to solving practical management questions? Why or why not? You must substantiate your position with credible resources and examples.
Discuss how your organization might or might not use the findings from these studies. Substantiate your opinion with concrete examples.
Article 2: Incremental Analysis
Insert reference in APA formatting, 6th ed. 4th printing
Research Topic
The topic is a broad subject. The topic is not the problem to be solved; that comes later. Example: Cost Behavior
Problem or Opportunity
The problem is established with factual data and is found in the introductory portion of the research article or report.
Purpose for the Research
The purpose of the study defines what the researcher wants to find out and is found in the introductory section of the research article. Sometimes the purpose contains a research question/s.
Research Methods
A researcher makes a decision about the broad nature of a research approach: typically quantitative/confirmatory or qualitative/exploratory. Research design strategies are driven by the chosen research approach and the research purpose. Research design strategies include: types of data collected, how the data is collected, and what preparation of data is used, analytical techniques, and presentation of information.
Audience
The groups, associates, profession, and/or individuals that the researcher suggests might benefit from the findings of this study
Research Evaluation
Assess the study’s Research Methods and Analytic Techniques. Are the methods and analytic techniques applicable to solving practical management questions? Why or why not? You must substantiate your position wit.
4508 Final Quality Project Part 2 Clinical Quality Measur.docxblondellchancy
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
4508 Final Quality Project Part 2 Clinical Quality Measurromeliadoan
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
This document summarizes key findings about value-based purchasing models from a systematic review of the research literature. It finds that value-based purchasing initiatives aim to improve quality, slow healthcare spending growth, and reduce unnecessary care through the use of financial incentives linked to provider performance on defined quality measures. Common models include pay for performance programs, accountable care organizations, and bundled payment programs. The document also examines which elements, such as stakeholder engagement and use of evidence-based quality measures, are associated with more effective value-based purchasing programs. However, it notes that firm conclusions about the impact of these programs are difficult to make due to variations in methodology and program design across studies.
Health Equity Investments: Opportunities and Challenges in 2023Health Catalyst
Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions. Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions.
Removing Barriers to Clinician Engagement: Partnerships in Improvement WorkHealth Catalyst
The document summarizes strategies for overcoming barriers to engaging clinicians in quality improvement work. It describes how the University of Kansas Health System partners with clinicians at three levels - local improvement projects, departmental value-based performance, and leadership planning - to achieve system-wide improvements. Examples include reducing COPD readmissions, adopting a less costly acetaminophen, and antibiotic cost savings. The framework aligns clinicians in data-driven improvement work through dedicated performance teams.
Quality measures and performance indicators are important for nurse practitioners (NPs) to demonstrate the impact of their care and meet organizational goals. Quality measures assess standards of care delivery and outcomes, ensuring patient safety and efficient use of healthcare services. They can improve access to preventive care, patient experience, and outcomes for high-risk groups. Performance indicators also evaluate clinical performance but from a holistic nursing perspective. Productivity measures for NPs may include patient visits, billing levels, or accomplishing specific clinical goals depending on specialty. Incentive plans that link pay to quality metrics and productivity can increase NP retention, satisfaction, and overall productivity, benefiting both NPs and healthcare organizations.
We have spent a lot of time this semester talking about various as.docxmelbruce90096
We have spent a lot of time this semester talking about various aspects of the health care industry -- cost, access, utilization, strategy. Another important aspect that needs to be balanced with all these other concerns is QUALITY!
What does QUALITY mean in health care?
How do you go about defining quality in health care? Is there just one measure of quality, or more?!
Find one outside article that addresses health care quality. Tell us about the article and how they define quality.
Be sure to post your citations
Alicia AliendreCOLLAPSE
Top of Form
Parent Post
In the health care industry quality of care means everyone participating in ways to improve health care such as health care professionals, patients and their families, researchers, payers, planners and educators. These changes lead to better outcomes in health, a better system performance in care, as well as better professional development.
When you describe quality, it’s the process for making strategic choices in health systems for quality assurance in health care and decision making. Although there are many outcomes to improve quality of care, the main concern is accomplishing a goal that will be beneficial for the future.
Good quality means providing patients with appropriate services in a technically competent manner, with good communication, shared decision making, and cultural sensitivity. In practical terms, poor quality can mean too much care (e.g., providing unnecessary tests, medications, and procedures, with associated risks and side effects), too little care (e.g., not providing an indicated diagnostic test or a lifesaving surgical procedure), or the wrong care (e.g., prescribing medicines that should not be given together, using poor surgical technique).
Quality can be evaluated based on structure, process, and outcomes (Donabedian 1980). Structural quality evaluates health system characteristics, process quality assesses interactions between clinicians and patients, and outcomes offer evidence about changes in patients' health status. All three dimensions can provide valuable information for measuring quality, but the published quality-of-care literature reveals that there is more experience with measuring processes of care.
