I need this by Thursday
MybusinessRN
Quality_Improvement_Proposal__Susie.docx.pdf
1
Quality Improvement Proposal
Susie Mayo
Capella University
MSN FP6612-Healthcare Models used in Care Coordination
Dr. Kimberly Sniffen
February 2021
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
2
Quality Improvement Proposal
Since hiring as the new case manager with Sacred Heart Hospital(SHH), I have been
asked by Karen Dellington, Admissions and Discharge Director, to assist SHH in becoming an
Accountable Care Organizations (ACOs)(Capella University, n.d.). Vila Health recently took
over SHH, and Vila Health wants all its hospitals to be ACOs. The American Hospital
Association (AHA) defines ACOs as healthcare providers and hospitals who voluntarily provide
coordinated care to patients with select Medicare plans(American Hospital Association, n.d.).
The goal of participating in an ACO coordinated care is to avoid duplication of services, prevent
medical errors, and improve the quality and cost of care. At the same time, those participating in
the ACOs also receive a share of the savings they generated for Medicare as long as the quality
of care was maintained(American Hospital Association, n.d.). As a small rural hospital, we need
to improve our Health Information Technology (HIT) system to better track quality metrics data,
and to do this, our electronic health record system (EHR) needs to be also updated because we
are not gathering nearly enough data from patients)(Capella University, n.d.). ACOs are
primarily geared toward the 65 years and older population, and this is the population SHH
serves; and with the help of Vila Health, we can do better.
Today's meeting will investigate strategies for expanding the HIT to better track quality
metrics, and we will recommend strategies for improving the tracking of quality metrics so SHH
can qualify to become an ACO.
Ways to expand HIT to Include Quality Metrics
Revitalizing healthcare is essential to achieve high quality, accessible, efficient, and
affordable healthcare for all. Utilizing HIT offers a wide range of sharing public and private data
collection, including health surveys, billing records, medical health history, and records available
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
3
to healthcare professionals, hospitals, and insurance companies such as Medicare and Medicaid
(HealthIT.gov, n.d.). The Agency for Healthcare Research and Quality(AHRQ) reports that
effective and meaningful use of HIT and EHRs helps facilitate quality improvement (QI) that can
help practices improve their ability to deliver high-quality care, decrease the cost of care,
increase efficiency, reduce medical errors and improve patient satisfaction and patient outcomes
while raising reimbursement for healthcare providers(Higgins et al., 2015). First, SHH needs to
determine how to implement these changes to track quality metrics on patients who do not get
mammograms or colonoscopies. Being a small, rural hospital, SHH has expressed funding
concerns for implementing an upgraded HER system. The Office of the National Coordinator for
Health Information Technology (ONC) collaborates with the United States Departments of
Agriculture(USDA), Veterans Affairs(VA), Rural Development (RD), and The United States
Department of Health and Human Services(HHS) to support rural health, economic development
and help rural health care providers and hospitals in obtaining the necessary technology to
improve their health systems and patients quality of care (HealthIT.gov, n.d.). These agencies
assist in linking rural health clinics and hospitals to USDA grants and loans to help fund health
information technology(HIT) infrastructure, including hardware and software(HealthIT.gov,
n.d.). With the assistance of Pete Wade, SSH Director of Information Technology(IT), we will
reach out to these agencies for assistance with funding(Capella University, n.d.). In the
meantime, we can access our current EHR data to see what can be pulled from the data
warehouse concerning patient populations and mammogram and colonoscopy testing. Depending
on what EHR data we collect, we can reach out to local and community health departments to
assist with data collecting concerning our high-risk populations(Keller et al., 2018). SHH can
also start reaching out to those patients via a mailed survey to understand better healthcare
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
4
attitudes and behaviors regarding lack of testing and follow-up(Keller et al., 2018). Once we
receive funding and establish better HIT, data metrics, and improved EHRs for staff charting and
patient record tracking, SHH will utilize computerized clinical reminders and alerts as reminders
for patient populations due for testing, medication refills, and procedures. Keller et al. (2018)
further report that evidence-based care management and follow-up care utilizing health
information technology such as electronic messaging to providers and patients regular reminders
of medications refills and appointments have shown a tremendous decrease in cost for patients
and the healthcare organizations(pp.85-86). Garcia-Dia (2018) reports, 'informatics has changed
the nursing practice through documentation and is an integral part of care coordination in nursing
by tracking staffing, workflow, and communication to help nurses identify areas where current
processes can be improved' (pp.485-487). Nursing informatics assists in data analysis to improve
patient care efficiency, assist in practical technical skills for developing or improving computer
systems, and effective communication skills between care coordination providers(Garcia-Dia,
2018).
