The Dynamics Of Hospital Performance

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

Typical long-term goals for hospitals could be expansion, offering more services, and quality management and assurance. Short-term goals to reach the long term goals could be funding, more medical equipment, and surveys. A hospital would need funding for new equipment, expansions, or services, so a look over the financial situation of the hospital would be needed. Finding areas to add funding, cut funding, or do fundraising could then be approached. Furthermore, quality assurance and management, there are several short-term goals such as questionnaires, quality and risk management (Wasik, M. 2006).

In terms of avoidable hospital stays and service use, I found that better medical care within the hospitals results in better satisfactory by the patients and physicians, which means that patients must receive the best care and not be avoided. For example, the website helps me understand that if a primary care physician provides a diabetes patient with good quality care, then they may not need a hospital stay. This shows that not all hospital stays are avoidable, but they are preventable by providing the quality care they deserve. Another factor towards avoidable hospital stays may depend on where the patients live and where the hospitals are located. This would alter a number of people who would

The CMS reimbursement rules for never events cause serious revenue loss for the hospitals, hence a shift in the patient care delivery model in inpatient facilities is required. The goal of this rule is to motivate hospitals to accelerate improvement

My experience in both my previous career in nursing and human resources has dealt with approaches in quality improvement in patient safety and different metrics in the turning up organizational behavior as well as up swinging the operations of the organizations respectively. We live in a rapidly changing world, and healthcare industry is not exempted from it. Because I will be playing an indispensable role in the future, I am very interested on the concept of quality improvement and what not and identify possible future challenges and draw lessons from healthcare organizations that has spearhead innovative changes to providing healthcare by pursuing the triple dimensions of the improvement of healthcare in general that is Improving the patient experience of care (including quality and satisfaction); Enriching the health of populations; and Reducing the per capita cost of health care.

Patients want and expect to receive high quality care. Nurses want to provide the best care possible to their patients and like everybody else; want a pleasing job environment. Hospitals, on the other hand, are expected to provide a safe environment to patients, have enough nursing staff and remain profitable (Keller, Dulle, Kwiecinski, Altimier & Owens, 2013). The ultimate goal is to improve quality of care and patient safety across the United States; therefore, all the different interests of these major stakeholders should be taken into

They collectively understood each other’s strengths and weakness. Cohen, Klein, and McCarthy reported this to be a great challenge in forming and operation of the ACO, but without this mutual understanding they would not have been successful. Dignity Health, a large catholic hospital system incorporated in this ACO, had “greater risks for hospital facility costs”, and Hill Physicians “accepted greater risk for professional services”. In this way each entity saw financial gains and losses in different areas, but overall saw similar savings. They accomplished reducing their spending by “$20 million in the first year” (Cohen, Klein, & McCarthy, 2014). There was also a “20 percent reduction in hospitalization cost – reflecting a 15 percent reduction in 30-day readmissions, a 15 percent reduction in inpatient days, and a 12.8 percent decline in the average length of a hospital stay from 4.05 to 3.53 days” (Cohen, Klein, & McCarthy,

Helping patients stay out of hospitals is not only an important quality improvement objective but also a financial one especially after the advent of Affordable Care Act (ACA). Efforts to improve clinical outcomes and reduce readmissions have been ongoing for several years, but still high readmission rates continue to be an issue for most healthcare organizations. Although many hospital readmissions cannot and should not be avoided, a wide variation in readmission rates across the hospitals nationwide, has led the researchers and Center for Medicare and Medicaid Services (CMS) to believe that hospitals can implement various quality improvement strategies to reduce their readmission rates and improve patient care as a whole. In an effort to reduce readmission rates and achieve better quality outcomes, CMS has started Hospital Readmission Reduction Program (HRRP) under which the hospitals will be penalized by up to 3% of total Medicare reimbursements, for readmission cases within 30 days specifically for conditions like heart attack, heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), and elective hip or knee replacement. The percentage of hospitals receiving a penalty in 2014 was around 64%, which has increased to about 78% in FY 2015 making it a high priority quality improvement concern for healthcare organizations in order to retain their Medicare patients and balance their Medicare reimbursements.

Organizational change can be an intimidating process for everyone that is involved. Resistance may be met, which is why strong leadership is crucial for implementation of an organizational change to succeed. The purpose of this paper is to discuss the effectiveness of an organizational change once implementation has occurred. It will also discuss outcome measurement strategies related to the organizational change process to include the tools necessary for these measurements. During this paper analysis of costs, quality of care and patient satisfaction measurements will also

Some of the important reasons for selecting patient-centered, time, safe, quality of work, and patient satisfaction measurements of quality for the hospital mentioned above, are due to risk of adverse effects that are revealed in clinical settings, which leads to the limitations in standards of medical care for in-patent and emergency treatment (Stelfox & Straus, 2013). For example, the measurements of Safe is variable to the quality

Hospitals are experiencing a financial impact with being reimbursed for the medical services provided to the patients. This can contribute to the patient having hospital acquired or related illnesses because of poor and inadequate quality of care rendered by the staff. Medicare and Medicaid are raising the bar with reimbursing the hospital for the medical services. They are basing the reimbursing for medical services upon the quality of care, patient satisfaction with services, mortality and readmission to the hospital rate (Carpenter, Short, Williams, Yandell, & Bowers, 2015, p. 255). As the level of quality of care is rendered to the patient, the medical staff objective becomes fostering patient centered care. This will increase patient satisfaction

Length Of Stay (LOS) is a term to describe the duration of a single episode of hospitalization and is commonly used as a quality metric for utilization and payment mechanism. The prospective payment system in Medicare for reimbursing hospital care promotes shorter length of stay by only paying the same amount for procedures by Diagnostic Related Groups (DRG), regardless of days spent in the hospital. Lowering LOS based on evidence-based guidelines frees up capacity to increase admissions, increase revenue and improve

The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.

Outcome measurements are used to evaluate the health status of patients following the care he/she has received in a given hospital. The measurements look at both the intended and unintended effects such care might have had on the health status of patients and general function. They also help evaluate the level to which a hospital is achieving its goals as they relate to the care being provided to a patients. Outcome measurements usually include traditional measures such as mortality, morbidity, and issues that are related to quality of life. They incorporate patient satisfaction reports related to the healthcare services they have received. These measures are important to patients looking for a hospital as he/she may seek the opinion of persons who have previously received medical care in a given hospital (Jha &Epstein, 2010).

Though they are not entirely comprehensive tools, a great deal can be learned about a hospital or other healthcare organization for-profit or not-for-profit from an examination of their annual financial documents (Finkler & Ward, 2006). The balance sheet and statement of revenue and expense can both yield valuable clues even in the absence of other evidence about changes that might be occurring in the organization, a definition of the type and degree of certain problems that it might be facing, and potential opportunities for improvement in performance that might exist (Finkler & Ward, 2006). Comparing two or more years' worth of financial information yields even more valuable insights, tracking movement in the hospital or other organization's ability to finance its activities and thus continue providing services at the same level, quantity, and scope as current operation.