Marie Savino
To many health care consumers quality of health care can mean several different things, including wait times, doctors professionalism, the courtesy of the medical staff and use of updated medical technology, which can all effect how people judge the quality of health care they are receiving. These characteristics may be important to the patient but they do not add up to a quality health care system. Quality health care can be defined as levels of superiority which distinguish the health care provided based on accepted standards of quality. Several factors help measure quality of care:
* Safety- health care does not cause harm
* Effective- health care service is based on scientific and medical knowledge and is right for the.
Speak to the idea of feminism from your perspective and.docxstirlingvwriters
The document asks students to discuss their perspectives on feminism by answering several questions: 1) What they were taught about feminism by family/culture, 2) If they identify as a feminist and how that label may change based on audience, 3) The most important issue regarding feminism/gender equality today, 4) Whether the quote about privilege and equality resonates regarding gender, and 5) What they wish another gender understood about their experiences. Students are asked to write a minimum 270-word initial post responding to the questions.
Demand/Supply Integration (DSI) aims to align demand signals with supply planning to achieve an ideal state where inventory levels and production schedules match customer demand. However, issues like data or system silos between functions can prevent the ideal DSI state. Warehouses and distribution centers create value in the supply chain by storing inventory in strategic locations to efficiently meet customer demand and support supply chain operations.
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Data Analysis And Quality Improvement Essay 2.pdfsdfghj21
The document provides instructions for an assignment to develop an 8-10 page quality improvement initiative proposal based on analyzing health care data. It includes:
1) Gathering internal and external benchmark data on a selected health issue and analyzing dashboards to identify areas for improvement.
2) Making evidence-based recommendations to improve outcomes related to the issue while considering challenges to meeting benchmarks.
3) Developing communication strategies to engage the interprofessional team and promote the initiative's success through improved strategies.
The document discusses using a health production function to analyze two existing programs and make recommendations about allocating resources. The programs aim to reduce diabetes among low-income obese individuals in Detroit. Program 1 focuses on bariatric surgery centers while Program 2 emphasizes healthy lifestyle education and coaching. The analysis recommends reallocating funding from Program 1 to Program 2 due to the latter's lower costs and ability to impact more patients through preventative efforts aligned with current health trends prioritizing prevention over treatment. Stakeholder views also influenced preferring Program 2's community-based approach.
The document discusses using a health production function to allocate resources between two programs in Detroit, Michigan. Program 1 is "Bariatricity Detroit", which establishes bariatric surgery centers. Program 2 is "Healthy Lifestyles Detroit", which provides education and coaching on healthy behaviors. The health production function shows that allocating funding to the smaller Program 2 would yield larger decreases in diabetes rates among low-income individuals due to diminishing returns. Marginal analysis also supports funding Program 2, as its marginal cost per individual is lower than Program 1's. The executive summary should recommend funding the lower-cost Program 2 to maximize health outcomes efficiently.
Capella Data Analysis Quality Improvement Initiative Proposal.docxstirlingvwriters
The document provides instructions for a quality improvement initiative proposal based on analyzing healthcare data and metrics. Students will either use provided data from a fictional hospital or obtain real data from their own institution. They will identify an issue or area for improvement, evaluate current quality indicators and initiatives, and propose strategies to enhance processes, outcomes, roles, and communication for interprofessional teams. The proposal should be 8-10 pages including analyses, benchmarks, target areas, and recommendations to improve patient safety, cost-effectiveness, and staff work-life quality through quality improvement.
ECO/561 Week 5 Assignment Rubric
Individual Assignment: Effectiveness of the Counter-Cyclical PoliciesPurpose of Assignment
This assignment addresses how both monetary and fiscal policies have been used during the so-called Great Recession, which began in December 2007 and ended in June 2009, to the present to moderate the business cycle. Resources Required
Tutorial help on Excel® and Word functions can be found on the Microsoft® Office website. There are also additional tutorials via the web offering support for Office products.Grading Guide
Content
Met
Partially Met
Not Met
Comments:
Selected an industry that suffered heavy losses during the Great Recession and produced an Excel® Workbook including the following data from December 2007 to the present:
· One dataset related to the U.S. housing industry such as housing starts, the FHFA housing price index, or another dataset of your choice related to the housing market.
· One dataset related to personal or household income or to personal or household saving.
· One dataset related to the labor market such as the unemployment rate, initial claims for unemployment insurance, or another dataset of your choice related to the U.S. labor force.
· One dataset related to production and business activity within the market or industry you choose to analyze.
15 points
Using data results analyzed the economic and sociological forces that drove the market equilibrium to unsustainable heights, commonly referred to as "bubbles," and the shocks that brought the markets back down.
10 points
Discussed specific changes in supply and demand within the markets and/or industries you chose to analyze.
