Improving Discharge Documentation: Poster Analysis

Outcome based processes geared towards improving outcomes by implementing performance improvement checks on all complaints or negative feedback acquired from patients, healthcare providers, employees, vendors (all stakeholders) and environment of care rounds. These would include QC measures, infectious control measures, ACC measures, HCAP measures to name a few. Align with nationally recognized locators for healthcare facilities to compare our organization with local and nationally recognized healthcare organizations to see where we rank. Strategic goals established by The Joint Commission and initiatives by CMS will help improve overall performance.

Four performance measuring components under MIPS will collectively make up the overall MIPS Composite Performance Score (CPS) to evaluate the performance in terms of quality and value of care by the eligible clinicians to earn adjusted Medicare payments. Each component of the MIPS carry weight to the overall composite performance score. Measuring criteria followed by MIPS underlies on evidence based clinical quality measures and specialty-specific standards which are reviewed as well supported by clinical leaders and endorsed under consensus process driving towards positive

Benchmarking for clinical performance measurement involves collecting and reporting data on practices’ clinical processes and outcomes. Measuring clinical performance can create buy-in for improvement work in the practice and enables the practice to track their improvements over time. This information should also be used to identify and prioritize improvement goals and to track progress toward those goals. In addition, these data should be used to monitor maintenance of changes already made ("Module 7. measuring," 2013). Benchmarking can also be utilized to do a comparison between other health care organizations, provide areas where training could improve staff functions.

Claxton, Cox, Gonzales, Kamal, and Levitt (2015) explains measuring the effectiveness and quality of care provided for the patients were unclear. Therefore, quality measures were developed by organizations, such as healthcare providers, the federal government, and accredited organizations. Thereby, focusing on measuring specific areas of care and performance

Healthcare organizations have a responsibility to its consumers and various stakeholders to ensure only the highest quality care is delivered. Quality measures such as performance measurement and quality improvement processes play a critical role in helping organizations achieve quality outcomes. This paper will contrast performance measurement and quality improvement processes. In addition, this paper will discuss a healthcare organization, Gulf Coast Medical Center, its mission and QI goals, and the role of the consumer and stakeholders in the QI process.

Supervisor Comments: Met with Michael for a weekly counseling session. This writer address with Michael about the expectations for supervision as the counselor did not arrive prepared for supervision. It is important for Michael to come prepare with updates with any high risk patient(s), address service due, and update on your direct services. This writer already printed Michael services due and address the following:

The most important measure to consumers is the process of care measures. Process measures are the evidence-based best practices that represent a health system’s efforts to systematize its improvement efforts. Basically, by implementing and tracking the right process metrics we can determine what treatments work and what needs to be improved. It is true that all patients expect to walk out of a hospital with good health outcomes and experiences. However, it is the process that leads up to the proof that the treatments being delivered work, which in turn gives those patients satisfaction in their healthcare. I would not say that one of the measures is necessarily least important than the others because they all hold value in the delivery of

Focusing on improving quality service and managing care at Fort Madison Community Hospital is something they are striving to do daily. Managers also have to take in account of looking at information technology and its applications. Using these they find benchmarking and milestones. By discovering the benchmarking it will allow Fort Madison Community Hospital to better manage quality improvement so that it will be for effective daily.

It is imperative that RMMC expands its patient mix in order to increase operating income. An important factor in achieving this result is improving the quality of care and customer satisfaction. RMMC needs to be able to measure the current outcomes and initiate changes for improvement. Implementation

I have truly enjoyed this course and the insight and perspective it has afforded me with regard to metrics and outcome measures. I have used data and outcome measures regularly throughout my career and particularity since I have been in leadership positions, but it was this course that helped me to understand the power behind the information. Through this course I have learned how outcome measures can be used to tell a story regarding performance, measure progress when changes are made and to elicit buy-in from interdisciplinary team members and administration when working to achieve a common goal. Outcome measures allow administrators and healthcare providers to discuss issues on common ground and in terms that both sides can understand. In my experience, physicians tend to be very data driven. By showing physicians the quantitative data that can be measured and evaluated enables the dialogue to occur that can help to align the organizational mission, vision and goals. This course also helped me to recognize the importance for qualitative data and metrics. I tend to be very focused on numbers and hence am drawn to quantitative data. I now see that assessing the qualitative data via techniques such as surveys and opinion polls can help to assess

Acute care nurses encounter and face a significant barrier in exchanging discharge teaching and information to patients. Nurses report that a lack of time is one of the barriers to delivering an effective discharge plan. Nosbusch et al. (2011) claim although discharge teaching should start from the beginning of admission, many staff nurses are struggling to develop an effective discharge teaching because of the “reduced length to hospital stay” (p.769) gives nurses an insufficient time to plan an individualized discharge plan. According Nosbusch et al. (2011) although documenting patient discharge planning must be done on every shift, the study mentioned that many nurses do not consistently document the discharge teaching in medical record because of their busy schedule trying to accomplish their daily routine tasks (p. 768). This study also reports that there is a lack interdisciplinary exchange of information and openness between nurses

Clinical practices are increasingly focused on QI strategies to improve population-based health outcomes and health-care systems” (Hoyle & Johnson, 2015, p. 15). Performance metrics that focus on patient outcomes, safety, and cost are identified and routinely monitored. Continuous quality improvement is embedded into the clinic and each provider team uses the PDSA framework. Refer to Appendix A. Work plan goals are developed , reviewed with staff, evaluated on a systematic basis, and are recorded in the performance narratives. Work teams are developed to address goals not met and changes are made as

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

For every patient admission to the hospital, comes a discharge for that patient. Discharges start at admission and can be simple or more complex. The simplicity or complexity of a patient’s discharge varies on things like the patient’s diagnosis, patient’s insurance, living arrangements and so on. Recently I have cared for a patient with pancreatitis who had a more complex discharge situation.

Healthcare industry is constantly changing we are seeing more technology and customer focus innovation to meet the needs and well being of the patient. The introduction of the New Healthcare Reform is challenging leaders to reduce cost, decrease waste, deliver personalized experience, improve quality, and safety. According to Mc Natt (2015), “improvement in the quality of hospital care is a fundamental aspect of health system strengthening that is directly linked to the service delivery dimension of the World Health Organization (WHO) building blocks of a health system” (p.719). Improvement in processes both internal and external will need to be continuous on a daily basis. Performance improvement projects are used to