A Brief Note On The Cms Hospital Quality Initiative And Has Information About The Quality Of Care

This paper will propose how TriCity Medical Center will monitor performance, achieve regulatory and accreditation compliance, and improve overall organizational performance. It will describe ways TCMC will communicate with leadership to ensure alignment of organizational goals and gain buy-in from staff to achieve compliance with the standards and requirements issued by regulatory and accreditation bodies. Also it will determine how compliance with the regulations and development of risk- and quality-management systems for the organization contributes to the organization’s overall performance-management system.

Keywords: The Joint Commission, Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, The American Nurses Association, Hospital Inpatient Quality Reporting,

They strive for quality, accessibility, affordability, innovation, and responsiveness to all patients who receive CMS services. In 2018, the CMS used multiple analyses of measure performance trends, disparities, patient impact, and cost avoided tools. In addition to this, they used national surveys in hospital and nursing homes to evaluate the impact of the use of quality measures. The performance regarding CMS quality of patient safety, person and family engagement, care coordination, effective treatment, healthy living, and affordable care all showed tremendous improvement. According to the Centers for Medicare & Medicaid Services research showed a major decrease in the following medical areas: controlled blood pressure, diabetes control, fewer deaths following hospitalization for heart attacks, fewer unplanned readmissions, and fewer pressure ulcers among nursing home residents. Also, they reported that 9 million more patients reported a highly favorable experience with their hospital

Quality can be difficult to measure, which is what has halted the strong pursuit of quality in the past. Healthcare organizations use quality assessment to measure quality against some established standard. This includes “defining how quality is to be determined, identification of specified variables... and the collection of appropriate data to make the measurement possible (Shi, 2015, pg. 493). The Affordable Care Act set new standards and incentives for achieving quality of care. This includes offering Medicare reimbursements for hospitals with low readmission rates, and ensuring that (not-for-profit) hospitals complete a community health needs assessment (to ensure that the needs of the community are being met) and by implementing HCAHPS scores, which measures efficiency and efficacy of care using patient surveys. HCAHPS and hospital readmission good example of how quality of care can be measured in efficiency as well as

The United States health care system has can be assessed for quality measures in many different ways such as mortality rate or infant mortality, but the United States government often judges the efficiency of health care provider or network on the Centers for Medicare & Medicaid (CMS) core measures. The reason the United States gauge health care performance on CMS standards is due to CMS is the federal governing body that operates Medicare and how the hospital will be reimbursed from Medicare patients. Formerly Medicare would reimburse a hospital based all services the hospital provided a patient or fee for service (FFS). The rising

In an ever increasingly competitive healthcare environment, there is a need to determine that 1) the desired outcome is produced, 2) quality care is provided and 3) the cost of care is the lowest possible. Yet the basis for the determination of such is having the right kind of measures available. Dr. Trudy Mallinson is one such specialist in the program who has the year of experience

The idea that the healthcare reimbursements should be linked to the quality outcomes and performance measures is central to the Patient Protection and Affordable Care Act. The legislation provides various reforms that either provide incentives to healthcare providers for better quality services and outcomes or reduce their payments if certain quality standards are unmet. This paper talks about the different reforms under PPACA, aimed at introducing payment variations based on quality of care such as, Hospital Value Based Purchasing (VBP) program, improvements to different quality reporting programs, payment adjustments for hospital acquired conditions (HAC), reduction of hospital readmission rates (HRRP), testing for

Quality Improvement can be defined as the combined effort of health care professionals including, doctors, nurses, healthcare managers who ensure better patients outcome such as quality care, safety, better system performance and better professional development. Healthcare system always goes through changes, whether its implementation of new systems or diagnosis of new disease. Therefore, health organizations are always in need of some improvement and advancement. In order to achieve improvement, systems have to go through a series of change; however, not all changes can be called an improvement. To ensure the improvement in these systems, some powerful strategies are planned, designed and implemented. These formal strategies analyze the systemic efforts and measure performance in order to improve the entire system and is called quality improvement or QI program.

Providers do not have any control over their patient population and hospitals attract specific patient groups based on the services they offer. Interpreting outcome data and rates, especially for different groups of patients may not be the best data to determine quality of care as these rates can also be tied to specific patient characteristics rather than care delivery. Also, comparison among these various groups will be considered to be unfair unless they are adjusted for risk. Including a case mix index is one way to account for the clinical complexity of procedures performed. Even though there are techniques to account for this variability, many of it can go unexplained and has the possibility of inaccurately ranking providers based on patient outcomes.

Consumer Reports conducted the study, in the article, in an attempt to identify what hospitals offer the best quality of service, including how safe hospitals are ranked after surgical procedures. Overall surgery ratings for 27 types of surgeries are identified in the article, based on a percentage of Medicare patients that die in hospitals or have their stay in the hospital extended beyond the original length expected. The medical based rating were developed statistically working with a health care consulting firm that specialized in analyzing medical claims and clinical records. The patient satisfaction information is based upon a survey of millions of patients regarding recent hospital stays. The patient satisfaction survey was completed with the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS. This survey rated overall patient experience based on the average responses to two survey questions. The percentage of patients who said they would "definitely" recommend the hospital; and the percentage of patients who responded that the hospital received an overall rating of 9 or 10 on a scale of 0 to 10. (Consumer Reports, 2013)

RHC has an average of 5 minutes before patients gets an EKG. The national average is 7 minutes. Another publically reported indicator for AMI is the administration of Aspirin within 24 hours of patients complaining of chest pain and possible heart attack. ILH and RHC have an impressive rate of 100% compared to NHC 98%. The national average is 96%. Unfortunately no other indicators for AMI are publically reported at this time.

These measurements provide feedback of a patient’s experience with the care offered at a given hospital. These measurements assess a wide range of factors including interpersonal aspects of care, clarity of - and ease of access to - information provided by the physician, speed of medical staff’s response to the patient’s urgent care needs, among other factors. These measurements are used by patients in their subjective evaluation during their process of choosing a hospital for emergency care or

The Prevention Quality Indicators (PQIs) are established set of measures that are used with hospital inpatient release data to identify and analyze quality of care for ambulatory or walk-in patient care with profound

Explained by Medicare.gov (n.d.), quality care was failed to be provided for the nursing home residents. This was based upon the resident and staff interviews. Residents were not served their meals at their tables on time, and received timely feeding assistance. Recent survey inspection results has shown complaints at the (Medicare.gov, n.d.) website, for the reporting period dates of 2/1/2014 -1/31/2015 at Chandler Post Acute and Rehabilitation. The deficiency category’s are rated with numbers, which 0 being no harm, 1 being minimal harm, 2 means minimal harm or potential for actual harm, 3 means actual harm and 4 means many risk of harm. The nursing home had mistreatment

-Examine at least three (3) examples of quality initiatives that could increase patient satisfaction and potentially reduce healthcare cost. Support your response with examples of the successful application your chosen quality initiatives.