10 points
Determined whether specialization of industry had any influence on the impact of the recession. 10 points
Examined prior government policies and legislation that might have exacerbated the impact of the shocks. Also, discuss government actions/regulations that might be undertaken, and/or have been undertaken, to moderate the effects of extreme economic fluctuations. 15 points
Evaluated the actions of the federal government (fiscal policy) and the Federal Reserve (monetary policy) to restore the economy and foster economic growth. Based your evaluation on information available at Internet sources such as, but not limited to, the Fed's The Economy Crisis and Response website as well as other appropriate sources found on the Internet and in the University Library. You did address the effectiveness of those counter-cyclical policies. 20 points
The analysis is a minimum of 1,050 words in length. 5 points
Total Available
Total Earned
85
#/85
Writing Guidelines
Met
Partially Met
Not Met
Comments:
The paper—including tables and graphs, headings, title page, and reference page—is consistent with APA formatting guidelines and meets course-level requirements. 10 points
Intellectual property is recognized with in-text citations and a reference page. 10 points
Paragraph and s ...
This report is written for the Board of Directors of the Nazarene Community Health Clinic (NCHC). It outlines the importance and necessity of quality management as it pertains to the health care reform’s mandate that all Americans have access to quality, affordable health care.
FINAL MSmith_ Medn Measures that Matter_ AJPB_Jan-Feb 2015Marie Smith, PharmD
This document discusses the need for new quality measures that assess medication management across care settings and providers. It notes that while current measures address prescribing and adherence, they do not address optimization, coordination of medications prescribed by multiple providers, or medication management during care transitions. The document advocates developing measures that close these gaps, such as those assessing comprehensive medication reviews, reconciliation of medication lists during care transitions, and development of patient medication action plans. It provides examples of how measures could be organized into families and sets that cut across conditions and specialties to promote coordination and alignment of quality measurement.
Emerging Public Health Issues Health Equity (Page 3) Public Health Accreditat...CookCountyPLACEMATTERS
"This tip sheet is provided to accredited health departments to use as they prepare their annual reports." "Health equity is noted as an emerging public health issue because best and promising practices are moving the science and practice of public health beyond the traditional considerations of minority health and health disparities to more comprehensive concepts associated with ensuring deliberate consideration of the multiple determinants of health."
Data Analysis and Quality Improvement Initiative Proposal.docxwrite31
This document provides instructions for developing an 8-10 page quality improvement initiative proposal. It involves analyzing internal and external data to identify an area for improvement, developing evidence-based recommendations, and creating communication strategies to gain support from interprofessional team members. Key aspects include measuring outcomes, validating data, focusing on best practices, and using health informatics and technologies to enhance patient outcomes through quality improvement initiatives.
The Healthy County Health Department convened organizations to develop a community health improvement plan. A council was established to improve population health through prevention and health promotion. The council used the MAPP process to conduct four assessments to identify health issues: community health status, forces of change, local public health system, and community themes/strengths. A subcommittee prioritized health problems using assessment data. The result was a plan identifying priority issues and goals. Performance management could be enhanced by developing standards, regular reporting, and quality improvement processes for addressing priority health issues.
M Heenan_PhD Dissertation Lecture_eHealth Lecture_Engaging Leaders in KPI Sel...Mike Heenan
Presentation of the proliferation of measurement in health care and how organizations should redesign indicator selection processes to engage and motivate managers to improve performance. Presentation to eHealth students based on 2023 PhD dissertation.
Pharmacy Services Development within ACO MSO Business Proposal.pdfsdfghj21
The document discusses implementing pharmacy services within an ACO/MSO business proposal. It provides background on ACOs, MSOs, and the evolving healthcare landscape. The proposal should include 1) pharmacy services to implement like medication therapy management, annual wellness visits, or chronic disease management and 2) how these services will improve patient care by impacting benchmarks for quality, care coordination, preventive health, and management of at-risk populations. The literature demonstrates benefits of these pharmacy services including reduced costs and improved outcomes.
ACT500 Research Evaluation TablesArticle 1 Measuring Perfo.docxbobbywlane695641
ACT500: Research Evaluation Tables
Article 1: Measuring Performance
Insert reference in APA formatting, 6th ed. 4th printing
Research Topic
The topic is a broad subject. The topic is not the problem to be solved; that comes later. Example: Balanced Scorecard
Problem or Opportunity
The problem is established with factual data and is found in the introductory portion of the research article or report.
Purpose for the Research
The purpose of the study defines what the researcher wants to find out and is found in the introductory section of the research article. Sometimes the purpose contains a research question/s.
Research Methods
A researcher makes a decision about the broad nature of a research approach: typically quantitative/confirmatory or qualitative/exploratory. Research design strategies are driven by the chosen research approach and the research purpose. Research design strategies include: types of data collected, how the data is collected, and what preparation of data is used, analytical techniques, and presentation of information.
Audience
The groups, associates, profession, and/or individuals that the researcher suggests might benefit from the findings of this study
Research Evaluation
Assess the study’s Research Methods and Analytic Techniques. Are the research methods and analytic techniques applicable to solving practical management questions? Why or why not? You must substantiate your position with credible resources and examples.
