Quality Improvement Data

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

Readmission to a hospital creates strain and added expense for the patient and hospital; in 2011, hospital costs due to readmission were almost $41.3 billion (Hines, Barrett, Jiang, & Steiner, 2014; Rau, 2014). There are many aspects of healthcare associated with readmission, such as lack of discharge planning and education, which need to be addressed i to decrease the amount of preventable re-hospitalizations.

This model reimburses hospitals based on quality of care instead of the volume of patients. The quality of care is assessed by patient questionnaires and if hospitals are unsatisfactory penalties may be imposed (Edwoldt, 2012). The value-based system also affects Medicare and Medicaid. It was reported that Medicare readmissions within 30 days of discharge cost 17 billion dollars annually (Edwoldt, 2012). Due to the high costs of readmissions Medicare and Medicaid have implemented a Hospital Readmission Reduction program. A formula is utilized to evaluate readmission rates within 30 days of discharge for any medical reason related to their original admission such as heart failure and pneumonia. Upon review the hospital is potentially penalized. It is important that nurses strive to provide excellence in care despite their beliefs on the ACA. Nurses have the ability to provide a safe patient environment and reduce the risk of hospital associated infections by following hospital protocols such as hand washing.

Quality Improvement (QI) is an organizational approach leading to the quality of patient care and patient services through use of specific guidelines, principles, and methods to ensure quality of care for every patient and health care facility throughout the world. Quality outcomes focus on the principles of quality management. These measurements investigate the quality of care, patient outcomes and consumer needs, through being part of the participant group. This quality improvement discussion will review the foundational frameworks of QI and explanation of each framework in detail. Included in this QI report will be

The Affordable Care Act was enacted to improve health care and to lower health care cost in America. The ACA developed different strategies to meet these goals called the “pay for performance” programs. These strategies are aimed at the different providers to improve quality care. The strategy that I selected is the “Hospital Readmissions Reduction Program” this program/strategy is also known as the HRRP and was begun in October of 2012. HRRP is aimed at hospitals and penalizes hospitals that have a high 30 day readmission rate. The penalties are assessed and based on a number of comparisons, those such as, performance, patient demographics, comorbidities and frailty.

Health care managers need to improve quality services in health organizations. To improve these quality services they have to use methods that are proven helpful in the QI process. For example, Six Sigma is used to display and measure quality improvement data. It is also used to measure

In a world of budget cut and layoffs, medical corporations face new and different challenges in addition to helping and healing patients. I used to work as a medical biller in a physician’s office for five years and I experienced how difficult for the health care providers to get reimbursed. The government and the insurance companies have been limiting the budget towards the health care services. This action also affects the hospitals greatly because Centers for Medicare & Medicaid Services (CMS) and some policymakers have requested the hospitals to reduce the

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.

Quality improvement data is followed in all health care setting. The use of Cerner EHRs allows data to be obtained from patient charts to analyze core measures. According to the joint commission influenza and pneumococcal vaccinations measures should be addressed in all hospital in-patients (The Joint Commission, 2015). Data can be retrieved on those patient who were diagnosed with pneumonia to determine if they received the vaccinations for pneumonia and influenza. As well as tracking the time frame between diagnosis and treatment, and additionally the patient outcome. This is captured through the documentation of the clinical staff. The information can be analyzed to determine the quality improvement changes that need to be implemented to improve patient outcomes.

In addition, it also measures the quality of care and patient satisfaction. In 2015, the US Secretary of HHS has announced a goal of 85 percentages of Medicare Fee for Service payments tied to quality or value. In addition, many new payment models are associated with HRRP; for instance, forthcoming Skilled Nursing Facility VBP program and Dialysis Adequacy measure , potentially specifies preventable readmission measures. As the system is moving from quantity to quality, it is beneficial to implement quality of standards to optimize future benefits for the community and Central Health as well. Currently, Central Health has higher readmission rate than national average with an overall rating of 2 out of 5. Penalties incurred due to below standard of care could strain hospital resources to utilize for the betterment of our facility. Furthermore, the incentive structure has concerned Central Health to reevaluate the mode of practice and care provided engaging healthcare providers and patients. Central Health is committed to reducing readmission rates by identifying and sharing best practices for long term benefits. Given the flexibility of penalty under the 21st Cure Act, the initial program will focus on readmission prevention within 30 days of hospital

Falls are a major cause of injury and death in the frail older population with Alzheimer’s disease. Residents in the long-term care settings experience falls for many reasons and are likely to endure injuries more than those in other settings. Preventing falls in this setting posed significant challenge, many have cognitive problems, aged related changes, chronic medical conditions, medication effects, and physical limitations requiring dedicated interdisciplinary efforts (Vance, 2011).

Since 2008, Medicare has tracked readmissions for various conditions. According to a recent Center for Medicaid and Medicare Services review, at least 20% of hospitals in Illinois, Maryland, Massachusetts, New Jersey, New York and Rhode Island have higher rates of readmission than the national average (Rau, 2014).

In any continuous quality improvement effort, measurement is the key element (Sollecito, & Johnson, 2013). “Measurement and statistical analysis are used to assess the impact of an improvement effort” (Sollecito & Johnson, 2013). To Measure the impact of the program, the hospital utilized a departmental quality improvement assessment with a scoring matrix for self-assessment (McLaughlin, et. al., 2012). The scoring matrix consisted of five category ratings which each department head had to complete. Univer4sal Charting and Resource Utilization were also used for measurement (McLaughlin, et. al., 2012).

In an effort to curb these costs, in 2013 the Center for Medicare and Medicaid Services (CMS) enacted the Hospital Readmissions Reduction Program. Under this program, hospitals are penalized for readmissions occurring in the first 30 days. The penalties apply to specific conditions for CMS recipients including acute myocardial infarction, heart failure, coronary artery bypass graft

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