Quality Improvement Case Study

In 2012, the ACA found an excessive amount of readmissions of patients that were hospitalized within 30 days for the same medical conditions. This factor viewed under the ACA as a quality issue and CMS implemented value-based incentive payments based on performance in a set of quality measures. The plan is to implement a pay for performance (P4P) in formulas used by Medicare to reimbursement providers. “The objective is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system-wide costs” (Shi and Singh, 2015). In addition to the P4P, nonprofit hospitals also focus on continual improvement, data and cost containment throughout the organization (Adamopoulos,

Now a statute, the physician/hospital pay for quality, not quantity, public law number: 114-10 signed April 16, 2015 also referenced as H.R.2 —1st Session of 114th Congress (2015-2016), sometimes called the “Permanent Doc Fix” 04/14/2015 : Passed Senate; 03/26/2015 : Passed House (Medicare Access and CHIP Reauthorization Act of 2015, 2015), which defines the payment and reimbursement reform to doctors treating patients with Medicare. This extensive reform includes the CHIP program insuring children and those families that don’t qualify for Medicare but are unable to afford private insurance and is funded by the federal government and individual states.

Quality and financial viability being closely tied is an extremely salient point. Furthermore, the Affordable Care Act has influenced the requirement for high-quality, cost-effective care provision by implementing Value Based Purchasing (Aroh, Colella, Douglas, & Eddings, 2015). In addition, there are presently Centers for Medicare and Medicaid (CMS) quality indicators that effect reimbursement for hospitals (Xu, Burgess Jr, Cabral, Soria-Saucedo, & Kazis, 2015). For example, if a facility does not meet the indicator threshold for catheter associated urinary tract infections, central line infections and/or pressure ulcers their reimbursement is affected. Given that the quality of care provided by a hospital is

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

What do you consider to be the key issues for quality improvements in the NHS quality-improvement program as it goes forward?

Berry, L. L. (2000). Cultivating service brand equity. Journal of the Academy of Marketing Science, 28(1), 128-137. Retrieved from http://link.springer.com/article/10.1177/0092070300281012

The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.

The Affordable Care Act (ACA) has paved the way to move from fee for service to fee for quality. In order to accomplish this, federal reimbursement programs have been initiated to help hospitals improve outcomes. For example, Centers for Medicaid and Medicare Services (CMS) set up the Value Based Purchasing program. This program is broken down into four domains: Clinical care, patient experience, safety and efficiency (CMS, 2016). Each domain carries reimbursement tied them to ensure hospitals are doing their best to provide quality care.

Our aim is to do the right thing , in the right way ,the first time , every time and this is the way of our success .

After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when

In the United States alone there are 98,000 deaths per year caused by low quality health care (Ignatavicius & Workman, 2013, pg. 2). This statistic is disturbing because the errors that resulted in death were errors that were preventable. The intent of this chapter is to bring awareness to health care providers that are able to make a change in the quality of health care. In current practice patients are subjected to medication errors, preventable hospitalizations, premature death, and poor care provided due to racial, ethical, or low-income factors.

reimbursements are now tied to performance on quality metrics, as well as patient experience. All part

As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work

Quality Assurance and Performance Improvement (QAPI) communicates the following five elements: design and scope, governance and leadership, feedback, data systems and monitoring, performance improvement projects, and systematic analysis and systemic action. The purpose of this paper is to communicate issues surrounding these topics, as well as aging problems. Are the topics evidence based? Do they have supporting documentation to put them into practice at various facilities? Can executing the aforementioned items make a difference at institutions? Now, start the journey to see how each section can be applied to your workplace.

iConsultant is committed to implementing appropriate quality management systems and processes to enable the delivery of the highest practicable quality products and services. Dyson Limited engaged iConsultant to strategize a total quality transformation for the company to overcome its current quality challenges and hone its competitiveness in the world market.