Discuss how your organization might or might not use the findings from these studies. Substantiate your opinion with concrete examples.
Article 2: Incremental Analysis
Insert reference in APA formatting, 6th ed. 4th printing
Research Topic
The topic is a broad subject. The topic is not the problem to be solved; that comes later. Example: Cost Behavior
Problem or Opportunity
The problem is established with factual data and is found in the introductory portion of the research article or report.
Purpose for the Research
The purpose of the study defines what the researcher wants to find out and is found in the introductory section of the research article. Sometimes the purpose contains a research question/s.
Research Methods
A researcher makes a decision about the broad nature of a research approach: typically quantitative/confirmatory or qualitative/exploratory. Research design strategies are driven by the chosen research approach and the research purpose. Research design strategies include: types of data collected, how the data is collected, and what preparation of data is used, analytical techniques, and presentation of information.
Audience
The groups, associates, profession, and/or individuals that the researcher suggests might benefit from the findings of this study
Research Evaluation
Assess the study’s Research Methods and Analytic Techniques. Are the methods and analytic techniques applicable to solving practical management questions? Why or why not? You must substantiate your position wit.
4508 Final Quality Project Part 2 Clinical Quality Measur.docxblondellchancy
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
4508 Final Quality Project Part 2 Clinical Quality Measurromeliadoan
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
This document summarizes key findings about value-based purchasing models from a systematic review of the research literature. It finds that value-based purchasing initiatives aim to improve quality, slow healthcare spending growth, and reduce unnecessary care through the use of financial incentives linked to provider performance on defined quality measures. Common models include pay for performance programs, accountable care organizations, and bundled payment programs. The document also examines which elements, such as stakeholder engagement and use of evidence-based quality measures, are associated with more effective value-based purchasing programs. However, it notes that firm conclusions about the impact of these programs are difficult to make due to variations in methodology and program design across studies.
Health Equity Investments: Opportunities and Challenges in 2023Health Catalyst
Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions. Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions.
Removing Barriers to Clinician Engagement: Partnerships in Improvement WorkHealth Catalyst
The document summarizes strategies for overcoming barriers to engaging clinicians in quality improvement work. It describes how the University of Kansas Health System partners with clinicians at three levels - local improvement projects, departmental value-based performance, and leadership planning - to achieve system-wide improvements. Examples include reducing COPD readmissions, adopting a less costly acetaminophen, and antibiotic cost savings. The framework aligns clinicians in data-driven improvement work through dedicated performance teams.
Quality measures and performance indicators are important for nurse practitioners (NPs) to demonstrate the impact of their care and meet organizational goals. Quality measures assess standards of care delivery and outcomes, ensuring patient safety and efficient use of healthcare services. They can improve access to preventive care, patient experience, and outcomes for high-risk groups. Performance indicators also evaluate clinical performance but from a holistic nursing perspective. Productivity measures for NPs may include patient visits, billing levels, or accomplishing specific clinical goals depending on specialty. Incentive plans that link pay to quality metrics and productivity can increase NP retention, satisfaction, and overall productivity, benefiting both NPs and healthcare organizations.
We have spent a lot of time this semester talking about various as.docxmelbruce90096
We have spent a lot of time this semester talking about various aspects of the health care industry -- cost, access, utilization, strategy. Another important aspect that needs to be balanced with all these other concerns is QUALITY!
What does QUALITY mean in health care?
How do you go about defining quality in health care? Is there just one measure of quality, or more?!
Find one outside article that addresses health care quality. Tell us about the article and how they define quality.
Be sure to post your citations
Alicia AliendreCOLLAPSE
Top of Form
Parent Post
In the health care industry quality of care means everyone participating in ways to improve health care such as health care professionals, patients and their families, researchers, payers, planners and educators. These changes lead to better outcomes in health, a better system performance in care, as well as better professional development.
When you describe quality, it’s the process for making strategic choices in health systems for quality assurance in health care and decision making. Although there are many outcomes to improve quality of care, the main concern is accomplishing a goal that will be beneficial for the future.
Good quality means providing patients with appropriate services in a technically competent manner, with good communication, shared decision making, and cultural sensitivity. In practical terms, poor quality can mean too much care (e.g., providing unnecessary tests, medications, and procedures, with associated risks and side effects), too little care (e.g., not providing an indicated diagnostic test or a lifesaving surgical procedure), or the wrong care (e.g., prescribing medicines that should not be given together, using poor surgical technique).
Quality can be evaluated based on structure, process, and outcomes (Donabedian 1980). Structural quality evaluates health system characteristics, process quality assesses interactions between clinicians and patients, and outcomes offer evidence about changes in patients' health status. All three dimensions can provide valuable information for measuring quality, but the published quality-of-care literature reveals that there is more experience with measuring processes of care.