Information Gathering in Healthcare
When data gathering information from patients is linked up and pooled, researchers and
doctors can look for patterns in the data to help them develop new ways of predicting or
diagnosing illness and identify ways to improve clinical care(Higgins et al., 2015). Electronic
healthcare information exchange(HIE) provides doctors, nurses, pharmacists, other health care
providers, and patients the ability to access and securely share a patient's medical information
electronically by improving the speed, quality, security, coordination, and cost of patient
care(Higgins et al.,2018). However, when it is not used correctly, it leaves room for error, and
one of the complaints and concerns with SHH is using the current EHR system incorrectly and
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
5
not thoroughly filling it out. Due to understaffing, patient documentation is incomplete, leaving
room for errors and inefficient patient records. Once the new HIE system is implemented, proper
employee education needs to occur to train staff to use the system correctly and become the norm
for people to use the system correctly. Since SHH is a rural hospital, the National Rural Health
Resource Center offers an HIE assessment framework that allows organizations to create
operationally sustainable plans to exchange clinical data seamlessly and lower overall costs.
Other benefits of HIE include enhanced patient safety and clinical outcomes eliminating repeat
testing and procedures by allowing exchanges of data to determine the level of care needed for
patients. Information gathering contributes to developing organizational practices by enhancing
care transitions, reducing potentially preventable readmissions, reducing administrative costs,
and increasing revenue from enhanced billings and collection(National Rural Health Resource
Center, n.d.). With data gathering and sharing, healthcare information systems need to be secured
and ensure employers are correctly trained when accessing sensitive patient information and not
leaving computers open in vulnerable areas. Using integrated health information would also
allow hospital staff and primary care physicians(PCP) access to care provided during visits. This
access can provide the case management team access to the PCP office records to assist in
discharge planning and collaboration with the PCP staff for better patient care.
Potential Problems with Data Gathering
There are many challenges and potential problems that can arise with data gathering.
Data and patient information are still entered into the healthcare system manually by humans.
This manual process leaves much room for error, such as typos, wrong forms being completed,
patient's contact information entered incorrectly, overworked and understaffed employees in a
hurry, or internal resistance from employees who do not adapt well to change. Today's society is
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
6
inundated with computers, data gathering, and hackers. Utilizing EHRs is the only way forward
in improving healthcare, and unfortunately, EHRs have become a lucrative business for
hackers(Dash et al., 2019). According to the 2017 Thales Data Threat Report, 68 percent of
enterprises worldwide, healthcare included, experienced a data breach and estimates that data
breaches cost the healthcare industry $6.2 billion per year(Dash et al., 2019). Other problems or
barriers to data gathering include a lack of budget, too much data, lack of skilled employees, and
regulatory issues seen as equal current challenges(Keller et al., 2018).
Conclusion
After meeting with department leaders, we need to take steps and move forward with
improving our Health Information Technology(HIT) to include quality metrics to better care for
the rural population SHH serves. We have examined federal resources that specialize in assisting
rural healthcare entities with funding to establish the HIT infrastructure, including hardware and
software. Expanding our EHRs will assist SHH in meeting guidelines set by the Centers for
Medicare and Medicaid Services in becoming an ACO.
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
7
References
Accountable care organizations | aha. (n.d.). American Hospital Association.
https://www.aha.org/accountable-care-organizations-acos
American Hospital Association. (n.d.). Accountable care organizations | AHA.
https://www.aha.org/accountable-care-organizations-acos
Capella University. (n.d.). Quality Metrics Tracking. Vila Health.
https://media.capella.edu/coursemedia/msn6612element18001/transcript.asp
Dash, S., Shakyawar, S.K., Sharma, M., Kaushik, S. (2019). Big data in healthcare: management,
analysis and future prospects. Journal of Big Data 6, 54.
https://journalofbigdata.springeropen.com/articles/10.1186/s40537-019-0217-0#citeas
Garcia-Dia, M. J. (Ed.). (2018). Project management in nursing informatics. ProQuest Ebook
Central https://ebookcentral-proquest-com.library.capella.edu
HealthIT.gov. (n.d.). Resources for critical access hospitals and small rural hospitals |
HealthIT.gov. ONC | Office of the National Coordinator for Health Information
Technology. https://www.healthit.gov/topic/health-it-health-care-settings/resources-
critical-access-hospitals-and-small-rural-hospitals
Higgins, T., Crosson, J., Peikes, D., McNellis, R., Genevro, J., & Meyers, D. (2015, March).
Using Health Information Technology to Support Quality Improvement in Primary Care.
The Agency for Healthcare Research and Quality. https://pcmh.ahrq.gov/page/using-
health-information-technology-support-quality-improvemtn-primary-care
Keller, S., Nusser, S., Shipp, S., & Woteki, C. E. (2018). Helping Communities Use Data to
Make Better Decisions. Issues in Science & Technology, 34(3), 83–89.
http://web.a.ebscohost.com.library.capella.edu/ehost/detail/detail?vid=0&sid=a410f84b-
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
8
9039-403d-aca9-70323887c72b
%40sessionmgr4008&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ehh
&AN=129399645
National Rural Health Resource Center. (n.d.). HIE first considerations. National Rural Health
Resource Center | National Rural Health Resource Center.
https://www.ruralcenter.org/resource-library/hie-first-considerations
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/
9
This study source was downloaded by 100000772470296 from CourseHero.com on 05-09-2022 10:01:29 GMT -05:00
https://www.coursehero.com/file/81218256/Quality-Improvement-Proposal-Susiedocx/ Powered by TCPDF (www.tcpdf.org)
