HUM 2000 MOD 6 ASSN

M6A1 Database Assignment: Inpatient Readmissions

All data in this assignment is fictitious. Remember, patients may have the same name, but they do not have the same medical record number. For a quick study of the ACA section establishing the Hospital Readmissions Reduction Program for this assignment, read http://healthaffairs.org/blog/2014/07/24/examining-medicares-hospital-readmissions-reduction-program/

* Please note that for the purposes of this assignment, HF (heart failure) will be correlated to CHF (congestive heart failure, and PN (pneumonia) will be correlated to pneu or pneumonia.

Case Study

Willie Getwell Hospital has identified the CMS IPPS proposed legislation and in preparation for this legislation, they are tracking their 30-day readmission data. They have recently set in place an organization-wide education and discharge medication verification program for their patients. Please help the health information management director gather appropriate information to be shared with hospital leadership. She hopes the December numbers will continue to show an improvement.

You are provided an excel spreadsheet of information downloaded via a query from the hospital’s database. This is your sample data of November and December records. Apply the knowledge you gained from previous courses to help you complete this assignment. For example, this assignment demonstrates how if the hospital were to change electronic health records, why information, such as data dictionaries, from one EHR would need to be identical to the other, or an interface would have to be developed.

Objective #1

In the 1st and 2nd excel worksheet tabs, sort the November and December discharge data pertaining to AMI, CHF, and pneumonia to determine any readmissions within 30 days for the hospital for December discharges for these specific diagnoses identified by ICD-9 coding: AMI 410.0-410.9, CHF 428, pneumonia 486 on primary diagnosis. Recommend copying the November and then the December discharge data side by side in a blank worksheet tab FOR EACH ICD-9 code. Sort both November and December by the column for the ICD code. Compare November against December to find the duplicate readmissions FOR EACH ICD-9 code.

Transfer your calculations (the number of duplicate readmissions) determined for December 30-day readmissions onto the 3rd tab, 2010 IPPS 30-day Readmit Rates for each ICD-9 code in the yellow highlighted column. In the 3rd tab, derive the percentage of readmits by month and diagnosis in the format provided. Have Excel compute the percentage for you. In cell B12 enter the formula to divide Readmits for AMI by Total Discharges. Pull the formula to the right through to act on the remaining months. Do the same for CHF and Pneu.

Objective #2

Apply the 2010 data to reporting graphics (using a excel-generated chart) to demonstrate trending. Apply titles and labels. What chart describes the trend most clearly? Presentation should clarify the trend clearly to the hospital leadership. Highlight all of these rows and columns in the 3rd tab, including the header rows. Choose the Insert tab from the Ribbon at the top of Excel. Choose Charts. Try several charts. Which chart displays the trend most effectively?

Objective #3

Were Willie Getwell Hospital’s efforts to improve their 30-day readmission rates preliminarily effective according to the information gathered from this assignment? Summarize your analysis textually in a textbox. Insert a text box. Compose a paragraph summarizing your analysis. Describe the trend for each of the ICD-9 codes. Have Getwell Hospital’s efforts been effective? Describe research that you have found that addresses this subject.

Objective #4

Present your analysis in a hospital board-worthy presentation. Create a 4th tab within the spreadsheet. Name the fourth worksheet tab Summary 2010 30-day Readm Trend. Note that presentation is a factor in the rubric criteria. Use color to tie coordinating elements together. Label your chart. Include a list of your references.

In a fourth worksheet tab, present your summary information:

1. The numbers determined for 30 day readmissions

2. Trending chart

3. Textual summary

Submit the entire spreadsheet as a document in Assignment Files. Save assignment with the name: lastname, firstname, DB2 Readmissions.

Anecdotal information regarding this assignment: The ICD-9 coding used in this assignment is to demonstrate that a health information professional may have to look at and understand historical data displayed from ICD-9 coding. The coding required to be identified from this assignment is not meant to be encompassing of all coding required to be tracked for the 30-day readmission criteria for these diagnoses for determination of IPPS.

Grading Rubric: 150 points

Rubric Element	Points (up to)
Accuracy	Accurately completed objective #1, sorting & calculating the duplicate readmissions and percentage of re-admits.	20
	Accurately trends the data from Objective #2 with the use of graphical displays	20
Completeness	All instructions for Objectives 1-4 are completed	20
Presentation	Submission contains graphical displays of the date of the readmission data represented by use of labels and color coordination.	20
Comprehension	Accurate summarization of the Hospital’s efforts to improve their 30-day readmission rates	15
Grammar	Submission free of spelling, typographical, or formatting errors	5
Total	100