Marie Savino
To many health care consumers quality of health care can mean several different things, including wait times, doctors professionalism, the courtesy of the medical staff and use of updated medical technology, which can all effect how people judge the quality of health care they are receiving. These characteristics may be important to the patient but they do not add up to a quality health care system. Quality health care can be defined as levels of superiority which distinguish the health care provided based on accepted standards of quality. Several factors help measure quality of care:
* Safety- health care does not cause harm
* Effective- health care service is based on scientific and medical knowledge and is right for the.
Similar to Healthcare Challenges in Development of Tools of Quality Measurement in.pdf (20)
Speak to the idea of feminism from your perspective and.docxstirlingvwriters
The document asks students to discuss their perspectives on feminism by answering several questions: 1) What they were taught about feminism by family/culture, 2) If they identify as a feminist and how that label may change based on audience, 3) The most important issue regarding feminism/gender equality today, 4) Whether the quote about privilege and equality resonates regarding gender, and 5) What they wish another gender understood about their experiences. Students are asked to write a minimum 270-word initial post responding to the questions.
Demand/Supply Integration (DSI) aims to align demand signals with supply planning to achieve an ideal state where inventory levels and production schedules match customer demand. However, issues like data or system silos between functions can prevent the ideal DSI state. Warehouses and distribution centers create value in the supply chain by storing inventory in strategic locations to efficiently meet customer demand and support supply chain operations.
Thinking about password identify two that you believe are.docxstirlingvwriters
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Healthcare Challenges in Development of Tools of Quality Measurement in.pdf
1. Healthcare Assignment: Challenges in Development of Tools of Quality
Measurement in Healthcare Paper
Healthcare Assignment: Challenges in Development of Tools of Quality Measurement in
Healthcare Paper ON Healthcare Assignment: Challenges in Development of Tools of
Quality Measurement in Healthcare PaperFor performance standards to be useful in
improving patient outcomes, appropriate methods and techniques must first be developed.
These methods and techniques must accurately address those standards. In the health care
industry, many factors must be considered when developing and evaluating performance
measures. In this assignment, you research and analyze key challenges in developing
methods for measuring and evaluating performance.For this Assignment, you will first
develop the problem statement for your Premise, using the topic you selected for your
Premise in Week 1, and then you will complete your development of 1 to 2 research
questions that will help to address the problem.To prepare for this Assignment:Review the
Learning Resources for this week.Find three reputable resources that address challenges in
developing methods and techniques for measuring and evaluating performance in health
care.To complete this Assignment, write a 1- to 2-page paper that addresses the
following:Explain key challenges in developing methods for measuring and evaluating
performance in health care and why.Your written assignments must follow APA guidelines.
Be sure to your work with specific citations from this week’s Learning Resources and
additional scholarly sourcesresource_wk3.docxproquestdocuments_2019_07_Unformatted
Attachment PreviewQuality and Safety Assessments In order for any business to evaluate
and improve its performance, it must have clear, measurable outcomes to use for
assessment. Similarly, in order to effectively compare the performances of institutions
performing the same service within an industry, the same outcomes must be used for
assessment. These are often called performance measures and provide a way to compare
different companies against one another when they are working toward the same goals. In
health care, assessments are particularly important for both the individual patient
(consumer) and the institution (provider). This week, you consider and create effective
performance measures to improve health care and patient safety outcomes. You apply them
to the case study you identified in Week 1. Learning Objectives By the end of this week,
students will: Create effective performance measures that can be applied to improve the
quality of care and safety in different health care settings Distinguish between structural,
process, and outcome measures for evaluating performance Analyze the challenges in
2. developing tools for measuring and evaluating performance in health care Photo Credit:
[ONOKY – Eric Audras]/[Brand X Pictures]/Getty Images Learning Resources This page
contains the Learning Resources for this week. Be sure to scroll down the page to see all of
this week’s assigned Learning Resources. Required Readings Introduction to healthcare
quality management. Healthcare Assignment: Challenges in Development of Tools of Quality
Measurement in Healthcare PaperChapter 3, “Measuring Performance” Chapter 4,
“Evaluating Performance” Friesner, D., Neufelder, D., Raisor, J., & Bozman, C. (2009, Winter).
How to improve patient satisfaction when patients are already satisfied: A continuous
process-improvement approach. Hospital Topics, 87 (1), 24-40 Ilminen, G. (2003).
Improving healthcare quality measurement. Quality Progress, 36(12), 62-66.
https://search-proquest-
com.ezp.waldenulibrary.org/docview/214758419?accountid=14872 Improving Healthcare
Quality Measurement Ilminen, Gary R . Quality Progress ; Milwaukee Vol. 36, Iss. 12, (Dec
2003): 62-66. ProQuest document link ABSTRACT In November 2002, the Institute of
Medicine released a major report on Healthcare quality. The report issued a variety of
recommendations, including a call for the development and implementation of 15 sets of
national standardized performance measures by 2008. The report also recognized the
critical failings of current retrospective performance measure sets. Wisconsin has long
recognized insufficient encounter data as the central problem in measuring healthcare
quality. Significant progress came in 2002 with the completion and testing of a new system
called the Medicaid Encounter Data Driven Improvement Core Measure Set (MEDDIC-MS).
MEDDIC-MS does not aim to resolve all healthcare performance measurement issues. Since
it relies on multiple data streams that private HMOs do not have access to, it is not a
panacea for performance measurement in privately insured populations. However,
Wisconsin hopes other state Medicaid programs may find it a useful model to improve
performance measurement in the commercial sector. FULL TEXT In November 2002, the
Institute of Medicine (IOM) released a major report on Healthcare quality. Leadership by
Example: Coordinating Government Roles in Improving Healthcare Quality explored several
of the most difficult issues confronting publicly funded healthcare programs such as
Medicare and Medicaid. The report issued a variety of recommendations, including a call for
the development and implementation of 15 sets of national standardized performance
measures by 2008. The report also recognized the critical failings of current retrospective
performance measure sets, saying, “By the time retrospective performance measures reach
decision makers, it is too late for them to be useful.”1 Healthcare Assignment: Challenges in
Development of Tools of Quality Measurement in Healthcare PaperThe Problems
Healthcare quality measurement has long been a nettlesome issue. The first hurdle is
deciding what to measure and how to measure it. Once performance measure topics and
technical specifications are finally agreed on for a given healthcare setting, the next-and
biggest-problem is getting accurate, complete data quickly enough to derive useful
measurements. Most current healthcare performance measure systems require extensive
medical record review, because administrative data (claims or encounter data) are often
incomplete. Problems most frequently occur in capitated managed healthcare systems-
systems in which managed care plans pay healthcare providers a fixed amount over a given
3. period to care for a patient regardless of the nature of the treatment. In capitated systems,
submission of encounter data-which are any data relating to the treatment rendered by a
provider to a patient-is not necessary for payment, so the encounter data are often not even
there. Sometimes patients supply their own data, but they may be inaccurate, incomplete
and subjectively interpreted. PDF GENERATED BY SEARCH.PROQUEST.COM Page 1 of 7
Enlarge this image. Wisconsin has long recognized insufficient encounter data as the central
problem in measuring healthcare quality. Since performance measurement is essential in
publicly funded healthcare programs to ensure the funds are being put to good use, a
solution is clearly necessary. Years in the Making Wisconsin began operating a Medicaid
health maintenance organization (HMO) program in a limited number of counties in 1984.
In 1997, the HMO program was expanded nearly statewide (68 of 72 counties). Over the
years, the state struggled to find a cost effective, responsive performance measure system.
In 1996, Wisconsin began developing techniques and offering technical assistance to HMOs
on reporting encounter data. The state began implementing mandatory HMO encounter
data reporting in 1999, and the first full year of encounter data reporting across all HMOs
was 2000. To date, all HMOs in Medicaid/BadgerCare (the state’s children’s health
insurance program) have implemented encounter data reporting, and errors in reporting
(edit failures) have been very low. No HMOs are experiencing unacceptable rates of critical
edit failures. Ongoing data validity audits are essential to the operation of encounter data
driven performance measures. Significant progress came in 2002 with the completion and
testing of a new system called the Medicaid Encounter Data Driven Improvement Core
Measure Set (MEDDIC-MS). Development of MEDDIC-MS began in January 2001 with the
decision to migrate the HMO program’s performance measures from the retrospective,
medical record review system then in use to a system using encounter data. Following
development of the draft measures, internal and external stakeholders, including multiple
state staff, agencies and participating HMOs, gave their input. Testing began in early 2002,
and by July 2002 final technical specifications for the first version of MEDDIC-MS were
complete. MEDDIC-MS brings significant changes to performance measurement in the
Wisconsin Medicaid managed care program. It also introduces new concepts applicable to
performance measurement in any state’s publicly funded managed healthcare. PDF
GENERATED BY SEARCH.PROQUEST.COM Page 2 of 7 No More Self-Reporting Perhaps the
most noticeable change lies in data gathering and reporting. Traditional managed care
performance measures allow each HMO, as a vendor, to report its own performance to the
state, the customer. This is the reverse of the normal customer/vendor relationship in other
industries’ quality improvement systems. MEDDIC-MS restores the ability of the customer-
the state Medicaid program-to have greater control over performance assessment. Each
month, the HMOs report encounter data to the state for each service provided to enrollees,
including those used in performance measures, and the state calculates each HMO’s
performance. Having the state calculate performance facilitates greater consistency and
accuracy by eliminating several factors: * Variations in reporting caused by differing HMO
data processing systems, capabilities and personnel. * Problems with delayed reporting of
measures due to limitations of HMO data infrastructure. * Errors and inconsistencies due to
misinterpretation of reporting specifications. It also eliminates the duplicative data
4. gathering, calculation and reporting functions each HMO previously had to bear. This allows
HMOs to devote increased resources to performance improvement and reduces
administrative cost and complexity systemwide. Healthcare Assignment: Challenges in
Development of Tools of Quality Measurement in Healthcare PaperIt also frees the HMOs to
focus on reporting complete, accurate monthly encounter data. Medical Record Review All
but Ends In traditional measure systems, medical record review is necessitated by
incomplete encounter data. Unfortunately, it makes performance measurement slow,
cumbersome, intrusive and expensive. It is virtually eliminated with MEDDIC-MS in HMO
settings. For reducing or eliminating medical record review in non-HMO settings, MEDDIC-
MS uses multiple state controlled data streams such as fee-for-service data and public
health lead toxicity screening and immunization data. Use of these data streams is
necessary because Medicaid enrollees often receive services from public health
departments or other non-HMO fee-for-service providers. Those services are usually
provided just before enrollment in the HMO. Often, however, enrollees will obtain services
from those non-network providers even after enrollment in the HMO, because they are
unfamiliar with the HMO delivery system. An advantage of the multiple data stream
approach is that it allows the use of MEDDIC-MS measures to assess both services provided
by the HMO and enrollee status in terms of access to all services, HMO and otherwise. HMOs
may then calculate their individual performance on each measure if they wish by using only
HMO encounter data and including no service codes from the other data streams. Another
positive is that the measures focus on clinical criteria readily identifiable using standard
procedure and diagnosis codes. For example, the MEDDIC-MS measure for ambulatory
management of diabetes mellitus assesses the rate of delivery of hemoglobin A1c (HgbA1c)
tests and lipid profiles. Each is identifiable with distinct procedure codes. PDF GENERATED
BY SEARCH.PROQUEST.COM Page 3 of 7 Enlarge this image. While MEDDIC-MS does include
measures that assess outcomes, this particular measure does not. There are two reasons.
First, the lab results are not reported in encounter data, making the acquisition of the
results dependent on medical record review; second, the results of the tests can be affected
by multiple factors, such as comorbidities or noncompliance that the HMO and the
practitioner may not be able to control. Use of multiple data streams also reduces the
likelihood of underreporting of services (false negatives) and prevents reporting of services
that may not have been provided (false positives). Duplicate reporting across systems can
be prevented by eliminating repeat dates of service, a process known as unduplicating.
HMOs are free to supplement their encounter data by record review if they wish, but
otherwise it is used primarily for focused clinical quality audits and data validity audits.
False negatives and the need for medical record review are also minimized by denominator
specifications that focus on individuals enrolled when the services were due to be provided.
This is accomplished by designing denominator specifications to link enrollee age at the
date of service to applicable clinical guidelines for service delivery. The specifications are
designed to ensure measurement of performance by HMOs for enrollees they had when the
services should reasonably be expected to be provided. It eliminates attempts to account for
services that were due when the HMO did not have the enrollee in its care. Healthcare
Assignment: Challenges in Development of Tools of Quality Measurement in Healthcare
5. PaperFor example, the childhood immunization measure denominator targets children
enrolled in the HMO during the first 18 months of life-the period when the majority of
immunizations are supposed to be given. This reduces the problems caused by attempting
to measure immunization status of all children who are 2 years old, irrespective of their
enrollment status when the immunizations were due to be given, as is done in other
measure systems. This feature increases the likelihood encounter data will exist for the
services being measured. Speed Equals Relevance MEDDIC-MS capitalizes on the availability
of monthly HMO encounter data and current data submissions in other data streams to
move performance measurement much closer to real time, thus addressing one of the key
shortcomings identified by the IOM report. This capability makes data on HMO performance
relevant to the HMO’s current quality improvement program for provider network
management, access improvement, enrollee satisfaction and clinical quality of care. Analysis
of Wisconsin HMO encounter data submissions has shown that, on average, encounter data
are more than 95% complete, edited and uploaded to the Medicaid Management
Information System data warehouse 182 days from the date of service. This allows greater
flexibility in measure calculation timeframes than before. For example, it allows calculation
of measures in timeframes other than traditional calendar year reporting-even quarterly, if
necessary. This allows data extraction and analysis frequently enough for trending, and it
facilitates PDF GENERATED BY SEARCH.PROQUEST.COM Page 4 of 7 much more rapid
response to problems than with the current annual reporting systems. Contrast that with
the timeframes for traditional annual measure systems. For example, in Wisconsin,
reporting of calendar year 1998 performance measure data occurred in October 1999. By
the time the measures were edited, uploaded to the data warehouse, analyzed, and any
performance issues identified, it was calendar year 2000. By then, the data were of greater
historical interest than interventional value. Flexibility To Meet Changing Needs To meet
changing program needs, new measures must sometimes be developed and existing
measures refined. Under most existing systems, this can be time consuming.
Implementation of a new measure can take six months to a year for development and
approval of draft specifications. The measure must be operated for at least one test year
prior to actual implementation, which is followed by a year of data acquisition for the first
actual reporting year. Thus, from the time of concept, performance data acquisition on a
new measure may take up to three years. Because MEDDIC-MS is not dependent on
calendar year reporting, new measures can be developed or existing measures can be
adjusted in as little as 90 days. Realistic, Achievable Goal Setting Under MEDDIC-MS,
performance goal setting is designed to first establish baseline levels using MEDDIC-MS
technical specifications and then, through a collaborative process with participating HMOs
and other stakeholders, establish realistic intermediate goals for subsequent years to
facilitate ramping up programwide performance. Enlarge this image. MEDDIC-MS consists
of two subsets of measures: targeted performance improvement measures (TPIMs, see
Table 1, p. 64) and monitoring measures (see Table 2). Measures consist of state specified
clinical and nonclinical topics important to Medicaid and BadgerCare enrollees in quality of
care, access and satisfaction. The TPIMs are measures on topics of highest priority to the
Medicaid program. Healthcare Assignment: Challenges in Development of Tools of Quality
6. Measurement in Healthcare PaperThey are intended to ramp up performance using specific
minimum performance goals. The monitoring measures do not have specific performance
targets. They are used for tracking access to a wide range of services, for trending and for
augmenting some of the TPIMs. Both sets include measures driven by data acquired through
the state administered Consumer Assessment of Health Plans enrollee satisfaction survey.
They also include both process and outcome measures. Examples of outcome measures
include the rate of cervical/uterine malignancies among enrollees who had Pap tests and
breast malignancies diagnosed among the enrollees who had mammograms. Recognition
and Recommendations In October 2003, the Agency for Healthcare Research and Quality
recognized MEDDIC-MS by including it in the National Quality Measures Clearinghouse
(NQMC), making Wisconsin the first and, at present, only state to have this distinction.
Other organizations included in the NQMC are the National Committee for Quality
Assurance, the Joint Commission on Accreditation of Healthcare Organizations, the federal
Centers for Medicare and Medicaid Services and the American Medical Assn. MEDDIC-MS
does not aim to resolve all healthcare performance measurement issues. Since it relies on
multiple data streams that private HMOs do not have access to, it is not a panacea for
performance measurement in PDF GENERATED BY SEARCH.PROQUEST.COM Page 5 of 7
privately insured populations. However, Wisconsin hopes other state Medicaid programs
may find it a useful model to improve performance measurement in the commercial sector.
Sidebar In 50 Words Or Less * Healthcare performance measurement is handicapped by the
lengthy and inaccurate process of medical record review. * A new measurement system in
Wisconsin improves accuracy and responsiveness, reduces complexity and virtually
eliminates the need for medical record review. Sidebar New System, New Terms
Development of some new terminology has accompanied the new ways of thinking about
performance measurement. The new terms help make clear how the system itself works.
Here are a few: Clinical criteria: The diagnosis or procedure codes used to define the
numerator or denominator. Denominator: The number of enrollees meeting the enrollment
and clinical criteria to be included in the calculation of the measure-in other words, those
enrollees who could have received the service or care being measured. Enrollment criteria:
For most measures, the enrollee must have been continuously enrolled with the same HMO
for at least 304 days immediately prior to the measure end date with no more than one gap
in enrollment of not more than 45 days. The enrollee must have a total of not less than 259
enrolled days in the look-back period. Look-back period: The period preceding the measure
end date during which services must have been provided in order to be counted in the
measure numerator. This can be 365 days from the measure end date, but it can be more or
less as program needs dictate. Measure end date: The last date of service in the look-back
period to be included in the measure. Numerator: The number of enrollees in the
denominator found to meet the clinical criteria indicating they received the service or had
the diagnosis being measured. References REFERENCES 1. Leadership by Example:
Coordinat-ing Government Roles in Improving Healthcare Quality, Institute of Medicine,
2003. AuthorAffiliation GARY R. ILMINEN is a registered nurse and nurse consultant for the
State of Wisconsin, Department of Health and Family Services, Division of Health Care
Financing, in the Bureau of Managed Health Care Programs. He earned associate degrees in
7. mechanical design and nursing at Gogebic Community College in Ironwood, MI. DETAILS
Subject: Health care; Quality; Measurement Location: United States US Classification: 8320:
Health care industry; 9190: United States; 5320: Quality control Publication title: Quality
Progress; Milwaukee Volume: 36 Issue: 12 PDF GENERATED BY SEARCH.PROQUEST.COM
Page 6 of 7 Pages: 62-66 Publication year: 2003 Publication date: Dec 2003 Section: Quality
in healthcare Publisher: American Society for Quality Place of publication: Milwaukee
Country of publication: United States, Milwaukee Publication subject: Engineering ISSN:
0033524X CODEN: QUPRB3 Source type: Scholarly Journals Language of publication:
English Document type: Feature Document feature: tables refer